Features of the course and management of pregnant patients with COVID-19

Abstract

Objective . To assess the effectiveness of the treatment of pregnant patients with moderate COVID-19 pneumonia. Materials and methods . A dynamic prospective study of the course of pregnancy in the second and third trimesters was carried out in 36 female patients with moderate COVID-19 pneumonia undergoing treatment at the Department of Obstetrics and Observation of Gomel City Clinical Hospital No.3. The comparison groups consisted of 30 pregnant patients without COVID-19 and 30 female patients of childbearing age with moderate COVID-19 pneumonia. All pregnant patients with pneumonia received treatment with the antiviral drug «Remdesivir», all non-pregnant patients underwent clinical treatment without antiviral drugs. Results . The study has found no significant differences in the frequency of gynecological and obstetric pathology in the anamnesis between the groups of the pregnant patients. However, the pregnant patients with pneumonia were characterized by comorbidity (anemia, chronic pyelonephritis, obesity). The main clinical symptoms in the patients with pneumonia did not differ significantly and were related to adaptive changes to pregnancy. The pregnant patients with pneumonia showed more rapid normalization of body temperature, oxygen dependence, and laboratory parameters. The remdesivir treatment for pneumonia did not lead to any progression of obstetric complications of pregnancy (thereatened miscarriage, chronic placental insufficiency) or development of any other complications. All the patients were discharged from the hospital with progressing pregnancy. Conclusion . High efficiency of the treatment of pregnant patients with moderate pneumonia using the complex therapy with the antiviral drug «Remdesivir» has been shown. It leads to a rapid enhancement of clinical and laboratory parameters in patients, but does not affect the duration of the treatment. The absence of direct adverse side effects and complications of pregnancy makes it reasonable to use this drug in the complex therapy of moderate pneumonia in the second and third trimesters. It is necessary to continue this study to analyze the long-term treatment results.