Favorable outcome of the extremely severe course of the new coronavirus infection COVID-19 during pregnancy in the presence of overall lung damage, acute myocarditis, and myocardial infarction


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Background: The new coronavirus infection (NCI) COVID-19 in pregnant women occurs in various types from asymptomatic to extremely severe ones with the development of multiple organ failure and sepsis. SARS-CoV-2 infection occurs at the cellular level through viral binding to angiotensin-converting enzyme 2 (ACE2) receptors, the presence of which in the myocardium and vascular endothelial cells explains the mechanism of severe cardiovascular complications of NCI. The development of the latter has been demonstrated in few studies, whereas favorable outcomes for the mother and fetus in the presence of overall lung damage and acute coronary syndrome have not been reflected in the literature. Case report: The article describes and analyzes the favorable outcome of extremely severe NCI Covid-19 in a pregnant woman with overall lung damage, the development of acute myocarditis and myocardial infarction in the postpartum period. Conclusion: The timely referral of a pregnant woman with extremely severe NCI COVID-19 to the obstetric hospital of an infectious diseases hospital for patients with NCI COVID-19 for specialized medical care using a multidisciplinary approach, as well as the consideration of possible cardiac complications in this disease, their timely diagnosis and correction made it possible to effectively prevent an unfavorable outcome for the mother and fetus.

Full Text

Restricted Access

About the authors

Ekaterina E. Voropaeva

South Ural State Medical University, Ministry of Health of the Russian Federation; Regional Clinical Hospital No. 2, Chelyabinsk

Dr. Med. Sci., Associate Professor, Professor of the Department of Pathological Anatomy and Forensic Medicine

Lyudmila S. Ishchenko

South Ural State Medical University, Ministry of Health of the Russian Federation; Regional Clinical Hospital No. 2, Chelyabinsk

Email: lyudalyn@mail.ru
PhD, Associate Professor, Associate Professor of the Department of Obstetrics and Gynecology

Svetlana A. Mikhailova

South Ural State Medical University, Ministry of Health of the Russian Federation; Regional Clinical Hospital No. 2, Chelyabinsk

Dr. Med. Sci., Chief Physician; Professor of the Department of Faculty Surgery

Demyan I. Aleksandrov

Regional Clinical Hospital No. 2, Chelyabinsk

Email: dema_alex@mail.ru
Head of the Department of Anesthesiology and Resuscitation No. 2

Yulia V. Khaidukova

Regional Clinical Hospital No. 2, Chelyabinsk

Email: jumi.06@mail.ru
Head

Ella A. Kazachkova

South Ural State Medical University, Ministry of Health of the Russian Federation

Email: doctorkel@narod.ru
Dr. Med. Sci., Professor, Professor of the Department of Obstetrics and Gynecology

Evgeny L. Kazachkov

South Ural State Medical University, Ministry of Health of the Russian Federation

Dr. Med. Sci., Professor, Head of the Department of Pathological Anatomy and Forensic Medicine

References

  1. Breslin N., Baptiste C., Guamfi-Bannerman C., Miller R., Martinez R., Bernstein K. et al. Coronavirus disease 19 infection among asymptomatic and symptomatic pregnant women: two weeks of confirmed presentations to an affiliated pair of New York City hospitals. Am. J. Obstet. Gynecol. MFM. 2020; 2(2): 100118. https://dx.doi.org/10.1016/j.ajogmf.2020.100118.
  2. Ghi T., di Pasquo E., Mekinian A., Calza L., Frusca T. Sars-Cov-2 in pregnancy: why is it better than expected? Eur. J. Obstet. Gynecol. Reprod. Biol. 2020; 252: 476-8. https://dx.doi.org/10.1016/j.ejogrb.2020.07.025.
  3. Артымук Н.В., Белокриницкая Т.Е., Филиппов О.С., Шифман Е.М. Новая короновирусная инфекция COVID-19 у беременных Сибири и Дальнего Востока. Вестник интенсивной терапии им. А.И. Салтанова. 2020; 2: 41-8. https://dx.doi.org/10.21320/1818-474X-2020-2-41-48.
  4. Liu D., Li L., Wu X., Zheng D., Wang J., Yang L. et al. Pregnancy and perinatal outcomes of women with coronavirus disease (COVID-19) pneumonia: a preliminary analysis. Am. J. Roentgenol. 2020; 215(1): 127-32. https://dx.doi.org/10.2214/AJR.20.23072.
  5. Dashraath P., Wong J.L.J., Lim M.X.K., Lim L.M., Li S., Biswas A. et al. Coronavirus disease 2019 pandemic and pregnancy. Am. J. Obstet. Gynecol. 2020; 222(6): 521-31. https://dx.doi.org/10.1016/j.ajog.2020.03.021.
  6. Белокриницкая Т.Е., Артымук Н.В., Филиппов О.С., Фролова Н.И. Клиническое течение, материнские и перинатальные исходы новой коронавирусной инфекции COVID-19 у беременных Сибири и Дальнего Востока. Акушерство и гинекология. 2021; 2: 48-54. https://dx.doi.org/10.18565/aig.202L2.48-54.
  7. Воропаев Д.Д., Кошкина А.И. Частота встречаемости различных форм новой коронавирусной инфекции COVID-19 у беременных женщин. В. кн.: Материалы международного молодежного форума «Неделя науки - 2020». Ставрополь; 2020: 12-4.
  8. Jafari M., Pormohammad A., Sheikh Neshin S.A., Ghorbani S., Bose D., Alimohammadi S. et al. Clinical characteristics andoutcomes of pregnant women with COVID-19 and comparison with control patients: A systematic review and meta-analysis. Rev. Med. Virol. 2021; 31(5): 1-16. https://dx.doi.org/10.1002/rmv.2208.
  9. Li M.Y., Li L., Zhang J., Wang X.-S. Expression of the SARS-CoV-2 cell receptor gene ACE2 in a wide variety of human tissues. Infect. Dis. Poverty. 2020; 9(1): 45. https://dx.doi.org/10.1186/s40249-020-00662-x.
  10. Liu K., Fang J.J., Deng J., Liu W., Wang M.-F., Ma J.-P. et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Clin. Med. J. (Engl). 2020; 133(9): 1025-31. https://dx.doi.org/10.1097/CM9.0000000000000744.
  11. Inciardi R.M., Lupi L., Zaccone G., Italia L., Raffo M., TomasoniD. et al. Cardiac involvement in a pacient with COVID-19. J.A.M.A. Cardiol. 2020; 5(7): 819 24. https://dx.doi.org/10.1001/jamacardio.2020.1096
  12. Zeng J.H., Liu Y.X., Yuan J., Wang F.-X., Wu W.-B., Li J.-X. et al. First case of COVID-19 complicated with fulminant myocarditis: a case report and insights. Infection. 2020; 48(5): 773-7. https://dx.doi.org/10.1007/s15010-020-01424-5.
  13. Канорский С.Г. COVID-19 и сердце: прямое и косвенное влияние. Кубанский научный медицинский вестник. 2020; 28(1): 16-31. [Kanorskii S.G. COVID-19 and the heart: direct and indirect impact. Kubanskii nauchnyi meditsinskii vestnik/Kuban Scientific Medical Bulletin. 2020; 28(1): 16-31. (in Russian)]. https://dx.doi.org/10.25207/1608-6228-2021-28-1-16-31.
  14. Методические рекомендации «Организация оказания медицинской помощи беременным, роженицам, родильницам и новорожденным при новой коронавирусной инфекции Covid-19». Версия 2 (утвержденная МЗ РФ май 2020). Доступно по: https://www.garant.ru/products/ipo/prime/doc/74089861/
  15. Временные методические рекомендации. Профилактика, диагностика и лечение новой коронавирусной инфекции (Covid-19). Версия 9. 26.10.2020. Доступно по: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/052/550/original/%D0%9C%D0%A0_COVID-19_%28v9%29.pdf?1603788097
  16. Фавипиравир (Favipiravirum). Доступно по: https://www.rlsnet.ru/mnn_index_id_7093.htm
  17. Еремеева Д.Р., Беженарь В.Ф., Зайнулина М.С., Глоба Ю.С. Патогенез Covid 19. Роль гепаринов в терапии тяжелых состояний у пациентов с Covid-19. Акушерство и гинекология. 2020; 12: 25-33. https://dx.doi.org/10.18565/aig.2020.12.25-33
  18. Маркелов М.И., Безнощенко О.С., Иванец Т.Ю., Пырегов А.В., Есаян Р.М., Гаврилова Т.Ю., Кречетова Л.В. Особенности системы плазменного гемостаза у пациентов с новой коронавирусной инфекцией Covid-19. Акушерство и гинекология. 2020; 9: 138-44. https://dx.doi.org/10.18565/aig.2020.9.138-144.
  19. Panigada M., Bottino N., Tagliabue P., Grasselli G., Novembrino C., Chantarangkul V. et al. Hypercoagulability of Covid-19 pacients in intensive care unit. A report of thromboelastography findings and other parametres of hemostasis. J. Thromb. Haemost. 2020; 18(7): 1738-42. https://dx.doi.org/10.1111/jth.14850.
  20. Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z. et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229): 1054-62. https://dx.doi.org/10.1016/S0140-6736(20)30566-3.
  21. Tang N., Li D., Wang X., Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J. Thromb. Hemost. 2020; 18(4): 844-7. https://dx.doi.org/10.1111/jth14768.
  22. Huan H., Lan Y., Liu R., Liu F., Wu K.-L., Li J. et al. Prominent changes in blood coagulation of patients with SARS-Cov2 infection. Clin. Chem. Lab. Med. 2020; 58(7): 1116-20. https://dx.doi.org/10.1515/cclm-2020-0188.
  23. Буланов А.Ю., Симарова И.Б., Буланова Е.Л., Синявкин Д.О., Феклистов А.Ю., Работинский С.Е., Катрыш С.А. Новая коронавирусная инфекция COVID-19: клиническая и прогностическая значимость оценки фибриногена плазмы. Вестник интенсивной терапии имени А.И. Салтанова. 2020; 4: 42-7.
  24. Ranucci M., Ballotta A., Di Dedda U., Bayshnikova E., Dei Poli M., Resta M. et al. The procoagulant pattern of patients with COVID-19 acute respiratory distress syndrome. J. Thromb. Haemost. 2020; 18(7): 1747-51. https://dx.doi.org/10.1111/jth.14854.
  25. Работинский С.Е., Буланова Е.Л. Патогенетические механизмы развития гипофибриногенемии при COVID-19. Тромбоз, гемостаз и реология. 2021; 1: 26-30.
  26. Babapoor-Farrokhran S., Gill D., Walker J., Rasekhi R.T., Bozorgnia B., Amanullah A. Myocardial injury and COVID-19: possible mechanisms. Life Sci. 2020; 253: 117723. https://dx.doi.org/10.1016/j.lfs.2020.117723.
  27. Руководство по диагностике и лечению болезней системы кровообращения (БСК) в контексте пандемии COVID-19. Доступно по: https://scardio.ru/content/Guidelines/COVID-19.pdf
  28. Галиуллина Ф.Ф., Максумова Н.В. Роль электрокардиографии в ведении пациентов с Covid-19, наблюдения из практики. Дневник Казанской медицинской школы. 2020; 4: 15-9.
  29. Щеголев А.И., Туманова У.Н., Серов В.Н. Поражения плаценты у беременных с SARS-CoV-2-инфекцией. Акушерство и гинекология. 2020; 12: 44-52. https://dx.doi.org/10.18565/aig.2020.12.44-52.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies