Coronavirus disease-2019 (COVID-19) infection in a 3-month-old infant: Clinical features, treatment and probable route of transmission

This study aims to explore the clinical and epidemiological characteristics of infant patients with coronavirus disease-2019 (COVID-19) infection. Clinical and epidemiological data of a 3-month-old patient with COVID-19 were collected, including general status, clinical results, laboratory tests, imaging characteristics, and epidemiological reports. The infant had no fever but had mild respiratory symptoms. The major laboratory results included normal white blood cell counts and lymphocytopenia, notably with elevated interleukin (IL-)-17A, IL-17F, and tumor necrosis factor (TNF-)-alpha. The main manifestation of his chest computed tomography scan was pulmonary patchy shadows. All throat swabs and urine of the infant detected via Real-time Quantitative Polymerase Chain Reaction (RT-PCR) were negative, but his anal swab continued to test positive up to 40 days after onset of illness. Our study indicated that infants infected with COVID-19 may have relatively mild symptoms or clinical signs, IL-17A, IL-17 F, and TNF-alpha could be involved in the immune response of COVID-19. In addition, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) may shed through the gastrointestinal tract and convalescent carriers may exist among infant patients. We cannot rule out the possibility that infants may acquire infection from breastfeeding. Intensive care and nutrition support are recommended for infant patients with mild symptoms. (c) 2020 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).