Pulmonary air leak syndrome in a premature infant born to mother with COVID-19

Introduction The clinical course of premature infants born to mothers with coronavirus disease 2019 (COVID-19) has not been well characterized. The aim of this paper was to report a complicated clinical course of pulmonary air leak syndrome (pneumomediastinum and pneumothorax) in a premature infant born to a mother with COVID-19. Case outline The patient was a male infant born at 35 weeks of gestation. The mother had confirmed coronavirus pneumonia six days prior to delivery. At approximately 25 hours of age, chest X-ray showed pneumomediastinum, giving the classic "spinnaker-sail" sign. After intubation, chest X-ray showed the typical "angel-wing" sign, which indicates pneumomediastinum and bilateral pneumothorax (pulmonary air leak syndrome). Conclusion Based on the presented case, we believe that the mother's COVID-19 infection is an additional risk factor for the occurrence of pulmonary air leaks in the infant. To confirm this hypothesis as well as explain the exact pathophysiology of air leakage in COVID-19, larger, prospective, and well designed studies are needed.