Management of life‐threatening acute respiratory syndrome and severe pneumonia secondary to COVID‐19 in pregnancy: A case report and literature review

Yaqoub, Salwa; Ahmad, Shamsa; Mansouri, Zaina; Pallivalapila, Abdulrouf; Kassem, Wessam El; Maslamani, Muna Al; Jubara, Mahmoud Abu; Minisha, Fathima; Tarannum, Asma; Babarinsa, Isaac; Abdussalam, Ahmed; Sayed, Hamdy; Rivero, T. de Portugal Fernández del; Azad, Aftab; Thomas, Binny; Hail, Moza Al

doi:10.1002/ccr3.3485

Cited by 6 publications

(18 citation statements)

References 40 publications

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“…At that point, 13 articles were assessed for eligibility [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. After reading the full texts, one article was removed: Chong et al [ 15 ] reported the case of a 41-year-old woman, 32 weeks pregnant, who developed severe acute respiratory distress syndrome (ARDS) from SARS-CoV-2 infection, necessitating emergency Cesarean section in the intensive care room.…”

Section: Resultsmentioning

confidence: 99%

“…At the end of the assessment phase, 12 records were included in this review; all were case reports involving a total of 12 pregnancies [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. Table 1 presents the characteristics of the studies included in the final review.…”

Section: Resultsmentioning

confidence: 99%

“…According to this assessment, the overall quality of the studies included in this systematic review was low. The reports originated from the USA ( n = 5) [ 19 , 20 , 24 , 26 , 27 ], Italy ( n = 2) [ 17 , 22 ], Iran ( n = 2) [ 16 , 18 ], Mexico [ 23 ], Qatar [ 21 ] and China [ 25 ]. The age of the women ranged between 22 [ 20 ] and 42 years [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

“…No comorbidity was declared in five cases [ 18 , 22 , 23 , 25 , 27 ]. Two women had one comorbid condition (obesity) [ 16 , 17 ] and five had multiple comorbid conditions [ 19 , 20 , 21 , 24 , 26 ]. The gestational age at CP treatment ranged between 21 + 2 [ 16 ] and 36 + 2 [ 24 ] weeks.…”

Section: Resultsmentioning

confidence: 99%

“…All patients received other medications during their stay in hospital: antivirals of the nucleotide analogue class (remdesivir, n = 5), protease inhibitors (lopinavir/ritonavir; n = 4), steroids ( n = 8), heparin ( n = 7), hydroxychloroquine ( n = 5) and humanized monoclonal antibodies (tocilizumab, n = 2). Additional maternal interventions were described in nine patients, of whom six were given invasive mechanical ventilation, three received extracorporeal membrane oxygenation [ 21 , 25 , 27 ] and three required tracheostomy [ 20 , 22 , 27 ].…”

Section: Resultsmentioning

confidence: 99%

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Convalescent Plasma for Pregnant Women with COVID-19: A Systematic Literature Review

Franchini

Prefumo

Grisolia

et al. 2021

Viruses

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The treatment of COVID-19 is particularly critical in pregnant women, considering the potential teratogenic effects of antiviral agents and the immune-depression related with pregnancy. The aim of this review is to systematically examine the current evidence on the clinical use of convalescent plasma during pregnancy. The electronic databases Medline PubMed Advanced Search Builder, Scopus, Web Of Science and Google Scholar were searched (until 1 January 2021). Inclusion criteria were pregnant women with COVID-19 (or SARS-CoV-2 infection), in whom convalescent plasma (or hyperimmune plasma) was used as treatment. We searched clinical trial registries (censored 5 January 2021) for eligible studies under way. After elimination of duplications, the initial search yielded 79 potentially relevant records, of which 67 were subsequently excluded. The 12 remaining records were case reports involving 12 pregnancies. Six of the mothers were reported to be well, two were reported to have preeclampsia, and in one case each the maternal outcome was described as survival, clinical improvement, discharged with oxygen and rehabilitation. With regard to the neonates, two were declared to be well, four had transient morbidity, two were critically ill and one died; normal ongoing pregnancies, but no post-delivery information, were reported for the remaining three cases. Clinical trials under way or planned to investigate the use of convalescent plasma for COVID-19 during pregnancy are lacking. This is the first systematic review of the literature regarding the treatment of COVID-19 in pregnancy. The published literature data seem to indicate that convalescent plasma administered to pregnant women with severe COVID-19 provides benefits for both the mother and the fetus. The quality of the available studies is, however, very limited since they are all case reports and thus suffer from relevant reporting bias.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Convalescent Plasma for Pregnant Women with COVID-19: A Systematic Literature Review

Franchini

Prefumo

Grisolia

et al. 2021

Viruses

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Treatment of pregnant and early postpartum women with severe and critical COVID-19: experience at a tertiary center

et al. 2022

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Background The management of acute respiratory failure during pregnancy is a poorly defined issue in the literature, especially regarding the use of the prone position and the appropriate time for delivery. This study describes our experience in treating pregnant and postpartum women with severe or critical coronavirus disease 2019 (COVID-19). Materials and methods This descriptive retrospective study included 25 pregnant and 4 postpartum women admitted to an ICU due to respiratory complications from COVID-19 from June 2020 to August 2021. Results The mean maternal age was 33.6 years, and the median gestational age (GA) at admission was 33 weeks. Obesity was the most common comorbidity. The median time between symptom onset and ICU admission was 10 days, while the median length of ICU stay was 14 days. Invasive mechanical ventilation (IMV) was required in 16 (55.2%) patients for a median time of 16.5 days. Prone positioning (PP) was performed in 68.7% of the patients on IMV, and resulted in an expressive increase in arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2 ratio). Eleven (44%) pregnant women delivered during their ICU stay for obstetric or fetal reasons: of these, 2 (18%) developed postpartum hemorrhagic shock and 1 (9%) developed abdominal wall infection. None of the 25 pregnant women underwent delivery due to acute respiratory failure or in an attempt to avoid intubation. There were 2 fetal deaths, but no maternal or neonatal deaths. Conclusion We observed favorable outcomes in pregnant and postpartum women with severe and critical COVID-19 admitted to our institution. This finding reinforces the effectiveness of PP in the treatment of hypoxemic respiratory failure secondary to COVID-19 in pregnant women undergoing IMV, and suggests that gestation should only be interrupted in cases of obstetric and fetal complications, provided the patient is stable, or when hypoxemia is refractory to PP.

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Treatment of pregnant and early postpartum women with severe and critical COVID-19: experience at a tertiary center

Barbosa¹,

Braga²,

Costa³

et al. 2022

Preprint

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Background: The management of acute respiratory failure during pregnancy is a poorly defined issue in the literature, especially regarding the use of the prone position and the appropriate time for delivery. This study describes our experience in treating pregnant and postpartum women with severe or critical coronavirus disease 2019 (COVID-19). Materials and Methods: This descriptive retrospective study included 25 pregnant and 4 postpartum women admitted to an ICU due to respiratory complications from COVID-19 from June 2020 to August 2021. Results: The mean maternal age was 33.6 years, and the median gestational age (GA) at admission was 33 weeks. Obesity was the most common comorbidity. The median time between symptom onset and ICU admission was 10 days, while the median length of ICU stay was 14 days. Invasive mechanical ventilation (IMV) was required in 16 (55.2%) patients for a median time of 16.5 days. Prone positioning (PP) was performed in 68.7% of the patients on IMV, and resulted in an expressive increase in arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2 ratio). Eleven (44%) pregnant women delivered during their ICU stay for obstetric or fetal reasons: of these, 2 (18%) developed postpartum hemorrhagic shock and 1 (9%) developed abdominal wall infection. None of the 25 pregnant women underwent delivery due to acute respiratory failure or in an attempt to avoid intubation. There were 2 fetal deaths, but no maternal or neonatal deaths. Conclusion: We observed favorable outcomes in pregnant and postpartum women with severe and critical COVID-19 admitted to our institution. This finding reinforces the effectiveness of PP in the treatment of hypoxemic respiratory failure secondary to COVID-19 in pregnant women undergoing IMV, and suggests that gestation should only be interrupted in cases of obstetric and fetal complications, provided the patient is stable, or when hypoxemia is refractory to PP.

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Management of life‐threatening acute respiratory syndrome and severe pneumonia secondary to COVID‐19 in pregnancy: A case report and literature review

Cited by 6 publications

References 40 publications

Convalescent Plasma for Pregnant Women with COVID-19: A Systematic Literature Review

Convalescent Plasma for Pregnant Women with COVID-19: A Systematic Literature Review

Treatment of pregnant and early postpartum women with severe and critical COVID-19: experience at a tertiary center

Treatment of pregnant and early postpartum women with severe and critical COVID-19: experience at a tertiary center

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