AUTHOR=Shaiba Lana A. , Hadid Adnan , Altirkawi Khalid A. , Bakheet Hind M. , Alherz Aminah Mohammed , Hussain Shaik Asfaq , Sobaih Badr H. , Alnemri Abdulrahman M. , Almaghrabi Rana , Ahmed Medina , Arafah Maria A. , Jarallah Abdullah , Bukhari Elham Essa , Alzamil Fahad A. 

TITLE=Case Report: Neonatal Multi-System Inflammatory Syndrome Associated With SARS-CoV-2 Exposure in Two Cases From Saudi Arabia

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 9 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.652857

DOI=10.3389/fped.2021.652857

ISSN=2296-2360

ABSTRACT=Background:
Vertical transmission of SARS-COV-2 is under investigation. A few reports suggest the possibility of SARS-COV-2 transmission from the mothers to their neonates. Most neonates have mild symptoms but some develop multi system involvement and shock.  
Case Presentation:
We report two cases of possible SARS-COV-2 vertical transmission from mothers to their neonates. The first case shows maternal infection with SARS-COV-2 in the second trimester followed by recurrent infection in the third trimester right before the delivery. The infant demonstrated respiratory distress soon after delivery along with myocardial dysfunction and multi-organ system involvement. The second case shows maternal infection with SARS-COV-2 at the time of delivery with preterm labor secondary to abruptio-placenta and resulted in a preterm neonate requiring none invasive ventilation with multi-system involvement in the context of persistently positive SARS-COV-2 PCR in the neonate. Both neonates were treated with IVIG along with steroids. Both neonates recovered fully and were discharged home. 
Conclusion:
In neonates, COVID-19 usually presents as an asymptomatic or mild illness; some of them may develop a more severe course. Our two cases, however, demonstrate that multi-system involvement, although rare, but is possible. This report also supports the current evidence of possible vertical transmission from mothers to their neonates. This multi-system involvement might be under-reported and should be considered in neonates with respiratory distress when born to mothers suffering of COVID-19.