%0 Journal Article %A Priyanka Olety %A Gundyadka Moideen Safwan %A Rathika Damodara Shenoy %T Inborn error of metabolism precipitated by COVID-19: challenges in the absence of an expanded newborn screening as state health programmes %D 2022 %R 10.1136/bcr-2021-248001 %J BMJ Case Reports %P e248001 %V 15 %N 6 %X 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. %U https://casereports.bmj.com/content/bmjcr/15/6/e248001.full.pdf