SARS-COV-2 infection during pregnancy, a risk factor for eclampsia or neurological manifestations of COVID-19? Case report

BMC Pregnancy Childbirth. 2020 Oct 6;20(1):587. doi: 10.1186/s12884-020-03275-2.

Abstract

Background: There are no published cases of tonic-clonic seizures and posterior bilateral blindness during pregnancy and Severe Acute Respiratory Syndrome (SARS) Coronavirus (COV) 2 (SARS-COV-2) infection. We do not just face new and unknown manifestations, but also how different patient groups are affected by SARS-COV-2 infection, such as pregnant women. Coronavirus Disease 2019 (COVID-19), preeclampsia, eclampsia and posterior reversible leukoencephalopathy share endothelium damage and similar pathophysiology.

Case presentation: A 35-year-old pregnant woman was admitted for tonic-clonic seizures and SARS-COV-2 infection. She had a normal pregnancy control and no other symptoms before tonic-clonic seizures development. After a Caesarean section (C-section) she developed high blood pressure, and we initiated antihypertensive treatment with labetalol, amlodipine and captopril. Few hours later she developed symptoms of cortical blindness that resolved in 72 h with normal brain computed tomography (CT) angiography.

Conclusion: The authors conclude that SARS COV-2 infection could promote brain endothelial damage and facilitate neurological complications during pregnancy.

Keywords: COVID-19; Case-report; Neurological manifestations; Preeclampsia; Pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antihypertensive Agents / administration & dosage*
  • Betacoronavirus / isolation & purification*
  • Blindness, Cortical* / diagnosis
  • Blindness, Cortical* / virology
  • Brain / diagnostic imaging
  • COVID-19
  • Cesarean Section / methods*
  • Computed Tomography Angiography / methods
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / physiopathology
  • Diagnosis, Differential
  • Eclampsia* / diagnosis
  • Eclampsia* / therapy
  • Eclampsia* / virology
  • Female
  • Fibrinolytic Agents / administration & dosage*
  • Humans
  • Neurologic Examination / methods
  • Pandemics*
  • Pneumonia, Viral* / diagnosis
  • Pneumonia, Viral* / physiopathology
  • Pregnancy
  • Pregnancy Complications, Infectious* / diagnosis
  • Pregnancy Complications, Infectious* / etiology
  • Pregnancy Complications, Infectious* / physiopathology
  • Pregnancy Outcome
  • SARS-CoV-2
  • Seizures* / diagnosis
  • Seizures* / etiology
  • Seizures* / therapy
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • Antihypertensive Agents
  • Fibrinolytic Agents