Poor perinatal outcome in a woman with severe pre-eclampsia and asymptomatic COVID-19

Abstract

There is currently little known about the complex interaction between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and pregnancy. Past data from MERS-CoV and SARS-CoV-1 indicated that infection was associated with an adverse neonatal outcome. A 20-year-old primigravida presented at 23 weeks gestation and was found to have severe pre-eclampsia complicated by HELLP syndrome (haemolysis, elevated liver enzymes, low platelets) and acute fatty liver of pregnancy (AFLP). She had no respiratory symptoms and only one documented elevated body temperature from the referring facility. She was subsequently found to be COVID-19 positive. Within several hours of admission, she had an intrauterine demise. Following delivery, her condition steadily improved. COVID-19 may worsen pre-eclampsia leading to an adverse outcome. Obstetricians should be aware of the possible negative impact of COVID-19 on hypertensive disorders of pregnancy and the need for further research on this complex relationship.