Death of a 3 Month-Old Infected Infant with Dilated Cardiomyopathy after COVID-19 Infection: A Case Report

Document Type : Case Report


1 Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Department of Medical Genetics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

3 Laboratory Hematology and Blood Banking Department, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran


Background: Several numbers of studies have reported that coronavirus disease-2019 (COVID-19) in infants and children have shown milder symptoms and a better prognosis than in adult patients. However, there is no sufficient evidence on the effect of cardiovascular involvement in COVID-19 in the infant.
Case Report: Here, we report an infant infected with COVID-19 with the manifestations of dilated myocarditis. The patient was referred to Pediatric Emergency with lethargy and tachypnea. On physical examination, she had holosystolic murmur with grade 3/6. The laboratory examinations showed anemia as well as increased alkaline phosphatase (ALP) levels. Due to respiratory distress, she was intubated and put under mechanical ventilation. The diagnosis of COVID-19 infection was confirmed by real-time polymerase chain reaction (RT-PCR) using a pharyngeal specimen. Finally, dilated cardiomyopathy (DCM) was diagnosed and one day after hospitalization the infant was died due to complications of DCM.
Conclusion: It seems that in the infant with severe underlying disease, even a mild COVID-19 infection, may be lethal. Focal viral myocarditis is a very rare condition described by localized disturbance of the myocardium occurring in ventricular dysfunction with significant morbidity and mortality. Thus, due tothe possibility of cardiac injury in infected neonates with COVID-19 disease and the manifestation of myocarditis, effective measurement is recommended.


  1. Amiraskari R, Sayarifard E, Kharrazi H, Naserfar N, Sayarifard A. Neonatal sars-cov-2 infection and congenital myocarditis: A case report and literature review. Arch Pediatr Infect Dis 2020; 8(3): e103504.
  2. Filatov A, Sharma P, Hindi F, Espinosa PS. Neurological complications of Coronavirus disease (COVID-19): Encephalopathy. Cureus 2020; 12(3): e7352.
  3. Hopkins KA, Webster G. Aberrated supraventricular tachycardia associated with neonatal fever and COVID-19 infection. BMJ Case Rep 2021; 14(4): 10-3.
  4. Zimmermann P, Curtis N. Coronavirus infections in children including COVID-19: An overview of the epidemiology, clinical features, diagnosis, treatment and prevention options in children. Pediatr Infect Dis J 2020; 39(5): 355-68.
  5. Sanna G, Serrau G, Bassareo PP, Neroni P, Fanos V, Marcialis MA. Children’s heart and COVID-19: Up-to-date evidence in the form of a systematic review. Eur J Pediatr 2020; 179(7): 1079-87.
  6. Courtney RJ, Pennesi ME. Retinal Dystrophy in 2 Brothers With α-Mannosidosis. Arch Ophthalmol 2011; 129(6): 798-804.
  7. Alsaied T, Tremoulet AH, Burns JC, Saidi A, Dionne; Audrey, Lang SM, et al. Review of Cardiac Involvement in Multisystem Inflammatory Syndrome in Children. Circulation 2021; 143(1): 78-88.
  8. Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr 2020; 109(6): 1088-95.
  9. Alsaied T, Aboulhosn JA, Cotts TB, Daniels CJ, Etheridge SP, Feltes TF, et al. Covid-19 in pediatric and congenital heart disease. J Am Heart Assoc 2020; 9(12): 1-29.
  10. Kristoffersen AW, Knudsen PK, Møller T. SARS-CoV-2 infection in an infant with severe dilated cardiomyopathy. Cardiol Young 2021;31(3): 485-7.
  11. Zareef RO, Younis NK, Bitar F, Eid AH, Arabi M. Covid-19 in pediatric patients: A focus on CHD patients. Front Cardiovasc Med 2020; 7: 612460.
  12. Wise J. Covid-19: New coronavirus variant is identified in UK. BMJ 2020; 371: m4857.
  13. Li C, Luo F, Wu B. A 3-month-old child with COVID-19. 2020; 99(23): e20661.
  14. Bahrami R, Neamatzadeh H, Akbarian E. COVID-19 and Renal Complications in Neonates and Pediatrics. World J Peri Neonatol 2020; 3(2): 48-9.
  15. Piccinelli M. Psicoterapia e Scienze Umane. 2020; 54: 481-9.
  16. Javaheri A, Noorishadkam M, Mazaheri M, Dadbinpour A, Dastgheib SA, Bahrami R, et al. Current State of Knowledge about Transplacental Transmission of SARS-CoV-2 Infection. World J Peri Neonatol 2020; 3(2): 50-5.
  17. De Avila C, Toro S, Applegate S, Ugale-Wilson J. focal viral myocarditis in an infant : a challenging diagnosis. [Online], [2020]. Available from: URL: