Complicated COVID-19 in pregnancy: a case report with severe liver and coagulation dysfunction promptly improved by deli
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(2020) 20:511
CASE REPORT
Open Access
Complicated COVID-19 in pregnancy: a case report with severe liver and coagulation dysfunction promptly improved by delivery Louise Ronnje1, John-Kalle Länsberg2, Olga Vikhareva3, Stefan R. Hansson3, Andreas Herbst3 and Mehreen Zaigham3*
Abstract Background: It has been proposed that pregnant women and their fetuses may be particularly at risk for poor outcomes due to the coronavirus (COVID-19) pandemic. From the few case series that are available in the literature, women with high risk pregnancies have been associated with higher morbidity. It has been suggested that pregnancy induced immune responses and cardio-vascular changes can exaggerate the course of the COVID-19 infection. Case presentation: A 26-year old Somalian woman (G2P1) presented with a nine-day history of shortness of breath, dry cough, myalgia, nausea, abdominal pain and fever. A nasopharyngeal swab returned positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Her condition rapidly worsened leading to severe liver and coagulation impairment. An emergency Caesarean section was performed at gestational week 32 + 6 after which the patient made a rapid recovery. Severe COVID-19 promptly improved by the termination of the pregnancy or atypical HELLP (Hemolysis, Elevated Liver Enzymes and Low Platelet Count) exacerbated by concomitant COVID-19 infection could not be ruled out. There was no evidence of vertical transmission. Conclusions: This case adds to the growing body of evidence which raises concerns about the possible negative maternal outcomes of COVID-19 infection during pregnancy and advocates for pregnant women to be recognized as a vulnerable group during the current pandemic. Keywords: COVID-19, Coronavirus, SARS-CoV-2, Neonate, Pregnancy, Differential diagnosis, HELLP syndrome, Liver, Coagulation, Morbidity, Fever, Mortality, Obstetric management, Pandemic, Respiratory distress syndrome, Respiratory failure, Sepsis, Susceptibility, Virus
* Correspondence: [email protected] 3 Department of Obstetrics & Gynaecology, Institute of Clinical Sciences Lund, Lund University and Skåne University Hospital, 205 01 Malmö/Lund, Sweden Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright h
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