Management outcome of a COVID-19 Positive Child with Multiple Contacts admitted in a General Intensive Care Unit-A Case Report

Abstract

COVID-19 infection in paediatric patients is relatively low in Nigeria. The low index of suspicion made healthcare providers to be at risk of  contracting the disease from this age group making prevention and contact tracing difficult. We report the management of a 9-month- old male child who had palatoplasty following a prior negative polymerase chain reaction (PCR) screening. The patient underwent palatoplasty for isolated cleft palate under general anaesthesia and endotracheal intubation. The patient was found to be desaturating  significantly on admission to the recovery room and was subsequently taken back to the theatre with multiple attempts at intubation. A  repeat PCR done was positive and subsequently, he was admitted into the ICU for ventilatory support. A chest radiograph taken on admission revealed features of severe bronchopneumonia and COVID-19 pneumonic changes. He was ventilated for 14 days and  thereafter, was discharged home on a tracheostomy in good clinical condition. The mother of the child and 20 members of staff (23.5%)  out of the 85 personnel who had close contact with the child in the course of treatment tested PCR positive. Contact tracing was difficult among those infected. They all recovered from the disease without complications. The treatment outcome in this COVID-19-positive child  was good and contact tracing was effective in reducing the transmission of SARS-CoV-2 and limiting the impact of the outbreak. We  hereby recommend preventive measures against the infection, vaccination and establishment of dedicated paediatric ICU for infectious   diseases.