Case Report: severe paediatric COVID-19 pneumonitis treated with remdesivir and nitazoxanide

Paediatric severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rarely results in a critical respiratory presentation. It is not yet known which children are at particular risk of adverse outcomes. We describe a paediatric case of critical SARS-CoV-2 infection requiring Extra Corporeal Membrane Oxygenation (ECMO), who made a full recovery after receiving a dual antiviral therapy of remdesivir and nitazoxanide.

Extra-corporeal membrane oxygenation and emergency C-section for a pregnant COVID-19 positive patient

Introduction: Data on extra-corporeal membrane oxygenation (ECMO) therapy for pregnant patients with Coronavirus 2019 (COVID-19) infection are limited. Here we report a case of an emergency cesarean section performed while the COVID-19 positive mother was on ECMO support. Case report: A 36-year-old COVID-19 positive patient at 26 weeks gestational age presented with respiratory failure requiring extra-corporeal membrane oxygenation therapy. Nine days later fetal distress demanded an emergency C-section. After 5 weeks on ECMO, the patient was weaned off. Both mother and child were discharged. Discussion: The decision to perform an urgent C-section is one that requires meticulous thought from the attending team. Pulmonary maturation is key as pregnancy may need to be terminated at any time during ECMO. Conclusion: Data on ECMO support for pregnant patients with COVID-19 infection are scarce. Best results can be achieved ensuring adequate anticoagulation, meticulous choice of cannulas, continued fetal monitoring, early lung maturation, and precision timing of delivery.