Severe COVID-19 during pregnancy treated with pulse corticosteroid therapy and mid-trimester termination: A case report.

Autor:	Bui TN; COVID-19 Intensive Care Unit 2, Thu Duc City Hospital, Ho Chi Minh City, Viet Nam., Huynh NM; COVID-19 Intensive Care Unit 2, Thu Duc City Hospital, Ho Chi Minh City, Viet Nam., Do-Tran NH; School of Medicine, Vietnam National University Ho Chi Minh City, Viet Nam., Ngo HA; Woolcock Institute of Medical Research, Hanoi, Viet Nam.; Usher Institute, University of Edinburgh, Edinburgh, United Kingdom., Tran H; COVID-19 Intensive Care Unit 2, Thu Duc City Hospital, Ho Chi Minh City, Viet Nam., Nguyen NT; COVID-19 Intensive Care Unit 2, Thu Duc City Hospital, Ho Chi Minh City, Viet Nam., Pham TT; COVID-19 Intensive Care Unit 2, Thu Duc City Hospital, Ho Chi Minh City, Viet Nam., Le KD; COVID-19 Intensive Care Unit 2, Thu Duc City Hospital, Ho Chi Minh City, Viet Nam., Nguyen TA; Woolcock Institute of Medical Research, Hanoi, Viet Nam.; Sydney School of Medicine, The Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.
Jazyk:	angličtina
Zdroj:	Case reports in women's health [Case Rep Womens Health] 2022 Apr; Vol. 34, pp. e00396. Date of Electronic Publication: 2022 Feb 09.
DOI:	10.1016/j.crwh.2022.e00396
Abstrakt:	Background: At the early stage of the pandemic, severe COVID-19 was thought to be rare among pregnant women. However, cumulating data showed that gestational state is a risk factor for severe pneumonia, particularly due to the hyperinflammatory state. Recent reports suggested the efficacy of pulse corticosteroids in stopping the cytokine storm in people infected with SARS-CoV-2, but limited data exists regarding its use in pregnant women. Moreover, pregnancy termination is a treatment option in this population, but it has been reported mainly in the third trimester and rarely in the second trimester. Case Presentation: A 37-year-old woman infected with SARS-CoV-2 at 23 weeks of gestation presented with fatigue and dyspnea but soon deteriorated to severely acute respiratory failure and cytokine storm requiring mechanical ventilation combined with hemodialysis just one day after hospitalization. Low-dose corticosteroids and antibiotics were initiated, followed by antiviral therapy, anticoagulant and high-dose corticosteroid therapy. On hospital day 3, a decision to terminate her pregnancy was made; termination led to significant improvement in her clinical condition and a gradual decrease in demand for oxygen supplementation as well as the corticosteroid dose. She was discharged two weeks after admission. Conclusions: Due to the specific immune response, pregnant women with COVID-19 may differ from others in their clinical presentation, especially the probability of classic acute respiratory distress syndrome (ARDS). This report provides evidence related to the efficacy of pulse corticosteroids on this group and the influence of the mid-trimester termination on recovery. (© 2022 The Authors.)
Databáze:	MEDLINE
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