Pregnant Women Infected with Coronavirus Disease 2019 Pneumonia: A Case Series in Medan, Indonesia

Authors

  • Bintang Yinke Magdalena Sinaga Department of Pulmonology and Respiratory Medicine, Division of Infection, Universitas Sumatera Utara, Medan, Indonesia https://orcid.org/0000-0003-1447-3266
  • Fannie Rizki Ananda Department of Pulmonology and Respiratory Medicine, Universitas Sumatera Utara, Medan, Indonesia https://orcid.org/0000-0002-5982-2194

DOI:

https://doi.org/10.3889/oamjms.2022.8272

Keywords:

COVID-19, Fetal outcome, High-risk thrombosis, Maternal outcome, Pregnant women

Abstract

BACKGROUND: Pregnancy state affects the immune regulation including physical barrier, innate, and adaptive immunity-related to susceptibility of infections and increasing risk for severe to critical case of COVID-19. Further, high risk of thrombosis becomes a challenge in the management of COVID19 in pregnancy due to the strong association with worse outcome.

CASE REPORT: Here, we present three cases of pregnant women infected with COVID-19 pneumonia with different outcomes in maternal and fetal condition related to high-risk thrombosis. Serial inflammatory markers were needed to the early detect the disease progressivity in pregnant women with COVID-19. Further, complete assessment of fetus including reverse transcriptase-polymerase chain reaction and chest X-ray must be performed to the early diagnosis of COVID-19 in neonatal whose mother was infected by SARS-CoV-2.

CONCLUSION: Pregnancy state affects the immune regulation including physical barrier, innate, and adaptive immunity-related to susceptibility of infections and increasing risk for severe to critical case of COVID-19. Further, high risk of thrombosis becomes a challenge in the management of COVID19 in pregnancy due to the strong association with worse outcome. Although fetal transmission of COVID-19 to fetus remains unclear, complete assessment of fetus including RT-PCR, and chest X-ray must be performed to the early diagnosis of COVID-19 in neonatal whose mother was infected by SARS-CoV-2.

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References

Lapinsky SE. Acute respiratory failure in pregnancy. Obstet Med. 2015;8(3):126-32. https://doi.org/10.1177/1753495X15589223 PMid:27512467 DOI: https://doi.org/10.1177/1753495X15589223

Wastnedge EA, Reynolds RM, van Boeckel SR, Stock SJ, Denison FC, Maybin JA, et al. Pregnancy and COVID-19. Physiol Rev. 2021;101(1):303-18. https://doi.org/10.1152/physrev.00024.2020 PMid:32969772 DOI: https://doi.org/10.1152/physrev.00024.2020

Mattar CN, Kalimuddin S, Sadarangani SP, Tagore S, Thain S, Thoon KC, et al. Pregnancy outcomes in COVID-19: A prospective cohort study in Singapore. Ann Acad Med Singapore. 2020;49(11):857-69. https://doi.org/10.47102/annals-acadmedsg.2020437 PMid:33381779 DOI: https://doi.org/10.47102/annals-acadmedsg.2020437

Tay MZ, Poh CM, Rénia L, MacAry PA, Ng LF. The trinity of COVID-19: Immunity, inflammation and intervention. Nat Rev Immunol. 2020;20(6):363-74. https://doi.org/10.1038/s41577-020-0311-8 PMid:32346093 DOI: https://doi.org/10.1038/s41577-020-0311-8

Bhaskar S, Sinha A, Banach M, Mittoo S, Weissert R, Kass JS, et al. Cytokine storm in COVID-19 immunopathological mechanisms, clinical considerations, and therapeutic approaches: The REPROGRAM consortium position paper. Front Immunol. 2020;11:1648. https://doi.org/10.3389/fimmu.2020.01648 PMid:32754159 DOI: https://doi.org/10.3389/fimmu.2020.01648

Di Renzo GC, Giardina I. Coronavirus disease 2019 in pregnancy: Consider thromboembolic disorders and thromboprophylaxis. Am J Obstet Gynecol. 2020;223(1):135. https://doi.org/10.1016/j.ajog.2020.04.017 PMid:32333857 DOI: https://doi.org/10.1016/j.ajog.2020.04.017

Oudkerk M, Buller HR, Kuijpers D, van Es N, Oudkerk SF, McLoud T, et al. Diagnosis, prevention, and treatment of thromboembolic complications in COVID-19: Report of the national institute for public health of the Netherlands. Radiology. 2020;297(1):E216-22. https://doi.org/10.1148/radiol.2020201629 PMid:32324101 DOI: https://doi.org/10.1148/radiol.2020201629

Yeh CH, De Wit K, Levy JH, Weitz JI, Vaezzadeh N, Liaw PC, et al. Hypercoagulability and coronavirus disease 2019-associated hypoxemic respiratory failure: Mechanisms and emerging management paradigms. J Trauma Acute Care Surg. 2020;89(6):e177-81. https://doi.org/10.1097/TA.0000000000002938 PMid:32890338 DOI: https://doi.org/10.1097/TA.0000000000002938

Yadav R, Bansal R, Budakoty S, Barwad P. COVID-19 and sudden cardiac death: A new potential risk. Indian Heart J. 2020;72(5):333-6. https://doi.org/10.1016/j.ihj.2020.10.001 PMid:33189190 DOI: https://doi.org/10.1016/j.ihj.2020.10.001

Ji HL, Zhao R, Matalon S, Matthay MA. Elevated plasmin (ogen) as a common risk factor for COVID-19 susceptibility. Physiol Rev. 2020;100(3):1065-75. https://doi.org/10.1152/physrev.00013.2020 PMid:32216698 DOI: https://doi.org/10.1152/physrev.00013.2020

Yazan Abou-Ismail M, Diamond A, Kapoor S, Arafah Y, Nayak L. The hypercoagulable state in COVID-19: Incidence, pathophysiology, and management. Thromb Res. 2020;194:101-15. https://doi.org/10.1016/j.thromres.2020.06.029 PMid:32788101 DOI: https://doi.org/10.1016/j.thromres.2020.06.029

Fogarty H, Townsend L, Ni Cheallaigh C, Bergin C, Martin-Loeches I, Browne P, et al. COVID19 coagulopathy in Caucasian patients. Br J Haematol. 2020;189(6):1044-9. https://doi.org/10.1111/bjh.16749 PMid:32330308 DOI: https://doi.org/10.1111/bjh.16749

Helms J, Tacquard C, Severac F, Leonard-Lorant I, Ohana M, Delabranche X, et al. High risk of thrombosis in patients with severe SARS-CoV-2 infection: A multicenter prospective cohort study. Intensive Care Med. 2020;46(6):1089-98. https://doi.org/10.1007/s00134-020-06062-x PMid:32367170 DOI: https://doi.org/10.1007/s00134-020-06062-x

Wang Z, Gao X, Miao H, Ma X, Ding R. Understanding COVID-19-associated coagulopathy: From PIC to SIC or DIC. J Intensive Med. 2021;1(1):35-41. https://doi.org/10.1016/j.joitm.2021.03.002 DOI: https://doi.org/10.1016/j.jointm.2021.03.002

Kasehagen L, Byers P, Taylor K, Kittle T, Roberts C, Collier C, et al. COVID-19-associated deaths after SARS-CoV-2 infection during pregnancy Mississippi, March 1, 2020-October 6, 2021. MMWR Morb Mortal Wkly Rep. 2021;70(47):1646-8. https://doi.org/10.15585/mmwr.mm7047e2 PMid:34818319 DOI: https://doi.org/10.15585/mmwr.mm7047e2

Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: Living systematic review and meta-analysis. BMJ. 2020;370:m3320. https://doi.org/10.1136/bmj.m3320 PMid:32873575 DOI: https://doi.org/10.1136/bmj.m3320

Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, et al. Clinical analysis of 10 neonates born to mothers with 2019- nCoV pneumonia. Transl Pediatr. 2020;9(1):51-60. https://doi.org/10.21037/tp.2020.02.06 PMid:32154135 DOI: https://doi.org/10.21037/tp.2020.02.06

Moreno SC, To J, Chun H, Ngai IM. Vertical transmission of COVID-19 to the neonate. Infect Dis Obstet Gynecol. 2020;2020:8460672. https://doi.org/10.1155/2020/8460672 PMid:33273803 DOI: https://doi.org/10.1155/2020/8460672

Del Nonno F, Colombo D, Nardacci R, Falasca L. Fatal pulmonary arterial thrombosis in a COVID-19 patient, with asymptomatic history, occurred after swab negativization. Thromb J. 2021;19(1):1. https://doi.org/10.1186/s12959-020-00255-6 PMid:33407578 DOI: https://doi.org/10.1186/s12959-020-00255-6

Hantoushzadeh S, Shamshirsaz AA, Aleyasin A, Seferovic MD, Aski SK, Arian SE, et al. Maternal death due to COVID-19. Am J Obstet Gynecol. 2020;223(1):109.e1-16. https://doi.org/10.1016/j.ajog.2020.04.030 PMid:32360108 DOI: https://doi.org/10.1016/j.ajog.2020.04.030

Karimi L, Makvandi S, Vahedian-Azimi A, Sathyapalan T, Sahebkar A. Effect of COVID-19 on Mortality of Pregnant and Postpartum Women: A Systematic Review and Meta- Analysis. J Pregnancy 2021;2021:8870129. https://doi.org/10.1155/2021/8870129 DOI: https://doi.org/10.1155/2021/8870129

Karimi-Zarchi M, Neamatzadeh H, Dastgheib SA, Abbasi H, Mirjalili SR, Behforouz A, et al. Vertical transmission of coronavirus disease 19 (COVID-19) from infected pregnant mothers to neonates: A review. Fetal Pediatr Pathol. 2020;39(3):246-50. https://doi.org/10.1080/15513815.2020.1747120 PMid:32238084 DOI: https://doi.org/10.1080/15513815.2020.1747120

Fornari F. Perinatology and child health 7 citation: Federico fornari. Vertical transmission of Covid-19-A systematic review. J Pediatr Perinatol Child Heal. 2020;4(2):7-13. https://doi.org/10.26502/jppch.7405034 DOI: https://doi.org/10.26502/jppch.74050034

Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: A retrospective review of medical records. Lancet. 2020;395(10226):809-15. https://doi.org/10.1016/S0140-6736(20)30360-3 PMid:32151335 DOI: https://doi.org/10.1016/S0140-6736(20)30360-3

Zhang L, Jiang Y, Wei M, Cheng BH, Zhou XC, Li J, et al. Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province. Zhonghua Fu Chan Ke Za Zhi. 2020;55(3):166-71. https://doi.org/10.3760/cma.j.cn112141-20200218-00111 PMid:32145714

Liu W, Wang Q, Zhang Q, Chen L, Chen J, Zhang BM, et al. Coronavirus disease 2019 (COVID-19) during pregnancy: A case series. Preprints 2020;2020:20373. Available from: https://www.preprints.org/manuscript/202002.0373/v1 [Last accessed on 2021 Mar 30].

Dong L, Tian J, He S, Zhu C, Wang J, Liu C, et al. Possible vertical transmission of SARS-CoV-2 from an infected mother to her Newborn. JAMA. 2020;323(18):1846-8. https://doi.org/10.1001/jama.2020.4621 PMid:32215581 DOI: https://doi.org/10.1001/jama.2020.4621

Zeng H, Xu C, Fan J, Tang Y, Deng Q, Zhang W, et al. Antibodies in infants born to mothers with COVID-19 Pneumonia. JAMA. 2020;323(18):1848-9. https://doi.org/10.1001/jama.2020.4861 PMid:32215589 DOI: https://doi.org/10.1001/jama.2020.4861

Sethuraman N, Jeremiah SS, Ryo A. Interpreting diagnostic tests for SARS-CoV-2. JAMA. 2020;323(22):2249-51. https://doi.org/10.1001/jama.2020.8259 PMid:32374370 DOI: https://doi.org/10.1001/jama.2020.8259

Barrero-Castillero A, Beam KS, Bernardini LB, Ramos EG, Davenport PE, Duncan AR, et al. COVID-19: Neonatal-perinatal perspectives. J Perinatol. 2021;41:940-51. https://doi.org/10.1038/s41372-020-00874-x PMid:33293665 DOI: https://doi.org/10.1038/s41372-020-00874-x

Shalish W, Lakshminrusimha S, Manzoni P, Keszler M, Sant’anna GM. COVID-19 and neonatal respiratory care: Current evidence and practical approach. Am J Perinatol. 2020;37(8):780-91. https://doi.org/10.1055/s-0040-1710522 PMid:32359226 DOI: https://doi.org/10.1055/s-0040-1710522

Brownstein NC, Chen YA. Predictive values, uncertainty, and interpretation of serology tests for the novel coronavirus. Sci Rep. 2021;11(1):5491. https://doi.org/10.1038/s41598021-84173-1 PMid:33750810 DOI: https://doi.org/10.1038/s41598-021-84173-1

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Published

2022-02-07

How to Cite

1.
Sinaga BYM, Ananda FR. Pregnant Women Infected with Coronavirus Disease 2019 Pneumonia: A Case Series in Medan, Indonesia. Open Access Maced J Med Sci [Internet]. 2022 Feb. 7 [cited 2024 Apr. 18];10(C):246-51. Available from: https://oamjms.eu/index.php/mjms/article/view/8272

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Case Report in Internal Medicine

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