Severe Respiratory Failure from SARS-CoV-2, Complicated with Pneumothorax in a Pregnant Woman: A Case Report
Open Access Macedonian Journal of Medical Sciences
; 10:217-221, 2022.
Article
in English
| EMBASE | ID: covidwho-2066680
ABSTRACT
INTRODUCTION:
The first data for COVID-19 in pregnancy showed mild-to-moderate forms of the disease while the current data speak of severe forms in these subjects. Here, we present a case of a severe form of COVID-19 in a gemelar pregnant woman complicated with pneumomediastinum and pneumothorax, during her hospital stay, in a late stage of disease. CASE PRESENTATION A 38-year-old multiparous woman was referred to university hospital at 25 weeks of gemelar pregnancy. On admission, the patient presented with signs of moderate respiratory insufficiency, which after 12 h progressed further to severe ARDS. She tested positive for SARS-CoV-2 on quantitative real-time polymerase chain reaction. Under these conditions, it was decided that the patient undergoes a cesarean section for termination of pregnancy. Remdesivir 200 mg/day and tocilizumab 8 mg/kg were administered, based on national guidelines. The patient’s fever subsided, but her SpO2 remained at 94%, even with a 15 L/min oxygen mask. After 12 days, the patient complains of a severe back pain and her respiratory condition rapidly worsened and reduced saturations up to 80% being under O2 therapy with facial mask with 15 l/min. Chest CT findings confirmed pneumomediastinum and pneumothorax, which deteriorated the patient’s status. Thereafter, tube thoracostomy was performed. There was a clinical and ABG analysis parameter’s improvement. The patient was discharged 34 days after cesarean delivery with a proper general health.CONCLUSION:
Our case highlights even more convincingly the fact that, in pregnancy, can be severe to life-threating forms of COVID-19. Pneumothorax and pneumomediastinum are complications that can be encountered even in the late stages of severe forms cases with COVID-19 in pregnancy. Early diagnosis of these complications is essential in adequate management and treatment to avoid fatal outcome.
adult; adult respiratory distress syndrome; article; backache; case report; cesarean section; clinical article; complication; coronavirus disease 2019; diagnosis; early diagnosis; face mask; fatality; female; fever; hospital discharge; hospitalization; human; multipara; nonhuman; oxygen mask; oxygen therapy; pneumomediastinum; pneumothorax; practice guideline; pregnancy; pregnant woman; quantitative analysis; real time polymerase chain reaction; respiratory failure; Severe acute respiratory syndrome coronavirus 2; surgery; thoracostomy; thorax; university hospital; remdesivir; tocilizumab
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Case report
Language:
English
Journal:
Open Access Macedonian Journal of Medical Sciences
Year:
2022
Document Type:
Article
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