COVID-19 and HELLP: Overlapping Clinical Pictures in Two Gravid Patients
COVID-19 and HELLP: Overlapping Clinical Pictures in Two Gravid Patients
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DOI：
10.1055/s-0040-1712978
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发表时间：
2020-04-01
期刊：
影响因子：
0.9
通讯作者：
Clare, Camille A.
中科院分区：
文献类型：
--
作者：
Futterman, Itamar;Toaff, Miriam;Clare, Camille A.
严重急性呼吸综合征-冠状病毒2（SARS-CoV-2）对妊娠的影响目前正在调查中。2019年新型冠状病毒病（COVID-19）和溶血、肝酶升高和低血小板综合征（HELLP）的临床表现之间存在显著重叠。患者在妊娠22周和29周时出现疑似COVID-19肺炎。虽然患者在妊娠22周时随后发生宫内胎儿死亡，但患者在妊娠29周时因胎儿状态不安全而通过紧急剖宫产分娩。两名患者还发生了转氨酶升高、血小板减少和弥散性血管内凝血，外周血涂片显示溶血。结论鼓励临床医生在COVID-19大流行期间照顾孕妇时考虑这两种诊断，以确保孕产妇和胎儿的问题得到适当的解决和治疗。
Background The impact of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) on pregnancies is currently under investigation. There is a significant overlap between the clinical findings in novel coronavirus disease 2019 (COVID-19) and hemolysis, elevated liver enzymes, and low platelets syndrome (HELLP). Cases Patients presented at 22 and 29 weeks of gestation with suspected COVID-19 pneumonia. While the patient at 22 weeks of gestation subsequently had an intrauterine fetal demise, the patient at 29 weeks of gestation delivered via an emergency cesarean delivery for nonreassuring fetal status. Both patients also developed transaminitis, thrombocytopenia, and disseminated intravascular coagulation with a proof of hemolysis on peripheral smear. Conclusion Clinicians are encouraged to consider both of these diagnoses when caring for pregnant women during the COVID-19 pandemic to assure that both maternal and fetal concerns are addressed and treated appropriately.