Critical respiratory failure in pregnancy complicated with COVID-19: A case report

• Main Authors: Yukiko Chinen, Yoshino Kinjyo, Keiko Mekaru, Tadatsugu Kinjo, Yuuri Higure, Takeshi Kinjo, Kazuya Miyagi, Hisako Yamada, Hitoshi Masamoto, Hideki Goya, Tomohide Yoshida, Sakiko Maeshiro, Masashi Nakamatsu, Jiro Fujita, Yoichi Aoki
• Format: Article
• Language: English
• Published: Elsevier 2021-04-01
• Series: Case Reports in Women's Health
• Subjects: COVID-19; Pneumonia; Pregnancy; Respiratory failure
• Online Access: http://www.sciencedirect.com/science/article/pii/S2214911221000278

The case is presented of a 29-year-old primiparous woman who was COVID-19-positive at 34 weeks of gestation and who developed severe acute respiratory distress syndrome. After a four-day history of fever and mild dyspnea, she was referred to hospital. Ciclesonide, dexamethasone, heparin sodium, and sulbactam/ampicillin were initiated, followed by remdesivir and tocilizumab. On the fourth day after admission (at 34 weeks 5 days of gestation), respiratory failure required ventilator management. An emergency cesarean section was performed and a 2565-g male infant was delivered with an Apgar score of 8/8 and negative COVID-19 status. However, on the following day the patient's respiratory condition deteriorated and mechanical ventilation was initiated. Subsequently, her respiratory condition quickly improved and mechanical ventilation was terminated 4 days after intubation. She was discharged 12 days after cesarean delivery. Our case provides additional evidence that raises concerns regarding the unfavorable maternal consequences of COVID-19 infection during pregnancy.