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Cytokine Hemoadsorption in the Management of a Pregnant Woman with COVID-19 Pneumonia: Case Report

Here, we discussed a 22-year-old pregnant woman (gestational age: 32 weeks) infected with COVID-19 who presented with fever (39.1 °C) and respiratory symptoms. Thoracic computed tomography could not be obtained due to pregnancy. PCR testing was positive. The patient was treated with supportive care...

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Detalles Bibliográficos
Autores principales: Karabulut Keklik, Esra Sultan, Dal, Hakan, Bozok, Şahin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492132/
https://www.ncbi.nlm.nih.gov/pubmed/32954212
http://dx.doi.org/10.1007/s42399-020-00508-5
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author Karabulut Keklik, Esra Sultan
Dal, Hakan
Bozok, Şahin
author_facet Karabulut Keklik, Esra Sultan
Dal, Hakan
Bozok, Şahin
author_sort Karabulut Keklik, Esra Sultan
collection PubMed
description Here, we discussed a 22-year-old pregnant woman (gestational age: 32 weeks) infected with COVID-19 who presented with fever (39.1 °C) and respiratory symptoms. Thoracic computed tomography could not be obtained due to pregnancy. PCR testing was positive. The patient was treated with supportive care and anti-viral and anti-inflammatory agents; however, general health status deteriorated and patient was admitted to intensive care unit on day 3. After admission to COVID-19 ICU, clinical picture was rapidly worsened with development of respiratory failure and acute respiratory distress syndrome (ARDS). Thus, “extracorporeal cytokine hemoadsorption” (CytoSorb®, Cytosorbents Corporation, Monmouth Junction, NJ, USA) was planned and performed with regular intervals in order to remove inflammatory cytokines from circulation and to relieve systemic inflammatory response. The fever response and CRP elevation were controlled by hemoadsorption and cytokine filter performed in alternate days. On day 7 of ICU admission, it was decided to terminate pregnancy due to worsening hypoxemia and a healthy, premature infant was born. On day 2 after cesarean section, the patient was intubated and mechanical ventilation support was initiated. However, the patient showed an increasingly complicated clinical course and died on day 22 after ICU admission. It is seen that COVID-19 positivity carries an important risk for both mother and fetus, particularly in those at advanced stages of gestation, by physiological changes in the mother during pregnancy. We believe that, in the treatment of COVID-19 and its complications during pregnancy, cytokine filter treatment can give time to patient for hemodynamic and metabolic stabilization.
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spelling pubmed-74921322020-09-16 Cytokine Hemoadsorption in the Management of a Pregnant Woman with COVID-19 Pneumonia: Case Report Karabulut Keklik, Esra Sultan Dal, Hakan Bozok, Şahin SN Compr Clin Med Covid-19 Here, we discussed a 22-year-old pregnant woman (gestational age: 32 weeks) infected with COVID-19 who presented with fever (39.1 °C) and respiratory symptoms. Thoracic computed tomography could not be obtained due to pregnancy. PCR testing was positive. The patient was treated with supportive care and anti-viral and anti-inflammatory agents; however, general health status deteriorated and patient was admitted to intensive care unit on day 3. After admission to COVID-19 ICU, clinical picture was rapidly worsened with development of respiratory failure and acute respiratory distress syndrome (ARDS). Thus, “extracorporeal cytokine hemoadsorption” (CytoSorb®, Cytosorbents Corporation, Monmouth Junction, NJ, USA) was planned and performed with regular intervals in order to remove inflammatory cytokines from circulation and to relieve systemic inflammatory response. The fever response and CRP elevation were controlled by hemoadsorption and cytokine filter performed in alternate days. On day 7 of ICU admission, it was decided to terminate pregnancy due to worsening hypoxemia and a healthy, premature infant was born. On day 2 after cesarean section, the patient was intubated and mechanical ventilation support was initiated. However, the patient showed an increasingly complicated clinical course and died on day 22 after ICU admission. It is seen that COVID-19 positivity carries an important risk for both mother and fetus, particularly in those at advanced stages of gestation, by physiological changes in the mother during pregnancy. We believe that, in the treatment of COVID-19 and its complications during pregnancy, cytokine filter treatment can give time to patient for hemodynamic and metabolic stabilization. Springer International Publishing 2020-09-16 2020 /pmc/articles/PMC7492132/ /pubmed/32954212 http://dx.doi.org/10.1007/s42399-020-00508-5 Text en © Springer Nature Switzerland AG 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Covid-19
Karabulut Keklik, Esra Sultan
Dal, Hakan
Bozok, Şahin
Cytokine Hemoadsorption in the Management of a Pregnant Woman with COVID-19 Pneumonia: Case Report
title Cytokine Hemoadsorption in the Management of a Pregnant Woman with COVID-19 Pneumonia: Case Report
title_full Cytokine Hemoadsorption in the Management of a Pregnant Woman with COVID-19 Pneumonia: Case Report
title_fullStr Cytokine Hemoadsorption in the Management of a Pregnant Woman with COVID-19 Pneumonia: Case Report
title_full_unstemmed Cytokine Hemoadsorption in the Management of a Pregnant Woman with COVID-19 Pneumonia: Case Report
title_short Cytokine Hemoadsorption in the Management of a Pregnant Woman with COVID-19 Pneumonia: Case Report
title_sort cytokine hemoadsorption in the management of a pregnant woman with covid-19 pneumonia: case report
topic Covid-19
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492132/
https://www.ncbi.nlm.nih.gov/pubmed/32954212
http://dx.doi.org/10.1007/s42399-020-00508-5
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