Management of COVID-19 in an adolescent demonstrates lasting effects of extreme prematurity on pulmonary function

Extremely premature infants have demonstrated increased survival due to advancements in care. This population is at risk for decreased lung function that persists into adolescence. It is important for clinicians to consider this history when treating and assessing such patients who contract SARS-CoV-2 respiratory infection. A 17-year-old, former premature infant of 23 weeks gestation with BPD presented to the pediatric emergency department for evaluation of hypoxia and increased work of breathing in the setting of SARS-CoV-2 infection. He was managed aggressively with early noninvasive respiratory support, Remdesevir, systemic steroids, and convalescent plasma. Utilization of aggressive medical therapies early in the hospital course assisted in preventing intubation and mechanical ventilation for this patient. While there are studies examining the severity of SARS-CoV-2 infection in premature infants, there is a paucity of data on this vulnerable group as they age into adolescence. More studies are needed to assess the severity of illness and optimal management of this population.