Adult intensive care unit admissions with severe COVID-19 infection following emergency Caesarean section deliveries: A case series

被引：1

作者：

Morton, Sarah ^{[1
]}

Lamont, Holly ^{[1
]}

Silvey, Natalie ^{[1
]}

Browning, Thomas ^{[1
]}

Hayes, Michelle ^{[1
]}

Keays, Richard ^{[1
]}

Christie, Linsey ^{[1
]}

Davies, Roger ^{[1
]}

Singh, Suveer ^{[1
]}

Lockie, Chris ^{[1
]}

Sisson, Alice ^{[1
]}

Vizcaychipi, Marcela ^{[1
,2
]}

机构：

[1] Chelsea & Westminster Hosp NHS Fdn Trust, Magill Dept Anaesthesia, Adult Intens Care Unit, London, England

[2] Imperial Coll London, Acad Dept Anaesthesia, Chelsea Campus, London, England

[3] Chelsea & Westminster Hosp NHS Fdn Trust, Planned Care Div, London, England

来源：

JOURNAL OF THE INTENSIVE CARE SOCIETY | 2021年 / 22卷 / 04期

关键词：

COVID-19; pregnancy; post-partum; intensive care; respiratory failure; thrombosis; PREGNANCY; WOMEN;

D O I：

10.1177/1751143720947547

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background: UK data suggest 6% of COVID-19 hospital admissions are either currently pregnant or immediately postpartum. However, the current literature suggests that if COVID-19 occurs in pregnancy, or post-partum, symptoms are mostly mild. Methods: All COVID-19 admissions to one acute London National Health Service Foundation trust were reviewed since the beginning of the COVID-19 pandemic to 1 May 2020 to establish whether there were any pregnant or immediately post-partum admissions. Data were extracted from hospital electronic records and anonymised. Any patients admitted to adult intensive care unit had their case notes reviewed in detail and comparison made to a local risk-assessment guideline identifying patients at-risk of thromboembolic events or cytokine storms. Local hospital guidelines were followed. Patients admitted to adult intensive care unit gave written consent. Results: A total of 24 pregnant or immediately post-partum patients with COVID-19 were admitted. Three patients required long adult intensive care unit admissions for severe single-organ respiratory failure after emergency C-sections. Two of these patients required proning (three times and eight times, respectively). All were considered medium risk for thromboembolic events but had rising D-dimers following adult intensive care unit admission, resulting in increased dosing of pharmacological thromboprophylaxis throughout their admission. All were considered low risk for a cytokine storm, and none had any significant cardiovascular or renal involvement. One patient developed a super-imposed fungal lung infection. All three patients developed delirium following cessation of sedation. Conclusion: Pregnant or immediately post-partum women can develop severe COVID-19 symptoms requiring prolonged adult intensive care unit admission. It is likely to be single-organ failure, but patients are at a high risk of a thromboembolic event and delirium.

引用

页码：288 / 299

页数：12

共 28 条

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