Respiratory perspective of COVID-19 in pregnancy.

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a global pandemic in March 2020 by the World Health Organization (WHO). By February 2022, the disease had infected more than 500 million people globally. COVID-19 frequently manifests as pneumonia and mortality is mainly caused by acute respiratory distress syndrome (ARDS). Previous studies have reported that pregnant women are at a higher risk of SARS-CoV-2 infection and complications can happen due to alterations in the immune response, respiratory physiology, hypercoagulable state, and placental pathology. Clinicians face the challenge of selecting the proper treatment for pregnant patients with different physiological characteristics compared with the non-pregnant population. Furthermore, drug safety for both the patient and the fetus should also be considered. Efforts to prevent COVID-19, including prioritizing vaccination for pregnant women, are essential to break the chain of COVID-19 transmission in the pregnant population. This review aims to summarize the current literature regarding the effect of COVID-19 in pregnant women, its clinical manifestations, treatment, complications, and prevention.

Coronavirus disease 2019

Coronavirus disease 2019 (COVID-19) is a new name given by World Health Organization (WHO) of 2019 novel Coronavirus infection reported at the end of 2019 from Wuhan China. The spread of infection occurs rapidly and creates a new pandemic threat. Etiology of COVID-19 was identified in 10 January 2020 a beta Coronavirus similar with severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS CoV). The clue diagnosis pathway of COVID-19 was history of travel from Wuhan or others infected countries within 14 days prior and symptoms of acute respiratory illness (ARI) or lower respiratory infection (pneumonia) with the result of real time polymerase chain reaction (RT-PCR) specific for COVID-19. The WHO classified COVID-19 into suspect case probable case and confirmed case. Indonesia Ministry of Health classified the case into in monitoring (ODP) patient under surveillance (PDP) people without symptom (OTG) and confirmed case. Specimens for detection COVID-19 could be acquired from nasal and nasopharynx swab sputum and another lower respiratory aspirate including bronchoalveolar lavage (BAL). Management of COVID-19 consist of isolation and infection control supportive treatment according to the disease severity which could be mild (acute respiratory infection) to severe pneumonia or acute respiratory distress syndrome (ARDS). Disease transmission is via droplets and contact with droplets. Currently there is no antiviral and vaccine. Prevention is very important for this disease by limitation of transmission identification and isolate patients. Prognosis is determined by severity of the disease and patient comorbidity. Information about this novel disease remains very few studies are still ongoing and is needing further research to fight with this new virus. (J Respir Indo. 2020;40(2): 120-30)

Corona Virus Disease 2019

Corona virus disease 2019 (COVID-2019) was a new name of 2019 novel corona virus (2019 nCoV) infection by WHO, reported at the end of 2019 from Wuhan, China. Etiology of COVID-2019 was identified at 10 January 2020, a betacorona virus, similar with SARS and MERS CoV. The clue diagnosis pathway of COVID-2019 were history of travel from Wuhan or others infected countries within 14 days prior, and symptoms of acute respiratory illness (ARI) or lower respiratory infection (Pneumonia) then with the result of real time polymerase chain reaction (rt-PCR) specific for nCOv 2019. WHO classified COVID-2019 into suspect case, probable case;and confirmed case. Indonesia Ministry of Health classified the case into in monitoring (ODP), patient under surveillance (PDP), people without symptom (OTG) and confirmed case. Specimens for detection COVID-2019 could be nasal and nasopharynx swab, sputum and another lower respiratory aspirate including broncoalveolar lavage (BAL). Management of COVID-19 consist with isolation and infection control, supportive treatment as degree of disease that could be mild (acute respiratory infection) until severe pneumonia or acute respiratory distress syndrome (ARDS). Transmission via droplet and contact with droplet. Currently, there is no antiviral and vaccine. Prevention is very important for this disease by limitation of transmission, identification and isolate patients. Prognosis was determined by severity of the disease and patient comorbidity. Information about this novel disease remains very few, study still ongoing and need further research to fight with this new virus.

Discordance Between Clinical Status and Chest X-Ray (CXR) in COVID-19 Patient with Asymptomatic Transmission in Jakarta.

Coronavirus Disease 2019 (COVID-19) symptoms are highly various in each patient. CXR are routinely used to monitor the disease progression. However, it is not known whether chest X-Ray (CXR) is a good modality to assess COVID-19 pneumonia.Male, 55 years-old, with pneumonia caused by COVID-19. Discordance was found between patient's clinical status and CXR lesion. On the 7th day of symptoms, patient was clinically well despite severe lesion shown on CXR. On the following day, patient clinically deteriorated despite the improvement on CXR lesion.Improvement of CXR does not always correlate well with patient's clinical status. Clinician have to be careful when using CXR to monitor patient with COVID-19 pneumonia.