Severe COVID-19 Infection during Pregnancy Requiring ECMO: Case Report and Review of the Literature

Abstract

The risk of developing severe COVID-19 that requires admission to an intensive care unit (ICU) and invasive ventilation is increased in pregnant women. Extracorporeal membrane oxygenation (ECMO) has been successfully used to manage critical pregnant and peripartum patients. Case Report: A 40-year-old patient, unvaccinated for COVID-19, presented to a tertiary hospital in January 2021 at 23 weeks of gestation due to respiratory distress, cough, and fever. The patient had a confirmed diagnosis of SARS-CoV-2 with a PCR test in a private center 48 hours before. She required admission into the ICU due to respiratory failure. High-flow nasal oxygen therapy, intermittent noninvasive mechanical ventilation (BiPAP), mechanical ventilation, prone positioning, and nitric oxide therapy were administered. Additionally, hypoxemic respiratory failure was diagnosed. Thus, circulatory assistance using ECMO with venovenous access was performed. After 33 days of ICU admission, the patient was transferred to the internal medicine department. She was discharged 45 days after hospital admission. At 37 weeks of gestation, the patient presented active labor and underwent an uneventful vaginal delivery. Conclusions: Severe COVID-19 in pregnancy may lead to the requirement for ECMO administration. This therapy should be administered in specialized hospitals using a multidisciplinary approach. COVID-19 vaccination should be strongly recommended to pregnant women to decrease the risk of severe COVID-19.

Adverse events following COVID-19 vaccination among pregnant women attending primary health centers: An active-surveillance study

“… 1 Evidence shows that pregnant women are at increased risk to develop severe symptoms, hospitalizations, intensive care unit admissions, invasive ventilation, extracorporeal membrane oxygenation, and mortality due to COVID-19. 2 Safe and effective COVID-19 vaccines are a game-changing tool in the battle against COVID-19 infection. Globally, multiple vaccines were launched and shown a wide range of safety and efficacy profiles.…”