Maternal COVID-19 Infection: A Cause of Neonatal Stroke?
Rufus Raj Kumar Singamala, Suneel Kumar Kommineni, Preethi Subramanian, Sudharshan Raj Chitgupikar
Abstract
Perinatal arterial ischemic stroke (PAIS) is a rare cause of neonatal seizures, with an incidence of 1 in 2500 to 4000 live births, globally. This is a case of a neonate with PAIS due to transplacental passage of COVID-19 IgG antibodies from the mother. A term, male neonate, born to a primigravida with an uneventful antenatal history was presented on the second day of life with multiple episodes of focal clonic seizures involving the right upper and lower limbs.
Magnetic resonance imaging revealed an acute infarct in the left frontal lobe, extending into the parietal region, anterior limb, and genu of internal capsule suggestive of arterial ischemic stroke. The known causes of PAIS were evaluated and ruled out. The result of reverse transcription polymerase chain reaction analysis for SARS-CoV-2 antigen was negative for both the mother and the neonate. COVID-19 IgG antibodies in the mother and neonate were elevated. Seizures were controlled with antiepileptics. The neonate had no further seizure episodes and was discharged on oral levetiracetam. The infant was developmentally and neurologically normal at 3 months of age. PAIS is a rare cause of neonatal seizures, and maternal COVID‑19 infection may be associated with neonatal stroke.
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