Preprint has been published in a journal as an article
DOI of the published article
Preprint / Version 1

Critical COVID-19 Pneumonia with Acute Respiratory Failure in a Healthy 12-year-old Girl


  • Karolina Dolezalova Department of Pediatrics, Thomayer University Hospital
  • Cabelova Tamara Department of Paediatrics, Thomayer University Hospital
  • Tomas Hecht Department of Paediatrics, Thomayer University Hospital
  • Pavel Heinige Clinic of Paediatric Surgery and Traumatology, Thomayer University Hospital



We present an otherwise healthy, fully immunized 12-year-old girl who was transferred intubated and ventilated to our Paediatric Intensive Care Unit with fever, cough, and acute respiratory failure. The epidemiologic history was positive for COVID-19, and, furthermore, she tested PCR positive resulting from a nasopharyngeal swab. CT of the thorax revealed bilateral consolidation with the tree-in-bud signs. Her condition required artificial ventilation support for 13 days. Remdesivir, pronation, high dose Ascorbic acid with Thiamine, and combined antimicrobial therapy were successfully used. Our patient made a full clinical recovery. The case demonstrates that even though critical course of COVID-19 infection in children is scarce, it might occur. We hereby would like to share our experience with the medical community.


COVID-19, Pneumonia, Acute Respiratory Failure, Artificial Ventilation


Download data is not yet available.


“Coronavirus disease (COVID-19).” (accessed Jun. 05, 2021).

B. M. Henry et al., “Laboratory abnormalities in children with mild and severe coronavirus disease 2019 (COVID-19): A pooled analysis and review,” Clinical Biochemistry, vol. 81. Elsevier Inc., pp. 1–8, Jul. 01, 2020, doi: 10.1016/j.clinbiochem.2020.05.012.

T. H. de Souza, J. A. Nadal, R. J. N. Nogueira, R. M. Pereira, and M. B. Brandão, “Clinical manifestations of children with COVID-19: A systematic review,” Pediatric Pulmonology, vol. 55, no. 8. John Wiley and Sons Inc, pp. 1892–1899, Aug. 01, 2020, doi: 10.1002/ppul.24885.

F. Palabiyik, S. O. Kokurcan, N. Hatipoglu, S. O. Cebeci, and E. Inci, “Imaging of COVID-19 pneumonia in children,” The British journal of radiology, vol. 93, no. 1113, p. 20200647, Sep. 2020, doi: 10.1259/bjr.20200647.

B. Zhou et al., “Risk profiles of severe illness in children with COVID-19: a meta-analysis of individual patients,” Pediatric Research, 2021, doi: 10.1038/s41390-021-01429-2.

J. H. Beigel et al., “Remdesivir for the Treatment of Covid-19 — Final Report,” New England Journal of Medicine, vol. 383, no. 19, pp. 1813–1826, Nov. 2020, doi: 10.1056/nejmoa2007764.

P. Ghelichkhani and M. Esmaeili, “Prone Position in Management of COVID-19 Patients; a Commentary,” Archives of Academic Emergency Medicine, vol. 8, no. 1, pp. 1–3, Jan. 2020, doi: 10.22037/aaem.v8i1.674.