Preterm delivery in pregnant woman with critical COVID-19 pneumonia and vertical transmission

Vertical transmission due to intrauterine infection has not been reported in pregnant women who develop COVID-19 pneumonia in late pregnancy Amniotic fluid and infant PCR test was positive for COVID-19 infection This case study raises concerns again about the possible vertical transmission of COVID-19 in pregnant women infected by SARS-CoV-2, especially in critical case that undergoes pregnancy termination This case report presents the clinical course and management of a 22-year-old female, who was 32-weeks pregnant, presented at emergency clinic of Imam Khomeini Hospital, Sari, Iran, with dyspnea, myalgia, anorexia, nausea, non-productive cough, and fever during the fourth days before Lung auscultation revealed fine rales and absence of breath sounds over the left lower lung zone She had lost her uncle a week before due to COVID-19 pneumonia Given the patient's history and fever and cough, two nasal and throat swab samples were taken and tested to be positive for SARS-CoV-2 with SuperScript III Platinum, Quantitive Real-time PCR system Kits Other laboratory findings included a leukocyte count of 7 80*109/litre, neutrophils of 9 00*109/litre, lymphocytes of 1 00*109/litre, and C-reactive protein of 32 9 mg/litre Serum levels of aminotransferase and normal LDH A routine pregnancy ultrasound showed a fetus with the normal structure of about 30-weeks+2 days of gestational age However, she found fever on March 25 and ultrasonography found no important findings Amikacin added to another drug administrated Her condition dramatically worsened Unfortunately, she died from this critical disease on March 26 at midnight Her neonate nourished with formula and kept away from the mother Third and fourth neonate's PCR test was positive 1 week later, but she was good