38 Pregnant with COVID-19 and acute renal insufficiency attended in a hospital in the Amazon region: Case report

Abstract

Introduction: COVID-19 caused by the infection of the new coronavirus (SARS-COV-2) was recognized by the WHO as a pandemic. With an acute condition, its symptoms are variable and can lead to death. Pregnant women generally have mild symptoms and there is no evidence of vertical transmission, and should receive specialized multidisciplinary assistance,with conditions of safety and isolation. Objective: To report a case of a pregnant woman with COVID-19 and Acute Renal Insufficiency treated at a hospital in the Amazon Region, demonstrating the importance of the correct and early diagnosis to indicate the best therapeutic approach. Methodology: The present work uses a bibliographic research framework, for theoretical basis and to report this case of a pregnant woman with COVID-19 and Acute Renal Insufficiency. Results: DLA, 18 years old, 23s6d, complaints of shortness of breath, weakness, chest pain, vomiting, diarrhea and fever for 3 days, rapid COVID-19 positive test and urinary tract infection. On examination BCF138bpm, FR 19irpm, FC 153bpm, TAX 39.2°C, SAT.O2 96% in room air, hospitalized in respiratory isolation, prescribed azithromycin, ceftriaxone, dexamethasone, acetylcysteine, enoxaparin. Tests urea 85mg/dL and creatinine 3.07mg/dL. On the second day, 131mg/dL urea and 5.01mg/dL creatinine, renal USG: kidneys with increased echogenicity of the parenchyma, slight loss of cortical-medullary relationship, mild bilateral pyelocalytic dilation. Nephrology diagnosed pre-renal insufficiency, maintained oral hydration, potassium replacement, due to hypokalemia (K+ 2.94).She was followed up by obstetrics, medical clinic and nephrology, remaining hemodynamically stable, with antibiotic therapy and improvement of renal function. Hospital discharge on the 9th day for outpatient follow-up. Conclusion: Due to the impact of COVID-19 on pregnancy, differentiated attention is needed from the preventive aspects, diagnosis, management, early treatment and follow-up of these women and their concepts, by a multidisciplinary team to improve the quality of care provided to pregnant women.