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Severe COVID-19 during Pregnancy and Possible Vertical Transmission

American journal of perinatology, 2020-06, Vol.37 (8), p.861-865 [Peer Reviewed Journal]

ISSN: 0735-1631 ;EISSN: 1098-8785 ;DOI: 10.1055/s-0040-1710050

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  • Title:
    Severe COVID-19 during Pregnancy and Possible Vertical Transmission
  • Author: Alzamora, Maria Claudia ; Paredes, Tania ; Caceres, David ; Webb, Camille M. ; Valdez, Luis M. ; La Rosa, Mauricio
  • Subjects: Short Communication
  • Is Part Of: American journal of perinatology, 2020-06, Vol.37 (8), p.861-865
  • Description: Abstract There are few cases of pregnant women with novel corona virus 2019 (COVID-19) in the literature, most of them with a mild illness course. There is limited evidence about in utero infection and early positive neonatal testing. A 41-year-old G3P2 with a history of previous cesarean deliveries and diabetes mellitus presented with a 4-day history of malaise, low-grade fever, and progressive shortness of breath. A nasopharyngeal swab was positive for COVID-19, COVID-19 serology was negative. The patient developed respiratory failure requiring mechanical ventilation on day 5 of disease onset. The patient underwent a cesarean delivery, and neonatal isolation was implemented immediately after birth, without delayed cord clamping or skin-to-skin contact. The neonatal nasopharyngeal swab, 16 hours after delivery, was positive for severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) real-time polymerase chain reaction (RT-PCR), and immunoglobulin (Ig)-M and IgG for SARS-CoV-2 were negative. Maternal IgM and IgG were positive on postpartum day 4 (day 9 after symptom onset). We report a severe presentation of COVID-19 during pregnancy. To our knowledge, this is the earliest reported positive PCR in the neonate, raising the concern for vertical transmission. We suggest pregnant women should be considered as a high-risk group and minimize exposures for these reasons. Key Points We report a severe presentation of COVID-19 in pregnancy requiring invasive ventilatory support. This is a case of positive RT-PCR in first day of life, suggesting possible vertical transmission. There were no detectable maternal antibodies for COVID-19 until after delivery.
  • Publisher: 333 Seventh Avenue, New York, NY 10001, USA: Thieme Medical Publishers
  • Language: English
  • Identifier: ISSN: 0735-1631
    EISSN: 1098-8785
    DOI: 10.1055/s-0040-1710050
  • Source: Open Access: Thieme Open Access Journals
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