High-Dose Corticosteroids for a Pregnant Woman Critically Ill With Coronavirus Disease 2019

Abstract

Pregnancy was reported to be a risk factor for coronavirus disease 2019 (COVID-19), with an increased risk for premature birth. Corticosteroids and remdesivir are used for patients with COVID-19; however, there is no established treatment for these patients. In particular, the effective management of pregnant, critically ill patients with COVID-19 remains unknown. We describe a 34-year-old, critically ill woman at 30 weeks of gestation with COVID-19, who was successfully treated with remdesivir and combined high-dose betamethasone (12 mg/day for two days) and methylprednisolone (125 mg/day for three days) followed by steroid tapering. During treatment, fetal biophysical profile scores on obstetric ultrasound were normal; her pregnancy course progressed well. Since high-dose corticosteroids improve fetal lung maturation and as well as cytokine storm due to COVID-19, this case provides an insight into the management of pregnant COVID-19 patients.

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“…Case reports are particularly useful for sharing information and experiences of treating rare conditions, harms associated with therapy, recognition of new diseases and unusual presentations in recognised diseases. 53,54 Indeed, during the COVID pandemic, case reports were used to present potential therapeutic options for specific patient groups such as pregnant women, 55 that had not been addressed in the randomised controlled trials which were rapidly published in the face of this global emergency and to report unusual complications associated with infection [56][57][58][59] and with vaccination. 60,61 Case reports can have educational value, clinicians often enjoy reading them and compared to other forms of research reports, they are inexpensive and rapidly produced.…”