A Case of Asymmetric Vertical Transmission of SARS-COV-19 in Newborn Twins

Abstract

Management of newborns during the
SARS-COV-2 (COVID-19) pandemic
presents unique challenges. Fortunately,
infected newborns generally tend to be
asymptomatic or have milder symptoms
than older patients infected with COVID-19.
The true rate of vertical transmission is still
unclear, with some studies reporting none
and others reporting as high as 10% [1-3]. We
describe here a unique case of asymmetric
vertical transmission of COVID-19 in twin
newborns.
Full term dichorionic diamniotic twin
infants were born to a G6P3 25 year-old
mother. Pregnancy was complicated by scant
prenatal care, preeclampsia with severe
features requiring magnesium sulfate, and
maternal use of opioids and amphetamines.
Twin gestation was unknown prior to
delivery. The mother presented in active
labor. Twins were born via normal
spontaneous vaginal delivery. Apgars were 8
and 9 for both babies at 0 and 5 minutes of
life. Twin A required drying and stimulation
only. Twin B required deep suctioning and
CPAP briefly after delivery but transitioned
quickly to room air. Meconium was positive
for opioids in both twins however there were
no signs of neonatal abstinence syndrome. In
addition, mother was hepatitis C positive and
syphilis IgG reactive.