Yamamoto Koichiro, Hagiya Hideharu, Maki Jota, Okahara Shuji, Hasegawa Kou, Otsuka Fumio
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JPN.
Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JPN.
Cureus. 2021 Aug 23;13(8):e17398. doi: 10.7759/cureus.17398. eCollection 2021 Aug.
Pregnancy was reported to be a risk factor for coronavirus disease 2019 (COVID-19), with an increased risk for premature birth. Corticosteroids and remdesivir are used for patients with COVID-19; however, there is no established treatment for these patients. In particular, the effective management of pregnant, critically ill patients with COVID-19 remains unknown. We describe a 34-year-old, critically ill woman at 30 weeks of gestation with COVID-19, who was successfully treated with remdesivir and combined high-dose betamethasone (12 mg/day for two days) and methylprednisolone (125 mg/day for three days) followed by steroid tapering. During treatment, fetal biophysical profile scores on obstetric ultrasound were normal; her pregnancy course progressed well. Since high-dose corticosteroids improve fetal lung maturation and as well as cytokine storm due to COVID-19, this case provides an insight into the management of pregnant COVID-19 patients.
据报道，妊娠是2019冠状病毒病（COVID-19）的一个危险因素，早产风险增加。皮质类固醇和瑞德西韦用于COVID-19患者；然而，这些患者尚无既定的治疗方法。特别是，对于患有COVID-19的重症孕妇的有效管理仍然未知。我们描述了一名34岁、妊娠30周、患有COVID-19的重症妇女，她接受了瑞德西韦、联合高剂量倍他米松（12毫克/天，共两天）和甲泼尼龙（125毫克/天，共三天）治疗，随后逐渐减少类固醇剂量，治疗成功。治疗期间，产科超声检查的胎儿生物物理评分正常；她的妊娠过程进展顺利。由于高剂量皮质类固醇可改善胎儿肺成熟以及因COVID-19引起的细胞因子风暴，该病例为COVID-19孕妇的管理提供了见解。
