Elsevier

IDCases

Volume 26, 2021, e01284
IDCases

Cytokines storm in COVID-19 with dengue co-infection in pregnancy: Fatal maternal and fetal outcome

https://doi.org/10.1016/j.idcr.2021.e01284Get rights and content
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open access

Abstract

We report a 23-year-old pregnant woman who presented with acute high-grade fever, vomiting, and diarrhea for 5 days. She was first hospitalized in RSUD Tangerang—a secondary hospital based in Tangerang and were referred to Cipto Mangunkusumo General Hospital as a tertiary hospital. Initial laboratory results from previous hospital revealed leukopenia, low platelet, elevated aspartate transaminase, and alanine transaminase. Chest radiograph showed no pulmonary infiltration. Reverse transcriptase–PCR (RT-PCR) of the nasopharyngeal swab detected SARS-CoV-2, and NS1 antigen or IgM dengue-specific antibodies were positive. COVID-19 with dengue fever co-infection was diagnosed. Hemorrhagic manifestations were seen in both the mother (gum and gastrointestinal bleeding) and pregnancy (placental abruption). Patient was put on ventilator and was unfortunately lead to her death that were caused by multiorgan dysfunction failure due to co-infection of dengue and COVID-19. Both dengue and COVID-19 had similar manifestation, as it is a warning sign in pregnant patient experienced both that can lead to fatal result in mother and baby. Early diagnosis and management of co-infection is high clinical importance, especially in endemic area of dengue like Indonesia.

Keywords

COVID-19
IL-6
IL-10
TNF-α
IF-γ
RT-PCR
DENV
NS1
CT

Cited by (0)

1

These authors contributed equally to this work.

2

Current address: Department of Obstetrics and Gynecology, Cipto-Mangunkusumo Hospital, Jl. Diponegoro No. 71, Central Jakarta 10340, Indonesia.