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Coronavirus disease 2019 was declared as a pandemic by the WHO on 2020 a novel disease with no confirmed and precise therapeutic agent. Lopinavir/ ritonavir has shown no benefit in 199 COVID-19 hospitalized adult patients compared with standard care alone. Remdesivir has shown promising results in the first case of COVID-19 in the USA, but recent reports were disappointing and still are under more investigation in clinical trials. The arbidol (Umifenovir) and Favipiravir act well in postexposure prophylaxis and viral clearance. Interferons in combination with other antiviral agents, if administered in the early stages of the disease, can cause advantageous effects. Ribavirin is no more recommended in new guidelines. Tocilizumab (Actemra) is an effective treatment in severe patients of COVID-19 and a new therapeutic strategy. Systemic corticosteroids seem to have a great impact in reducing mortality rate in mechanically ventilated patients. There are also some supplementary agents such as vitamin C, A, D, selenium, and zinc that have been reported to be effective in the prevention and treatment of viral infections. Recent findings indicate human recombinant soluble angiotensin-converting enzyme 2, niclosamide, and ivermectin had strong in-vitro results which can lead to fast in-vivo trials and help us to control infection.

Background Bilateral ectopic pregnancy is extremely rare, with a tremendous maternal mortality and morbidity risk, requiring rapid diagnosis and management. This condition is usually diagnosed during surgery, as radiologists may not pay enough attention to the contralateral side of interest. Therefore, reminding of this rare but emergent situation can be beneficial for both radiologists and gynecologists. Here we report a case of bilateral ectopic pregnancy, which was first diagnosed with ultrasound and was confirmed during laparoscopy. Case presentation A 34 years old woman complaining of light vaginal bleeding at 6 weeks of gestation by her last menstrual period presented to our institute. The serum β-HCG levels were analyzed and followed during patient’s admission. Unfortunately, serum levels weren’t decreasing and blood test titration before surgery were as: 851,894,975 IU/l (checked daily and not every 48 h because of patient’s status and being bilateral). There was no evidence of intrauterine pregnancy at the transvaginal ultrasound, but heterogeneous adnexal masses were seen at both adnexa, suspected of bilateral ectopic pregnancy. She underwent laparoscopic exploration, which confirmed the diagnosis. Bilateral salpingostomy was done to preserve fertility, and the patient’s recovery was uneventful. Conclusions Even with a unilateral report of ectopic pregnancy preoperatively in ultrasonography, surgeons should always be aware of the probability of bilateral ectopic pregnancies anytime facing susceptible cases, especially in patients with known risk factors. Also, it is an important reminder for radiologists to check both adnexa when facing a unilateral adnexal mass resembling ectopic pregnancy.