A four-month-old baby who had been diagnosed with heart problems at birth died of Covid-19 at a hospital in Kerala’s Kozhikode district on Friday, PTI reported. The child is the fourth patient to die in the state after contracting the coronavirus.

The baby was admitted to Kozhikode Medical College Hospital on April 21 with a fever, cough, breathing difficulties and seizures, the news agency reported, citing a health bulletin. She was in shock and had respiratory failure.

The baby had no history of contact with any Covid-19 patient. “Even though there was no history of any high or low risk contact or any epidemiological links as the child comes from SARI [Sever Acute Respiratory infection] criteria, she was admitted to the COVID-ICU [intensive care unit] and swab was taken and she tested positive,” the bulletin added.

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“There’s no foreign travel history,” Malappuram District Medical Officer Dr Sakeena K told NDTV. “A distant relative had tested positive but that person was in strict quarantine. So we are checking various options.” She added that the child had been in and out of the hospital because of her heart problems.

Samples from the child’s parents, both of whom are in quarantine, have been sent for tests, NDTV reported.

Kerala has 447 cases of the coronavirus, according to the Union health ministry. More than 300 people in the state have recovered from Covid-19. Last month, a 93-year old man and his 88-year-old wife had recovered from Covid-19 in Kerala. The couple had contracted the infection from their son, who had returned from Italy.

Earlier this month, Kerala Finance Minister Thomas Isaac had claimed that the coronavirus curve in the state had begun to flatten. Kerala, which had reported the first Covid-19 infection in India on January 31, was for a time the state with the highest number of cases.