Late-neonatal SARS-CoV-2 infection: A curious case of COVID-19 with respiratory co-infection and treatment with surfactant

At the height of the COVID-19 pandemic, South Africa became the epicentre of the continent. Considering the paucity of data on COVID-19, we aimed to describe the clinical picture in a neonate, alert healthcare workers to the presence of co-infection with COVID-19 and propose alternative treatment modalities. The use of surfactant was based on the pathophysiological mechanisms of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). There is mounting evidence in support of using surfactant in the management of severe COVID-19. While viral co-infection is a common occurrence among neonates, our case shows that COVID-19, together with rhinovirus infection, may result in a more rapid clinical deterioration, as opposed to rhinovirus infection in isolation.