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Mortality of a pregnant patient diagnosed with COVID-19: A case report with clinical, radiological, and histopathological findings

Identifieur interne : 000175 ( Pmc/Checkpoint ); précédent : 000174; suivant : 000176

Mortality of a pregnant patient diagnosed with COVID-19: A case report with clinical, radiological, and histopathological findings

Auteurs : Parisa Karami [Iran] ; Maliheh Naghavi [Iran] ; Abdolamir Feyzi [Iran] ; Mehdi Aghamohammadi [Iran] ; Mohammad Sadegh Novin [Iran] ; Ahmadreza Mobaien [Iran] ; Mohamad Qorbanisani [Iran] ; Aida Karami [Iran] ; Amir Hossein Norooznezhad [Iran]

Source :

RBID : PMC:7151464

Abstract

This report highlights details on a pregnant case of COVID-19 who unfortunately did not survive. This 27-year-old woman at her 30 and 3/7 weeks’ gestation was referred to our center with fever, myalgia, and cough. The laboratory investigations showed leukopenia and lymphopenia as well as increased creatinine and CRP levels. The first chest X-ray (faint bilateral patchy opacities) and CT scan (some faint subpleural ground-glass opacities associated with pleural thickening) were not typical for initial COVID-19 pulmonary infection, however, the treatment for COVID-19 was started. Due to respiratory distress, she was intubated and put under mechanical ventilation. After a while, the fetus was born with Apgar score of 0 and did not react to the neonatal cardiopulmonary resuscitation protocol. Finally, due to deterioration in the clinical and imaging findings, the patient was expired as a result of multi-organ failure. Following the death, autopsy was performed and the histopathologic evaluations of the lungs showed evidence of viral pneumonia (viral cytopathic effect and a mild increase in alveolar wall thickness) and ARDS (hyaline membrane). Also, reverse transcription-polymerase chain reaction (RT-PCR) confirmed SARS-CoV-2 infection in the lungs. To our knowledge, this is the first report of maternal death with confirmed COVID-19 infection.


Url:
DOI: 10.1016/j.tmaid.2020.101665
PubMed: 32283217
PubMed Central: 7151464


Affiliations:


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PMC:7151464

Le document en format XML

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<p>This report highlights details on a pregnant case of COVID-19 who unfortunately did not survive. This 27-year-old woman at her 30 and 3/7 weeks’ gestation was referred to our center with fever, myalgia, and cough. The laboratory investigations showed leukopenia and lymphopenia as well as increased creatinine and CRP levels. The first chest X-ray (faint bilateral patchy opacities) and CT scan (some faint subpleural ground-glass opacities associated with pleural thickening) were not typical for initial COVID-19 pulmonary infection, however, the treatment for COVID-19 was started. Due to respiratory distress, she was intubated and put under mechanical ventilation. After a while, the fetus was born with Apgar score of 0 and did not react to the neonatal cardiopulmonary resuscitation protocol. Finally, due to deterioration in the clinical and imaging findings, the patient was expired as a result of multi-organ failure. Following the death, autopsy was performed and the histopathologic evaluations of the lungs showed evidence of viral pneumonia (viral cytopathic effect and a mild increase in alveolar wall thickness) and ARDS (hyaline membrane). Also, reverse transcription-polymerase chain reaction (RT-PCR) confirmed SARS-CoV-2 infection in the lungs. To our knowledge, this is the first report of maternal death with confirmed COVID-19 infection.</p>
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<title-group>
<article-title>Mortality of a pregnant patient diagnosed with COVID-19: A case report with clinical, radiological, and histopathological findings</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" id="au1">
<name>
<surname>Karami</surname>
<given-names>Parisa</given-names>
</name>
<xref rid="aff1" ref-type="aff">a</xref>
<xref rid="fn1" ref-type="fn">1</xref>
</contrib>
<contrib contrib-type="author" id="au2">
<name>
<surname>Naghavi</surname>
<given-names>Maliheh</given-names>
</name>
<xref rid="aff2" ref-type="aff">b</xref>
<xref rid="fn1" ref-type="fn">1</xref>
</contrib>
<contrib contrib-type="author" id="au3">
<name>
<surname>Feyzi</surname>
<given-names>Abdolamir</given-names>
</name>
<xref rid="aff2" ref-type="aff">b</xref>
</contrib>
<contrib contrib-type="author" id="au4">
<name>
<surname>Aghamohammadi</surname>
<given-names>Mehdi</given-names>
</name>
<xref rid="aff3" ref-type="aff">c</xref>
</contrib>
<contrib contrib-type="author" id="au5">
<name>
<surname>Novin</surname>
<given-names>Mohammad Sadegh</given-names>
</name>
<xref rid="aff3" ref-type="aff">c</xref>
</contrib>
<contrib contrib-type="author" id="au6">
<name>
<surname>Mobaien</surname>
<given-names>Ahmadreza</given-names>
</name>
<xref rid="aff4" ref-type="aff">d</xref>
</contrib>
<contrib contrib-type="author" id="au7">
<name>
<surname>Qorbanisani</surname>
<given-names>Mohamad</given-names>
</name>
<xref rid="aff1" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author" id="au8">
<name>
<surname>Karami</surname>
<given-names>Aida</given-names>
</name>
<xref rid="aff1" ref-type="aff">a</xref>
</contrib>
<contrib contrib-type="author" id="au9">
<name>
<surname>Norooznezhad</surname>
<given-names>Amir Hossein</given-names>
</name>
<email>norooznezhad@gmail.com</email>
<xref rid="aff5" ref-type="aff">e</xref>
<xref rid="aff6" ref-type="aff">f</xref>
<xref rid="cor1" ref-type="corresp"></xref>
</contrib>
</contrib-group>
<aff id="aff1">
<label>a</label>
Department of Radiology, Vali-e-asr Hospital, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran</aff>
<aff id="aff2">
<label>b</label>
Department of Pathology, Vali-e-asr Hospital, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran</aff>
<aff id="aff3">
<label>c</label>
Department of Internal Medicine, Vali-e-asr Hospital, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran</aff>
<aff id="aff4">
<label>d</label>
Department of Infectious Diseases, Vali-e-asr Hospital, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran</aff>
<aff id="aff5">
<label>e</label>
School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran</aff>
<aff id="aff6">
<label>f</label>
Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran</aff>
<author-notes>
<corresp id="cor1">
<label></label>
Corresponding author. Medical Biology Research Center, School of Medicine, Sorkheh Ligeh Blvd, Kermanshah, P.O. Box 67145-1673, Iran.
<email>norooznezhad@gmail.com</email>
</corresp>
<fn id="fn1">
<label>1</label>
<p id="ntpara0010">Authors contributed equally in this work.</p>
</fn>
</author-notes>
<pub-date pub-type="pmc-release">
<day>11</day>
<month>4</month>
<year>2020</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="epub">
<day>11</day>
<month>4</month>
<year>2020</year>
</pub-date>
<elocation-id>101665</elocation-id>
<history>
<date date-type="received">
<day>31</day>
<month>3</month>
<year>2020</year>
</date>
<date date-type="rev-recd">
<day>4</day>
<month>4</month>
<year>2020</year>
</date>
<date date-type="accepted">
<day>6</day>
<month>4</month>
<year>2020</year>
</date>
</history>
<permissions>
<copyright-statement>© 2020 Elsevier Ltd. All rights reserved.</copyright-statement>
<copyright-year>2020</copyright-year>
<copyright-holder>Elsevier Ltd</copyright-holder>
<license>
<license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p>
</license>
</permissions>
<abstract id="abs0010">
<p>This report highlights details on a pregnant case of COVID-19 who unfortunately did not survive. This 27-year-old woman at her 30 and 3/7 weeks’ gestation was referred to our center with fever, myalgia, and cough. The laboratory investigations showed leukopenia and lymphopenia as well as increased creatinine and CRP levels. The first chest X-ray (faint bilateral patchy opacities) and CT scan (some faint subpleural ground-glass opacities associated with pleural thickening) were not typical for initial COVID-19 pulmonary infection, however, the treatment for COVID-19 was started. Due to respiratory distress, she was intubated and put under mechanical ventilation. After a while, the fetus was born with Apgar score of 0 and did not react to the neonatal cardiopulmonary resuscitation protocol. Finally, due to deterioration in the clinical and imaging findings, the patient was expired as a result of multi-organ failure. Following the death, autopsy was performed and the histopathologic evaluations of the lungs showed evidence of viral pneumonia (viral cytopathic effect and a mild increase in alveolar wall thickness) and ARDS (hyaline membrane). Also, reverse transcription-polymerase chain reaction (RT-PCR) confirmed SARS-CoV-2 infection in the lungs. To our knowledge, this is the first report of maternal death with confirmed COVID-19 infection.</p>
</abstract>
<kwd-group id="kwrds0010">
<title>Keywords</title>
<kwd>Coronavirus disease 2019</kwd>
<kwd>SARS-CoV-2</kwd>
<kwd>Pregnancy</kwd>
<kwd>Intrauterine fetal death</kwd>
<kwd>Acute respiratory distress syndrome</kwd>
<kwd>Acute kidney injury</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
<affiliations>
<list>
<country>
<li>Iran</li>
</country>
</list>
<tree>
<country name="Iran">
<noRegion>
<name sortKey="Karami, Parisa" sort="Karami, Parisa" uniqKey="Karami P" first="Parisa" last="Karami">Parisa Karami</name>
</noRegion>
<name sortKey="Aghamohammadi, Mehdi" sort="Aghamohammadi, Mehdi" uniqKey="Aghamohammadi M" first="Mehdi" last="Aghamohammadi">Mehdi Aghamohammadi</name>
<name sortKey="Feyzi, Abdolamir" sort="Feyzi, Abdolamir" uniqKey="Feyzi A" first="Abdolamir" last="Feyzi">Abdolamir Feyzi</name>
<name sortKey="Karami, Aida" sort="Karami, Aida" uniqKey="Karami A" first="Aida" last="Karami">Aida Karami</name>
<name sortKey="Mobaien, Ahmadreza" sort="Mobaien, Ahmadreza" uniqKey="Mobaien A" first="Ahmadreza" last="Mobaien">Ahmadreza Mobaien</name>
<name sortKey="Naghavi, Maliheh" sort="Naghavi, Maliheh" uniqKey="Naghavi M" first="Maliheh" last="Naghavi">Maliheh Naghavi</name>
<name sortKey="Norooznezhad, Amir Hossein" sort="Norooznezhad, Amir Hossein" uniqKey="Norooznezhad A" first="Amir Hossein" last="Norooznezhad">Amir Hossein Norooznezhad</name>
<name sortKey="Norooznezhad, Amir Hossein" sort="Norooznezhad, Amir Hossein" uniqKey="Norooznezhad A" first="Amir Hossein" last="Norooznezhad">Amir Hossein Norooznezhad</name>
<name sortKey="Novin, Mohammad Sadegh" sort="Novin, Mohammad Sadegh" uniqKey="Novin M" first="Mohammad Sadegh" last="Novin">Mohammad Sadegh Novin</name>
<name sortKey="Qorbanisani, Mohamad" sort="Qorbanisani, Mohamad" uniqKey="Qorbanisani M" first="Mohamad" last="Qorbanisani">Mohamad Qorbanisani</name>
</country>
</tree>
</affiliations>
</record>

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