Acute respiratory distress syndrome and COVID-19 in a child with systemic lupus erythematosus

Simone Sukhdeo, Emily Negroponte, Hariprem Rajasekhar, Sunanda Gaur, Daniel B. Horton, Amisha Malhotra, Lakshmi Moorthy

Research output: Contribution to journalArticlepeer-review

Abstract

We report a case of COVID-19 in a pediatric patient with systemic lupus erythematosus (SLE), who presented with respiratory distress marked by increased work of breathing and low oxygen saturation. Lab tests confirmed COVID-19, and showed lymphocytopenia and elevated markers of inflammation and coagulopathy. Chest X-ray showed bilateral mid-lung opacities, and the patient required intubation early in his disease course. Imaging and clinical findings were consistent with acute respiratory distress syndrome (ARDS) with inflammation. The patient was treated with different combinations of antivirals (hydroxychloroquine and remdesivir), cytokine inhibitors (anakinra and tocilizumab), glucocorticoids (hydrocortisone and methylprednisolone), and an anticoagulant (enoxaparin). Inflammatory markers decreased before clinical improvement in lung aeration. This case highlights the potential for pediatric patients with SLE to present with COVID-19 similar to the clinical presentation described in adults.

Original languageEnglish (US)
JournalLupus
DOIs
StateAccepted/In press - 2021

All Science Journal Classification (ASJC) codes

  • Rheumatology

Keywords

  • ARDS
  • COVID-19
  • pediatric
  • Systemic lupus erythematosus

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