J Korean Med Sci.  2022 Mar;37(10):e82. 10.3346/jkms.2022.37.e82.

A Case Report for Using Methylprednisolone for Severe ARDS Caused by SARS-CoV-2 Delta Variant in a Pediatric Patient With Lennox-Gastaut Syndrome

• Park E
• You J

• KMID: 2526975
• DOI: http://doi.org/10.3346/jkms.2022.37.e82

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in the coronavirus disease 2019 (COVID-19) pandemic. COVID-19 can result in fatal comorbidities, including acute respiratory distress syndrome (ARDS). Several reports suggest that children have milder illness, though severe cases have still been reported. We report a 9-year-old boy with ARDS caused by the SARS-CoV-2 delta (B.1.617.2) variant. He was admitted to our hospital and carefully observed due to underlying Lennox-Gastaut syndrome. He developed intractable seizures with a high fever. Although the seizures were controlled, his respiratory condition deteriorated to severe ARDS. High-dose methylprednisolone was administered with high positive end-expiratory pressure and low tidal volume. After ARDS treatment, oxygenation improved sufficiently to permit extubation. This case suggests that close observation is required in pediatric patients with neurologic comorbidities because of an increased risk for severe COVID-19.

Keyword

Coronavirus Disease-19 (COVID-19); Respiratory Distress Syndrome; Lennox-Gastaut Syndrome; Methylprednisolone

Figure

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  Fig. 1 Chest X-ray images of the patient. (A) Upon admission. (B) Right upper lobe haziness following intractable seizures on post-admission day 3. (C) Increased opacity in both lungs on post-admission day 8 when PaO2/FiO2 decreased to 84.3. (D) Chest X-ray at the time of discharge on post-admission day 19.

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