Impact of Middle East Respiratory Syndrome coronavirus (MERS‐CoV) on pregnancy and perinatal outcome

Abstract

BackgroundMiddle East Respiratory Syndrome coronavirus (MERS-CoV) is a viral respiratory disease. Most people infected with MERS-CoV develop severe acute respiratory illness. It was first reported in Saudi Arabia in 2012 and has since spread to several other countries. We report the clinical course of MERS-CoV infection in a pregnant woman who acquired the infection during the last trimester.Case presentationThe patient is a 33-year-old female working as a critical care nurse. She was 32 weeks pregnant when she presented with respiratory symptoms after direct contact with a MERS-COV patient. Although the patient was in respiratory failure, necessitated mechanical ventilation, and intensive care (ICU) admission, a healthy infant was delivered. The mother recovered. To the best of our knowledge, this is the first reported case of a laboratory-confirmed Middle East Respiratory Syndrome Coronavirus in a pregnant woman.ConclusionsMiddle East Respiratory Syndrome coronavirus (MERS-CoV) known to cause severe acute respiratory illness associated with a high risk of mortality Various factors may have contributed to the successful outcome of this patient such as young age, presentation during the last stages of pregnancy, and possible differences in immune response.

Middle East Respiratory Syndrome Coronavirus Infection During Pregnancy: A Report of 5 Cases From Saudi Arabia: Table 1.

“…Our findings of severe disease and death are similar to previous reports of pregnant women with MERS-CoV [4–6]. Other respiratory pathogens, including severe acute respiratory syndrome coronavirus [8] and influenza [9], have also been associated with severe maternal and perinatal outcomes.…”

“…Case reports documenting outcomes among pregnant women infected with MERS-CoV have been previously published, including reports of a stillbirth in Jordan [4], a maternal death in the United Arab Emirates [5], and severe maternal disease with survival of mother and infant reported from Saudi Arabia [6]. To further understand the impact of MERS-CoV infection during pregnancy, we describe 5 additional cases from Saudi Arabia.…”

Coronavirus in pregnancy and delivery: rapid review and expert consensus

“…MERS In pregnant women affected by MERS, 7/11 (63%) were admitted to ICU and CFR was 3/11 (27%) (10)(11)(12)(13)(14)(15). (6).…”

Epidemic and Emerging Coronaviruses (Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome)

“…100 Pregnant women infected with MERS may develop severe disease and a fatal outcome, including stillbirth. [101][102][103][104] Concomitant infections and low albumin were found predictors of severe infection, whereas age greater than or equal to 65 years was the only predictor of increased mortality. 83 Based on data related to human-to-human transmission in several clusters, the incubation period has been estimated to be more than 5 days but could be as long as 2 weeks (median 5.2 days [95% CI, 1.9-14.7]).…”