Bowel Gangrene in Neonate Born to COVID Mother – Is it a Manifestation of Multisystem Inflammatory Syndrome in Newborn?

Aims: Pregnant mothers with SARS-CoV2 infection are postulated to transfer anti-COVID-19 antibodies to their fetus, which may lead to cytokine storm and fetal inflammatory syndrome, similar to multisystem inflammatory syndrome in children (MIS-C). Manifestations of this newly emerging entity are not elucidated, but MIS in Newborn (MIS-NB) must be suspected whenever a neonate born to COVID positive mother is presenting with unusual symptoms.

Clinical Description: We report a preterm, low birth weight, Monochorionic Diamniotic (MCDA) twin neonate born to COVID positive mother who developed abdominal distension in first few hours of life, initially suspected to have small bowel atresia. Baby had elevated inflammatory panel and given IVIG, suspecting MIS-NB. Intraoperatively the baby was noted to have gangrenous bowel, which required extensive surgical resection, but baby succumbed postoperatively.

Conclusion: This report highlights possible intestinal manifestations of possible COVID-19 related fetal inflammatory syndrome.