scholarly journals Pregnancy and Childbirth in the COVID-19 Era—The Course of Disease and Maternal–Fetal Transmission

2020 ◽  
Vol 9 (11) ◽  
pp. 3749
Author(s):  
Agnieszka Irena Mazur-Bialy ◽  
Daria Kołomańska-Bogucka ◽  
Sabina Tim ◽  
Marcin Opławski
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Pregnant Women ◽  
Premature Delivery ◽  
Course Of Disease ◽  
Pregnancy And Childbirth ◽  
Risk Of Disease ◽  
Maternal Fetal Transmission ◽  
The Moment

From the beginning of the Coronavirus Disease 2019 (COVID-19) pandemic, special attention has been paid to pregnant women and to monitoring comorbidities, such as gestational diabetes and hypertension, which could increase their risk of disease and death. The purpose of this review is to synthesize the available knowledge on the course of COVID-19 in pregnant women as well as the risk of maternal–fetal transmission. The study indicated that the course of COVID-19 is worse in pregnant women who are more often admitted to intensive care units or who require mechanical ventilation than nonpregnant women with COVID-19. Some symptoms, such as dyspnea and cough, were similar to those observed in nonpregnant women, but fever, headache, muscle aches, chills, and diarrhea were less frequent. A study revealed that premature delivery and cesarean section were more common in pregnant women diagnosed with COVID-19. In addition, recent studies confirm the possibility of intrauterine maternal–fetal transmission by positive genetic tests and the presence of IgM in newborns just after delivery; at the moment, the probability of transmission through mother’s milk is inconclusive. Considering all the above, a severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is an important factor that threatens the health and life of both the mother and the fetus, but further studies are still needed.

scholarly journals 375. COVID 19 infection in a Massachusetts community hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S257-S258
Author(s):  
Raul Davaro ◽  
alwyn rapose
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Essential Hypertension ◽  
Severe Acute Respiratory Syndrome ◽  
High Mortality ◽  
Case Series ◽  
World Health ◽  
Minimal Risk ◽  
The Impact

Abstract Background The ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections has led to 105690 cases and 7647 deaths in Massachusetts as of June 16. Methods The study was conducted at Saint Vincent Hospital, an academic health medical center in Worcester, Massachusetts. The institutional review board approved this case series as minimal-risk research using data collected for routine clinical practice and waived the requirement for informed consent. All consecutive patients who were sufficiently medically ill to require hospital admission with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by positive result on polymerase chain reaction testing of a nasopharyngeal sample were included. Results A total of 109 consecutive patients with COVID 19 were admitted between March 15 and May 31. Sixty one percent were men, the mean age of the cohort was 67. Forty one patients (37%) were transferred from nursing homes. Twenty seven patients died (24%) and the majority of the dead patients were men (62%). Fifty one patients (46%) required admission to the medical intensive care unit and 34 necessitated mechanical ventilation, twenty two patients on mechanical ventilation died (63%). The most common co-morbidities were essential hypertension (65%), obesity (60%), diabetes (33%), chronic kidney disease (22%), morbid obesity (11%), congestive heart failure (16%) and COPD (14%). Five patients required hemodialysis. Fifty five patients received hydroxychloroquine, 24 received tocilizumab, 20 received convalescent plasma and 16 received remdesivir. COVID 19 appeared in China in late 2019 and was declared a pandemic by the World Health Organization on March 11, 2020. Our study showed a high mortality in patients requiring mechanical ventilation (43%) as opposed to those who did not (5.7%). Hypertension, diabetes and obesity were highly prevalent in this aging population. Our cohort was too small to explore the impact of treatment with remdesivir, tocilizumab or convalescent plasma. Conclusion In this cohort obesity, diabetes and essential hypertension are risk factors associated with high mortality. Patients admitted to the intensive care unit who need mechanical ventilation have a mortality approaching 50 %. Disclosures All Authors: No reported disclosures

scholarly journals Infections in Pregnancy With COVID-19 and Other Respiratory RNA Virus Diseases Are Rarely, If Ever, Transmitted to the Fetus: Experiences With Coronaviruses, Parainfluenza, Metapneumovirus Respiratory Syncytial Virus, and Influenza

2020 ◽  
Vol 144 (8) ◽  
pp. 920-928 ◽  
Author(s):  
David A. Schwartz ◽  
Amareen Dhaliwal
Keyword(s):  
Respiratory Syncytial Virus ◽  
Middle East ◽  
Severe Acute Respiratory Syndrome ◽  
Pregnant Women ◽  
Rna Viruses ◽  
Middle East Respiratory Syndrome ◽  
Intrauterine Transmission ◽  
Fetal Infection ◽  
Syncytial Virus ◽  
Maternal Fetal Transmission

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the agent of coronavirus disease 2019 (COVID-19), is similar to 2 other coronaviruses, SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV), in causing life-threatening maternal respiratory infections and systemic complications. Because of global concern for potential intrauterine transmission of SARS-CoV-2 from pregnant women to their infants, this report analyzes the effects on pregnancy of infections caused by SARS-CoV-2 and other respiratory RNA viruses, and examines the frequency of maternal-fetal transmission with SARS-CoV-2, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza, respiratory syncytial virus (RSV), parainfluenza (HPIV), and metapneumovirus (hMPV). There have been no confirmed cases of intrauterine transmission reported with SARS-CoV-2 or any other coronaviruses—SARS and MERS. Influenza virus, despite causing approximately 1 billion annual infections globally, has only a few cases of confirmed or suspected intrauterine fetal infections reported. Respiratory syncytial virus is an unusual cause of illness among pregnant women, and with the exception of 1 premature infant with congenital pneumonia, no other cases of maternal-fetal infection are described. Parainfluenza virus and hMPV can produce symptomatic maternal infections but do not cause intrauterine fetal infection. In summary, it appears that the absence thus far of maternal-fetal transmission of the SARS-CoV-2 virus during the COVID-19 pandemic is similar to other coronaviruses, and is also consistent with the extreme rarity of suggested or confirmed cases of intrauterine transmission of other respiratory RNA viruses. This observation has important consequences for pregnant women because it appears that if intrauterine transmission of SARS-CoV-2 does eventually occur, it will be a rare event. Potential mechanisms of fetal protection from maternal viral infections are also discussed.

The swallowing telerehabilitation in COVID-19 (Preprint)

2020 ◽  
Author(s):  
Tomoo Mano ◽  
Shigeto Soyama
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Protective Equipment ◽  
Video Conference ◽  
Rehabilitation Professionals ◽  
Swallowing Rehabilitation ◽  
Swallowing Difficulty ◽  
The Individual

UNSTRUCTURED Direct swallowing rehabilitation is not recommended for patients who is positive or suspected for the severe acute respiratory syndrome coronavirus 2（SARS-CoV-2），because SARS-CoV-2 is extremely infectious and may transmit to the individual performing rehabilitation. Some of patients in the intensive care unit and on mechanical ventilation undergo the swallowing difficulty. To feed normally again and be discharged, an assessment of dysphagia and eventual targeted swallowing training by specialized rehabilitation professionals are provided. We analysis the benefit of telerehabilitation, and we experienced the case with COVID-19 of contactless swallowing rehabilitation using video conference software on the tablet-type devices. Telerehabilitation offers the risk reduction of infection and the prevention the shortage of personal protective equipment. Protecting the medical staff from nosocomial infection of COVID-19 is therefore extremely important, and we suggest telerehabilitation as a useful approach in the swallowing rehabilitation.

scholarly journals Experience of using surfactant therapy for pneumonia associated with COVID-19 of obstetric patients

2020 ◽  
pp. 42-47
Author(s):  
M.V. Shvechkova ◽  
◽  
I.I. Kukarskaya ◽  
R.N. Marchenko ◽  
I.I. Kuratcenko ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Pregnant Women ◽  
Integrated Treatment ◽  
Surfactant Therapy ◽  
Postpartum Women ◽  
Complex Therapy ◽  
Group 2 ◽  
Group 1

Introduction. Pregnant women may be at increased risk for severe COVID-19 illness. Pregnant women are more likely to be hospitalized at ICU, needed the mechanical ventilation compared to nonpregnant women. The pregnant women are currently excluded from the most of the clinical trials of COVID-19 drug therapy. This limits the formulation of appropriate recommendations for the treatment of pregnant women with SARS-CoV-2 infection. Building on the experience of the effective use of surfactant therapy for influenza A/H1N1 treatment of pregnant women with COVID-19, the domestic/local drug Surfactant BL was included in the complex therapy. The objective. To evaluate the effectiveness of surfactant therapy in the integrated treatment of severe COVID-19 pneumonia of pregnant women and postpartum women. Materials and methods. The study included 69 pregnant and postpartum women with severe COVID-19 pneumonia. All ofthem received antiviral, anticoagulant and anti-inflammatory therapy. 47 patients (group 1) with an initially more severe course of the disease received inhalations with Surfactant BL in 1–2 days after admission to the intensive care unit, 22 patients (group 2) were prescribed surfactant therapy for 4–5 days, due to the progression of respiratory failure. Surfactant BL was administered at a dose of 75 mg 2 times a day through a nebulizer for 2–5 days. Result. In group 1 patients, SpO2 recovered faster and dyspnea decreased. All patients of group 1 did not require mechanical ventilation; in group 2, 3 patients (14.3%) required mechanical ventilation. In the group of early use of surfactant therapy with CT control, in most cases, there was a positive trend (67.6%), in contrast to group 2 (37.5%). Stay in ICU conditions in group 1 was 8.6 days, in group 2 – 13.2 days. No lethal outcomes were observed with surfactant therapy in both groups. Conclusion. Early surfactant therapy against the background of complex therapy allows to avoid mechanical ventilation, reducing the length of stay of patients in the intensive care unit and preventing mortality from COVID-19 pneumonia.

COVID-19 IN PREGNANCY AND LITERATURE REVIEW

2021 ◽  
pp. 9-11
Author(s):  
Hari Kishan Boorugu
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Literature Review ◽  
Pregnant Women ◽  
Congenital Anomalies ◽  
Severe Illness ◽  
Increased Risk ◽  
Pregnancy And Lactation ◽  
In Pregnancy

COVID-19 pandemic has affected humankind in a major way. Pregnant women are as susceptible to SARS-COV-2 infection as non-pregnant population. Infections prevention is paramount as pregnancy is associated with increased risk of severe illness, admission to intensive care and mechanical ventilation. Pregnancy poses unique challenges in view of paucity of information regarding safety of drugs used in management of patients with COVID-19 infection. Fortunately SARS-COV-2 infection during pregnancy does not appear to cause congenital anomalies. Vaccination should not be withheld based on pregnancy and lactation status.

Improving medical-diagnostic actions of the flu during pregnancy

10.12737/8626 ◽  
2015 ◽  
Vol 9 (1) ◽  
pp. 0-0
Author(s):  
Шатунова ◽  
E. Shatunova ◽  
Калиматова ◽  
D. Kalimatova ◽  
Лимарева ◽  
...  
Keyword(s):  
Endothelial Dysfunction ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Correlation Coefficients ◽  
Respiratory Illness ◽  
Premature Delivery ◽  
Pregnancy And Childbirth ◽  
Medical Diagnostic ◽  
Vascular Endothelial Factor ◽  
Definition Of

Surveyed 202 pregnant women with a diagnosis of influenza medium (n=154) and severe (n=48) severity. An algorithm for management of pregnant women with influenza, which is monitoring the level of markers of endothelial dysfunction; it is shown that its use in clinical practice can reduce the frequency of complications of pregnancy and childbirth and to improve perinatal outcomes. The results were statistically evaluate the relationship between indicators of pregnancy and childbirth, and the dynamics of the concentrations of markers of endothelial dysfunction has revealed the presence of stable relationships indicators (statistically significant correlation coefficients Spearman moderate strength). In particular, it is shown that the vascular endothelial factor concentration is negatively associated with the incidence of intrauterine growth retardation, preeclampsia, placental insufficiency, anemia and threatened premature delivery, polyhydramnios. The results of the study, indicating the high prognostic value of the levels of markers of endothelial dysfunction, allow us to propose the inclusion of estimates of these parameters in the algorithm of management of pregnant women with influenza for the timely appointment of preventive and diagnostic and treatment activities in order to reduce the frequency of complications of pregnancy and childbirth and improve perinatal outcomes. The obtained results allow to conclude that pregnant women with symptoms of ARI (influenza) shows the definition of the levels of markers of endothelial dysfunction, a survey is recommended during the first indications of the disease. It is reasonable assessment of markers of endothelial dysfunction in this category pregnant in the dynamics after 1-2 months after acute respiratory illness.

scholarly journals Clinical features and the maternal and neonatal outcomes of pregnant women with coronavirus disease 2019

2020 ◽  
Author(s):  
Rui Nie ◽  
Shao-shuai Wang ◽  
Qiong Yang ◽  
Cui-fang Fan ◽  
Yu-ling Liu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Pregnant Women ◽  
Clinical Features ◽  
Neonatal Outcomes ◽  
Clinical Severity ◽  
Severe Illness ◽  
Increased Risk ◽  
Maternal And Neonatal Outcomes

ABSTRACTBACKGROUNDThere is little information about the coronavirus disease 2019 (Covid-19) during pregnancy. This study aimed to determine the clinical features and the maternal and neonatal outcomes of pregnant women with Covid-19.METHODSIn this retrospective analysis from five hospitals, we included pregnant women with Covid-19 from January 1 to February 20, 2020. The primary composite endpoints were admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Secondary endpoints included the clinical severity of Covid-19, neonatal mortality, admission to neonatal intensive care unit (NICU), and the incidence of acute respiratory distress syndrome (ARDS) of pregnant women and newborns.RESULTSThirty-three pregnant women with Covid-19 and 28 newborns were identified. One (3%) pregnant woman needed the use of mechanical ventilation. No pregnant women admitted to the ICU. There were no moralities among pregnant women or newborns. The percentages of pregnant women with mild, moderate, and severe symptoms were 13 (39.4%),19(57.6%), and 1(3%). One (3.6%) newborn developed ARDS and was admitted to the NICU. The rate of perinatal transmission of SARS-CoV-2 was 3.6%.CONCLUSIONSThis report suggests that pregnant women are not at increased risk for severe illness or mortality with Covid-19 compared with the general population. The SARS-CoV-2 infection during pregnancy might not be associated with as adverse obstetrical and neonatal outcomes that are seen with the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) infection during pregnancy. (Funded by the National Key Research and Development Program.)

scholarly journals Evaluation of COVID-19 as a risk factor for maternal-fetal and neonatal complications: protocol of a systematic review and meta-analysis of cohort and case-control studies

2021 ◽  
Author(s):  
Priscila Bezerra ◽  
Fernanda Gabriella de Siqueira Barros Nogueira ◽  
Alan Chaves dos Santos ◽  
Anna katharina Souza Lima ◽  
Davi Emanuel Ribeiro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intensive Care ◽  
Pregnant Women ◽  
Intrauterine Growth Restriction ◽  
Meta Analysis ◽  
Case Control ◽  
Premature Delivery ◽  
Case Control Studies ◽  
Intrauterine Growth ◽  
Meta Regression

ABSTRACTBackgroundCOVID-19 in pregnant women has been suggested to impair maternal-fetal and neonatal outcomes. We then designed the present systematic review with meta-analysis to evaluate the repercussion of such disease over maternal fetal and neonatal mortality, need for intensive care, way of delivery, premature delivery, birth weight, Apgar score, presence of intrauterine growth restriction (IGR), and presence of amniotic fluid change.MethodsWe will conduct a computerized search through MEDLINE/PubMed, LILACS/BIREME, Web of science, Biorxiv, Medrxiv, and Embase on July 23, 2020. We will include cohort and case-control studies fully reported comparing pregnant women with COVID-19 with those not affected by the disease for maternal fetal and neonatal mortality, need for intensive care, way of delivery, premature delivery occurrence, birth weight, Apgar scores, presence of intrauterine growth restriction, and presence of amniotic fluid change. Three doubles of reviewers will perform in duplicate and independently all steps on screening, risk of bias judgments, and data extraction with ability to discuss disagreements with supervising authors. Pooled effects will be estimated by both fixed and random-effects models and presented according to qualitative and quantitative heterogeneity assessment. Sensitivity analyses will be performed as well as a priori subgroup, meta-regression and multiple meta-regression analyses. We’ll also evaluate the risk of selective publication by assessing funnel plot asymmetry and the quality of the evidence by the application of the GRADE recommendations.DiscussionThis systematic review with meta-analysis aims to assess the repercussion of COVID-19 in pregnant women over maternal-fetal and neonatal outcomes and to help clinicians and health systems improve such population outcomes throughout the current pandemic.Systematic review registrationThis review protocol was also submitted to PROSPERO registration on February 9, 2021.

scholarly journals The case of severe botulism: artificial ventilation of lungs for 127 days

2013 ◽  
Vol 18 (6) ◽  
pp. 49-57
Author(s):  
V. V. Nikiforov ◽  
Yu. N Tomilin ◽  
A. V. Davydov ◽  
P. E Zimin ◽  
O. I Aleynikova
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Detailed Analysis ◽  
Intensive Care Units ◽  
Hospital Discharge ◽  
Artificial Ventilation ◽  
Severe Disease ◽  
Course Of Disease ◽  
Hospital Beds ◽  
First Admission

Botulism is a rare but extremely severe disease being difficult to treat and often leading to the death. In this context, undoubted interest is the detailed analysis of the course of disease in a patient with severe botulism, who in the course of therapy in total (from first admission to hospital discharge) spent totally on hospital beds (considering staying in various hospital) 152 days, including in intensive care units - 145 days, out of which 127 days - on a ventilator (the first 93 days of treatment there was carried out in the mode of mechanical ventilation IPPV, the next 34 days there was carried out intermittent mechanical ventilation in mode of BiPaP).

scholarly journals COVID-19 on a Patient with Familial Hypercholesterolemia

2020 ◽  
Vol 5 (10) ◽  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Familial Hypercholesterolemia ◽  
Distress Syndrome ◽  
Main Symptom ◽  
Entire World ◽  
Novel Coronavirus

Covid-19 is disease caused by a novel coronavirus also known as severe acute respiratory syndrome coronavirus 2, a name that describes the disease if causes. It was first detected in Wuhan, China in December of 2019 where it arose to spread in the entire world to cause the global COVID-19 Pandemic. This virus causes severe bilateral pneumonia and acute respiratory distress syndrome which requires to be managed in intensive care unit requiring mechanical ventilation. We present a 77-year old Covid-19 patient with familial hypercholesterolemia and stroke who presented with the main symptom of confusion. After exclusion of our first differential that was stroke, we tested the patient for Covid-19 and resulted positive. After treatment with oxygen, steroids and antibiotics, the patient recovered and was discharged. An important lesion from this patient was that the presentation of Covid-19 has various types and manifestations.

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