Mihajlovic S, Savic P, Potparevic N, Lackovic M
Department of Obstetrics and Gynecology, University hospital "Dr. Dragisa Misovic", Belgrade, Serbia.
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Hippokratia. 2022 Jan-Mar;26(1):32-37.
Pregnancy poses a risk factor for respiratory infections due to hormonal changes, reduced tolerance to hypoxia, immunodeficiency, and increased susceptibility towards viral infections. Pregnant women might develop a broad spectrum of clinical conditions associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, from asymptomatic to potentially life-threatening complications. Critical respiratory failure associated with the progression of viral pneumonia is the most severe complication of the coronavirus disease (COVID-19). In some cases, it may require intubation and invasive mechanical ventilation.
In this case series, we evaluated the outcomes and clinical features of eight critically ill pregnant patients requiring invasive mechanical ventilation during treatment. The most commonly observed symptoms were fever at admission to the hospital, cough, difficulty breathing, and fatigue. Less frequently observed were sore throat and loss of smell and taste. All patients had anemia, and hypertension was the second most common comorbidity in pregnancy. Pregnant patients with lethal outcomes were older than those who recovered. They had higher body mass index values, more symptoms at admission, and higher C-reactive protein values and ferritin levels. Acute Respiratory Distress Syndrome (ARDS) was diagnosed in five cases, and none of these patients survived.
Obesity, maternal age, and diagnosis of ARDS were most commonly observed in our group of patients with lethal outcomes. Preventive measurements, counseling, and enlightenment of potential risk factors, such as obesity, advanced maternal age, and pregnancy-related comorbidities, should be the cornerstones in crises such as COVID-19 when medical care and resources are limited or restricted. HIPPOKRATIA 2022, 26 (1):32-37.
由于激素变化、对缺氧耐受性降低、免疫缺陷以及对病毒感染易感性增加，妊娠是呼吸道感染的一个风险因素。孕妇可能会出现一系列与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染相关的临床状况，从无症状感染到可能危及生命的并发症。与病毒性肺炎进展相关的严重呼吸衰竭是冠状病毒病（COVID-19）最严重的并发症。在某些情况下，可能需要插管和有创机械通气。
在本病例系列中，我们评估了8例在治疗期间需要有创机械通气的重症孕妇的治疗结果和临床特征。最常见的症状是入院时发热、咳嗽、呼吸困难和疲劳。较少见的症状是咽痛、嗅觉和味觉丧失。所有患者均有贫血，高血压是妊娠第二常见的合并症。死亡的孕妇比康复的孕妇年龄更大。她们的体重指数更高，入院时症状更多，C反应蛋白值和铁蛋白水平更高。5例诊断为急性呼吸窘迫综合征（ARDS），这些患者均未存活。
在我们这组有致命结局的患者中，肥胖、产妇年龄和ARDS诊断最为常见。在医疗护理和资源有限或受限的情况下，如COVID-19疫情期间，对肥胖、高龄产妇和妊娠相关合并症等潜在风险因素的预防措施、咨询和宣传应成为应对危机的基石。《希波克拉底》2022年，第26卷（第1期）：32 - 37页。
