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Inborn error of metabolism precipitated by COVID-19: challenges in the absence of an expanded newborn screening as state health programmes
  1. Priyanka Olety,
  2. Gundyadka Moideen Safwan and
  3. Rathika Damodara Shenoy
  1. Pediatrics, KS Hegde Medical Academy, Mangalore, Karnataka, India
  1. Correspondence to Dr Gundyadka Moideen Safwan; gmsafwan{at}


Inborn errors of metabolism constitute a differential diagnosis in infants presenting with encephalopathy in developing countries where expanded newborn screening is not a state health programme. Acute neurological presentation with encephalopathy is documented in paediatric COVID-19. The pandemic has also altered parents' healthcare-seeking behaviour, leading to delays in emergency care. We illustrate the challenges faced in diagnosing and managing an 18-month-old child who presented with acute metabolic crisis due to methylmalonic acidaemia on the background of the COVID-19 pandemic. We discuss the current global status of expanded newborn screening services for inborn error of metabolism and the impact of the pandemic on the healthcare of children.

  • COVID-19
  • Congenital disorders

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  • Contributors All the authors were responsible for the management and diagnosis of the infant. All the authors contributed equally in literature search and drafting the manuscript. RDS will be the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.