Volume 7, Issue 4 (July - August 2022)                   J Obstet Gynecol Cancer Res 2022, 7(4): 286-295 | Back to browse issues page

‎ 10.30699/jogcr.7.4.286

XML Print

COVID-19 Infection in Iranian Pregnant Women: A Case Series of 25 Patients
Maryamsadat Hosseini1 , Farah Farzaneh * 2, Mahsa Mirhadi1, Seyed Ali Akbar Mahdavi Anari3 , Ladan Ajori1 , Saghar Salehpour1 , Tayebeh Jahed Bozorgan1 , Parichehr Pooransari1 , Shideh Ariana1, Minoo Yaghmaei1 , Behnaz Nouri1, Shahrzad Zadehmodarres1 , Sedighe Hosseini1 , Mehrdad Haghighi4, Mir Mohammad Miri5 , Seyedpouzhia Shojaei5 , Ali Reza Mirkheshti5 , Dariush Abtahi6 , Tannaz Valadbeigi7
1- Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2- Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran , farahzaneh@yahoo.com
3- Department of Radiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4- Department of Infectious Disease, Infectious Diseases and Tropical Medicine Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5- Department of Anesthesiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
6- Department of Anesthesiology, Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
7- Department Of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Abstract:   (936 Views)

Background & Objective: The COVID-19 infection remains a major pandemic threatening global health. Studies revealed that pregnant women are more prone to develop severe illness, with an increased risk of morbidity and mortality. So the objective of this study is to report the clinical presentation and perinatal outcomes after COVID-19 infection during pregnancy or the puerperium.
Materials & Methods: In this case series study, since February 2020, 25 pregnant women with a definitive diagnosis of the COVID-19 infection were registered. Their clinical signs and symptoms, laboratory findings, CT manifestations, pregnancy status, were recorded at the first visit, and they were followed six months after diagnosis.
Results: The most common symptoms were cough, feeling feverish, and dyspnea. Twenty mothers required hospitalization, 5 out of 20 monitored in COVID-ICU. The chest CT scan demonstrated a grand glass appearance in 77% of cases among admitted patients. The total mortality rate in C-ICU (COVID-19 ICU) admitted patients were 80%.
Conclusion: In this case series, among 25 pregnant women with confirmed COVID-19, the most vulnerable patients were in the early third trimester and twin pregnancy.

Keywords: COVID-19(https://www.ncbi.nlm.nih.gov/mesh/2052179)|CT scan (https://www.ncbi.nlm.nih.gov/mesh/68014057)|PCR (https://www.ncbi.nlm.nih.gov/mesh/68016133)|pregnancy (https://www.ncbi.nlm.nih.gov/mesh/68011247) ,
Full-Text [PDF 810 kb]   (133 Downloads) |   |   Full-Text (HTML)  (110 Views)  
Systematic Review: Original Research | Subject: Obstetrics and Gynecology
Received: 2021/08/18 | Accepted: 2021/10/16 | Published: 2022/03/14
References
1. Lu S, Lin J, Zhang Z, Xiao L, Jiang Z, Chen J, Hu C, Luo S. Alert for non‐respiratory symptoms of coronavirus disease 2019 patients in epidemic period: A case report of familial cluster with three asymptomatic COVID‐19 patients. J Med Virol. 2021;93(1):518-21. [DOI:10.1002/jmv.25776] [PMID]
2. Zeng JH, Liu YX, Yuan J, Wang FX, Wu WB, Li JX, et al. First case of COVID-19 complicated with fulminant myocarditis: a case report and insights. Infection. 2020;48(5):773-7. [DOI:10.1007/s15010-020-01424-5] [PMID] [PMCID]
3. Chan JF, Yuan S, Kok KH, To KK, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395(10223):514-23. [DOI:10.1016/S0140-6736(20)30154-9]
4. Han C, Duan C, Zhang S, Spiegel B, Shi H, Wang W, Zhang L, Lin R, Liu J, Ding Z, Hou X. Digestive symptoms in COVID-19 patients with mild disease severity: clinical presentation, stool viral RNA testing, and outcomes. Am J Gastroenterol. 2020; 115(6):916-23. [DOI:10.14309/ajg.0000000000000664] [PMID] [PMCID]
5. Puntmann VO, Carerj ML, Wieters I, Fahim M, Arendt C, Hoffmann J, et al. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020;5(11):1265-73. [DOI:10.1001/jamacardio.2020.3557] [PMID] [PMCID]
6. Huang L, Zhao P, Tang D, Zhu T, Han R, Zhan C, et . Cardiac involvement in patients recovered from COVID-2019 identified using magnetic resonance imaging. Cardiovasc Imag. 2020;13(11):2330-9. [DOI:10.1016/j.jcmg.2020.05.004] [PMID] [PMCID]
7. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of chest CT and RT-PCR testing for coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology. 2020;296(2):E32-40. [DOI:10.1148/radiol.2020200642] [PMID] [PMCID]
8. Liu D, Li L, Wu X, Zheng D, Wang J, Yang L, et al. Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis. AJR Am J Roentgenol. 2020;215(1):127-32. [DOI:10.2214/AJR.20.23072] [PMID]
9. Liu H, Liu F, Li J, Zhang T, Wang D, Lan W. Clinical and CT imaging features of the COVID-19 pneumonia: Focus on pregnant women and children. J Infect. 2020;80(5):e7-13. [DOI:10.1016/j.jinf.2020.03.007] [PMID] [PMCID]
10. Long C, Xu H, Shen Q, Zhang X, Fan B, Wang C, et al. Diagnosis of the Coronavirus disease (COVID-19): rRT-PCR or CT?. Eur J Radiol. 2020;126:108961. [DOI:10.1016/j.ejrad.2020.108961] [PMID] [PMCID]
11. 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. [DOI:10.1016/S0140-6736(20)30360-3]
12. Liu W, Wang Q, Zhang Q, Chen L, Chen J, Zhang B, et al. Coronavirus disease 2019 (COVID-19) during pregnancy: a case series.
13. Yu N, Li W, Kang Q, Xiong Z, Wang S, Lin X, Liu Y, Xiao J, Liu H, Deng D, Chen S. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. Lancet Infect Dis. 2020;20(5):559-64. [DOI:10.1016/S1473-3099(20)30176-6]
14. Schwartz DA. An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes. Arch Pathol Lab Med. 2020;144(7):799-805. [DOI:10.5858/arpa.2020-0901-SA] [PMID]
15. World Health Organization. Clinical management of severe acute respiratory infection (‎‎ SARI)‎‎ when COVID-19 disease is suspected: interim guidance, 13 March 2020. World Health Organization; 2020. [DOI:10.15557/PiMR.2020.0003]
16. Dashraath P, Wong JL, Lim MX, Lim LM, Li S, Biswas A, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020;222(6):521-31. [DOI:10.1016/j.ajog.2020.03.021] [PMID] [PMCID]
17. 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. [DOI:10.21037/tp.2020.02.06] [PMID] [PMCID]
18. de Souza Santos D, de Oliveira Menezes M, Andreucci CB, Nakamura-Pereira M, Knobel R, et al. Disproportionate impact of coronavirus disease 2019 (COVID-19) among pregnant and postpartum black women in Brazil through structural racism lens. Clin Infect Dis. 2021;72(11):2068-9. [DOI:10.1093/cid/ciaa1066] [PMID] [PMCID]
19. Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID‐19: a systematic review of 108 pregnancies. Acta Obstet Gynecol Scand. 2020;99(7):823-9.
20. Ashraf MA, Keshavarz P, Hosseinpour P, Erfani A, Roshanshad A, Pourdast A, et al. Coronavirus disease 2019 (COVID-19): a systematic review of pregnancy and the possibility of vertical transmission. J Reprod Infertil. 2020;21(3):157.
21. Blitz MJ, Rochelson B, Minkoff H, Meirowitz N, Prasannan L, London V, et al. Maternal mortality among women with coronavirus disease 2019 admitted to the intensive care unit. Am J Obstet Gynecol. 2020;223(4):595-9. [DOI:10.1016/j.ajog.2020.06.020] [PMID] [PMCID]
22. Cheng SO, Khan S, Alsafi Z. Maternal death in pregnancy due to COVID‐19. Ultrasound Obstet Gynecol. 2020;56(1):122. [DOI:10.1002/uog.22111] [PMID] [PMCID]
23. Hantoushzadeh S, Shamshirsaz AA, Aleyasin A, Seferovic MD, Aski SK, et al. Maternal death due to COVID-19. Am J Obstetrics Gynecol. 2020;223(1):109-e1. [DOI:10.1016/j.ajog.2020.04.030] [PMID] [PMCID]
24. Takemoto ML, Menezes MO, Andreucci CB, Knobel R, Sousa LA, Katz L, et al. Maternal mortality and COVID-19. J Matern Fetal Neonatal Med. 2020:1-7. [DOI:10.1080/14767058.2020.1786056] [PMID]
25. Reinhard G, Noll A, Schlebusch H, Mallmann P, Ruecker AV. Shifts in the TH1/TH2 balance during human pregnancy correlate with apoptotic changes. Biochem Biophys Res Commun. 1998;245(3):933-8. [DOI:10.1006/bbrc.1998.8549] [PMID]
26. Gujski M, Humeniuk E, Bojar I. Current state of knowledge about SARS-CoV-2 and COVID-19 disease in pregnant women. Med Sci Monit. 2020;26:e924725-1. [DOI:10.12659/MSM.924725]
Rights and permissions
Creative Commons License Journal of Obstetrics, Gynecology and Cancer Research by Farname Inc is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. Based on a work at http://jogcr.com/.