Zhou S, Liu MH, Deng XP. Critical respiratory failure due to pregnancy complicated by COVID-19 and bacterial coinfection: A case report. World J Clin Cases 2023; 11(23): 5559-5566 [PMID: 37637702 DOI: 10.12998/wjcc.v11.i23.5559]
Corresponding Author of This Article
Xiao-Peng Deng, MCh, Assistant Professor, Associate Chief Physician, Department of Gynaecology and Obstetrics, Dalian Women and Children’s Medical Group, No. 154 Zhongshan Road, Xigang District, Dalian 116011, Liaoning Province, China. Xiao1001peng@163.com
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 16, 2023; 11(23): 5559-5566 Published online Aug 16, 2023. doi: 10.12998/wjcc.v11.i23.5559
Critical respiratory failure due to pregnancy complicated by COVID-19 and bacterial coinfection: A case report
Shuang Zhou, Mei-Hong Liu, Xiao-Peng Deng
Shuang Zhou, Mei-Hong Liu, Department of Pulmonary and Critical Care Medicine, First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
Xiao-Peng Deng, Department of Gynaecology and Obstetrics, Dalian Women and Children’s Medical Group, Dalian 116011, Liaoning Province, China
Author contributions: Zhou S and Liu MH reviewed the literature and contributed to manuscript writing and interpretation of the clinical data and material; Deng XP was responsible for revising the manuscript for important intellectual content; All authors contributed to the manuscript and approved the final version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient and her parents for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Peng Deng, MCh, Assistant Professor, Associate Chief Physician, Department of Gynaecology and Obstetrics, Dalian Women and Children’s Medical Group, No. 154 Zhongshan Road, Xigang District, Dalian 116011, Liaoning Province, China. Xiao1001peng@163.com
Received: May 10, 2023 Peer-review started: May 10, 2023 First decision: June 19, 2023 Revised: July 2, 2023 Accepted: July 21, 2023 Article in press: July 21, 2023 Published online: August 16, 2023 Processing time: 97 Days and 15.8 Hours
Abstract
BACKGROUND
In the past 3 years, the global pandemic of coronavirus disease 2019 (COVID-19) has posed a great threat to human life and safety. Among the causes of death in COVID-19 patients, combined or secondary bacterial infection is an important factor. As a special group, pregnant women experience varying degrees of change in their immune status, cardiopulmonary function, and anatomical structure during pregnancy, which puts them at higher risk of contracting COVID-19. COVID-19 infection during pregnancy is associated with increased adverse events such as hospitalisation, admission to the intensive care unit, and mechanical ventilation. Therefore, pregnancy combined with coinfection of COVID-19 and bacteria often leads to critical respiratory failure, posing severe challenges in the diagnosis and treatment process.
CASE SUMMARY
We report a case of COVID-19 complicated with Staphylococcus aureus (S. aureus) coinfection in a pregnant woman at 34 wk of gestation. Her rapid progression of pulmonary lesions caused severe respiratory failure, and she received non-invasive ventilator-assisted respiratory treatment. Subsequently, we delivered a foetus via emergency caesarean section after accelerating the maturity of the foetal pulmonary system, and the respiratory condition of the puerperant woman significantly improved after the delivery of the foetus. Lavage fluid was taken under tracheoscopy to quickly search for pathogens by the metagenomic next-generation sequencing (mNGS), and both COVID-19 and S. aureus were detected. After targeted anti-infective treatment, the maternal condition gradually improved, and the patient was discharged from the hospital.
CONCLUSION
The coinfection of pregnancy with COVID-19 and bacteria often leads to critical respiratory failure, which is a great challenge in the process of diagnosis and treatment. It is crucial to choose the right time to deliver the foetus and to quickly find pathogens by mNGS.
Core Tip: Since 2020, coronavirus disease 2019 (COVID-19) has been rapidly spreading worldwide, posing a great threat to the lives of the global population. Approximately 10% to 15% of COVID-19 patients have combined or secondary bacterial infection, and the most common coinfected bacteria are streptococcus pneumoniae (79%). COVID-19 infection during pregnancy is associated with increased adverse events such as hospitalisation, intensive care unit admission, and mechanical ventilation. In this paper, we report a severe case of a 34-wk pregnant woman who was coinfected with COVID-19 and Staphylococcus aureus, leading to respiratory failure.
