Discussion
A pregnant woman requiring mechanical ventilation was the first case with the clinical symptoms and CT scan of the lungs suggesting infection with coronavirus. Molar pregnancy confirmed in the second trimester increased the risk of developing COVID-19 and complicated her conditions. The patient did not report any underlying diseases. Fever, dry coughs and shortness of breath were observed in the patient as in the case of other patients with COVID-19 reported in the literature (3, 8).
Knowledge about the clinical spectrum of infection with COVID-19 is very limited in molar pregnancy (11). Despite negative test RT-PCR sample results, clinical findings and the CT scan of the lungs suggesting COVID-19 as a life-threatening condition do not interfere with the disease management (1). The overall effects of COVID-19 on pregnancy and neonatal outcomes and its long-term prognosis are recommended to be further investigated in future studies. Collecting the information of more COVID-19 patients with molar pregnancy can lay the foundations for developing clinical guidelines aimed at managing future cases.
AUTHOR CONTRIBUTIONS
All authors have read and approved the manuscript, and en-sure that this is the case. MMH, SB, MZ, MSGM, EMT: involved in patient follow-up and management and final approval of the version to be published.SR, RJG and FA: involved in patient management and writing article, drafted the work, and substantively revised it.AP AND ZAK: involved in patient follow-up and management drafted the work and substantively revised it.
References
1. Liu H, Liu F, Li J, Zhang T, Wang D, Lan W. Clinical and CT imaging features of the COVID-19 pneumonia: Focus on pregnant women and children. Journal of infection. 2020.
2. Liu W, Wang Q, Zhang Q, Chen L, Chen J, Zhang B, et al. Coronavirus disease 2019 (COVID-19) during pregnancy: A case series. 2020.
3. Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, et al. First case of 2019 novel coronavirus in the United States. New England Journal of Medicine. 2020.
4. Liang H, Acharya G. Novel corona virus disease (COVID‐19) in pregnancy: What clinical recommendations to follow? Acta Obstetricia et Gynecologica Scandinavica. 2020;99(4):439-42.
5. Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, et al. Coronavirus disease 2019 (COVID-19): a perspective from China. Radiology. 2020:200490.
6. Mor G, Cardenas I, Abrahams V, Guller S. Inflammation and pregnancy: the role of the immune system at the implantation site. Annals of the New York Academy of Sciences. 2011;1221(1):80.
7. Favre G, Pomar L, Musso D, Baud D. 2019-nCoV epidemic: what about pregnancies? The Lancet. 2020;395(10224):e40.
8. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The Lancet. 2020;395(10226):809-15.
9. Bayefsky MJ, Bartz D, Watson KL. Abortion during the Covid-19 Pandemic—Ensuring Access to an Essential Health Service. New England Journal of Medicine. 2020.
10. Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Translational pediatrics. 2020;9(1):51.
11. Iqbal SN, Overcash R, Mokhtari N, Saeed H, Gold S, Auguste T, et al. An uncomplicated delivery in a patient with COVID-19 in the United States. New England Journal of Medicine. 2020.