Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Arkansas for the Medical Sciences, Little Rock, Arkansas.
Department of Obstetrics and Gynecology, University of Arkansas for the Medical Sciences, Little Rock, Arkansas.
Am J Perinatol. 2022 Jan;39(2):165-171. doi: 10.1055/s-0041-1739292. Epub 2021 Nov 14.
There is limited data on the treatment of coronavirus disease 2019 (COVID-19) in pregnancy. Arkansas saw an increase in COVID-19 cases in June 2020. The first critically ill pregnant patient was admitted to our institution on May 21, 2020. The objective of this study was to evaluate outcomes in critically ill pregnant women with COVID-19 at a single tertiary care center who received remdesivir and convalescent plasma (CCP).
This is a retrospective observational review of critically ill pregnant women with COVID-19 who received remdesivir and CCP. This study was approved by the institutional review board (#261354).
Seven pregnant patients with COVID-19 were admitted to the intensive care unit (ICU). All received remdesivir and CCP. Six received dexamethasone. The median ICU length of stay (LOS) was 8 days (range 3-17). Patient 1 had multi-organ failure requiring vasopressors, renal dialysis, and had an intrauterine fetal demise. Patients 4 and 6 required mechanical ventilation, were delivered for respiratory distress and were extubated at 2 and 1 days postpartum, respectively. The only common risk factor was obesity. There were no adverse events noted with remdesivir or CCP.
There is little data regarding the use of remdesivir or CCP for the treatment of COVID-19 in pregnant women. In our cohort, these were well tolerated with no adverse events. Previously reported median ICU LOS in critically ill pregnant women with COVID-19 was 8 days (range 4-15).1 Our study found a similar ICU LOS (8 days; range 3-17). Patient 1 did not receive remdesivir or CCP until transport to our facility on hospital day 3. Excluding patient 1, median ICU LOS was 6.5 days (range 3-9). Our institution's treatment of pregnant women with critical illness with remdesivir, CCP and dexamethasone combined with delivery in select cases has thus far had good outcomes.
· Combined therapy: remdesivir, CCP, dexamethasone.. · Remdesivir, CCP and dexamethasone was effective in treating critically ill pregnant women with COVID-19.. · No adverse events were associated with combined therapy.. · Delivery improved respiratory status..
关于妊娠期 2019 年冠状病毒病（COVID-19）的治疗，数据有限。阿肯色州在 2020 年 6 月 COVID-19 病例增加。2020 年 5 月 21 日，我们医院收治了首例重症妊娠患者。本研究的目的是评估单一三级保健中心接受瑞德西韦和恢复期血浆（CCP）治疗的重症 COVID-19 孕妇的结局。
这是一项对接受瑞德西韦和 CCP 治疗的重症 COVID-19 孕妇的回顾性观察性研究。本研究得到了机构审查委员会的批准（#261354）。
7 例 COVID-19 孕妇入住重症监护病房（ICU）。所有患者均接受瑞德西韦和 CCP 治疗。6 例接受地塞米松治疗。ICU 住院时间（LOS）中位数为 8 天（范围 3-17）。患者 1 出现多器官衰竭，需要升压药、肾脏透析，并发生宫内胎儿死亡。患者 4 和 6 需要机械通气，因呼吸窘迫分娩，并分别在产后 2 天和 1 天拔管。唯一常见的危险因素是肥胖。瑞德西韦或 CCP 均未出现不良反应。
关于瑞德西韦或 CCP 治疗妊娠期 COVID-19 的数据很少。在我们的队列中，这些药物耐受性良好，无不良反应。以前报告的重症 COVID-19 孕妇 ICU LOS 中位数为 8 天（范围 4-15）。1 我们的研究发现 ICU LOS 相似（8 天；范围 3-17）。患者 1 在入院第 3 天转至我们医院后才接受瑞德西韦或 CCP 治疗。不包括患者 1，ICU LOS 中位数为 6.5 天（范围 3-9）。我们机构对患有严重疾病的孕妇采用瑞德西韦、CCP 和地塞米松联合治疗，并在某些情况下分娩，目前取得了良好的效果。
·联合治疗：瑞德西韦、CCP、地塞米松·瑞德西韦、CCP 和地塞米松联合治疗重症 COVID-19 孕妇有效·联合治疗无不良反应·分娩改善呼吸状况
