中期妊娠合并新型冠状病毒肺炎2例报道

Report of two imported COVID-19 cases in mid-term pregnancy

【目的】研究中期妊娠合并输入性新型冠状病毒肺炎(COVID-19)患者的临床特点。【方法】对2020年3—4月收治于上海市公共卫生临床中心的2例输入性COVID-19病例(均为孕妇)的临床表现、辅助检查、治疗经过等进行回顾性分析。【结果】2例处于妊娠中期的COVID-19患者均为境外输入病例。例1来自美国,无症状;例2来自俄罗斯,有发热、咽痛,少许咳嗽、咳痰,伴有味觉及嗅觉减退症状。入院时的实验室检查结果提示例1白蛋白降低;例2的淋巴细胞计数及百分比降低,C反应蛋白、降钙素原增高,白蛋白降低,血清肌钙蛋白增高,但心电图无异常。2例孕妇肺部CT提示肺部均有病灶。例2因痰培养异常,给予头孢克洛口服。例1和例2分别住院14 d和12 d,2次咽拭子及粪便核酸检测转阴后出院。【结论】中期妊娠合并COVID‑19的普通型患者治疗应以加强孕期监护为主,合理营养支持,适当心理干预,但妊娠结局需进一步随访。

[Objective]To study the clinical characteristics of imported coronavirus disease 2019(COVID-19)cases in pregnancy.[Methods]Two imported COVID-19 cases in pregnancy admitted to Shanghai public health clinical center from March 2020 to April 2020 were retrospectively analyzed.[Results]The two COVID-19 patients were in the second trimester of pregnancy,and were imported cases:case 1 came from the United States and was asymptomatic;case 2 came from Russia,and had fever,sore throat,cough and expectoration,and taste and smell loss.Laboratory testing on admission suggested that the albumin decreased in case 1.In case 2,lymphocyte count and percentage decreased,C-reactive protein and procalcitonin increased,albumin decreased,serum troponin increased,while the electrocardiogram was normal.Chest CT scans of the two cases were abnormal.They were administered with intensive care and nutritional support.Case 2 was treated with cefaclor tablets for 5 days.Case 1 and case 2 were hospitalized for 14 days and 12 days,respectively.They were discharged until twice nasopharyngeal swabs and fecal specimen tested negative for the novel coronavirus nucleic acid.[Conclusion]The treatment for the patients with normal type of COVID-19 in the second trimester of pregnancy is aimed to strengthen the monitoring during pregnancy,which needs nutritional and psychological intervention.However,follow-up of pregnancy outcome is warranted.