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      Impact of Middle East Respiratory Syndrome coronavirus (MERS CoV) on pregnancy and perinatal outcome

      case-report

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          Abstract

          Background

          Middle East Respiratory Syndrome coronavirus (MERS-CoV) is a viral respiratory disease. Most people infected with MERS-CoV develop severe acute respiratory illness. It was first reported in Saudi Arabia in 2012 and has since spread to several other countries. We report the clinical course of MERS-CoV infection in a pregnant woman who acquired the infection during the last trimester.

          Case presentation

          The patient is a 33-year-old female working as a critical care nurse. She was 32 weeks pregnant when she presented with respiratory symptoms after direct contact with a MERS-COV patient. Although the patient was in respiratory failure, necessitated mechanical ventilation, and intensive care (ICU) admission, a healthy infant was delivered. The mother recovered. To the best of our knowledge, this is the first reported case of a laboratory-confirmed Middle East Respiratory Syndrome Coronavirus in a pregnant woman.

          Conclusions

          Middle East Respiratory Syndrome coronavirus (MERS-CoV) known to cause severe acute respiratory illness associated with a high risk of mortality Various factors may have contributed to the successful outcome of this patient such as young age, presentation during the last stages of pregnancy, and possible differences in immune response.

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          Most cited references7

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          A case‐controlled study comparing clinical course and outcomes of pregnant and non‐pregnant women with severe acute respiratory syndrome

          Objective  To compare the clinical courses and outcomes of pregnant severe acute respiratory syndrome (SARS) patients and non‐pregnant SARS patients. Design  A case–control study. Setting  Tertiary Hospital for Infectious Disease. Sample  Ten pregnant and 40 non‐pregnant female patients infected with SARS. Methods  Clinical course and outcomes of pregnant SARS patients were compared with a group of non‐pregnant SARS patient. Cases and controls were matched with respect to sex, age, timing of contracting SARS, health care workers status and underlying illness. Main outcome measures  The incidence of intensive care unit admission, intubation, medical complications and death rate. Results  Pregnancy had no discernible impact on clinical symptoms and presentation delay. Four out of the 10 pregnant patients, nevertheless, required endotracheal intubation and six were admitted to the intensive care unit (ICU), as compared with 12.5% intubation rate (P= 0.065) and 17.5% ICU admission rate (P= 0.012) in the non‐pregnant group. More pregnant SARS patients developed renal failure (P= 0.006) and disseminated intravascular coagulopathy (P= 0.006), as compared with non‐pregnant SARS group. There were three deaths in the pregnant group, whereas there was no death in the non‐pregnant control group (P= 0.006). Conclusion  Pregnant women with SARS experience a worse clinical course and poorer outcomes compared with non‐pregnant women.
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            Stillbirth During Infection With Middle East Respiratory Syndrome Coronavirus

            Abstract We conducted an epidemiologic investigation among survivors of an outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Jordan. A second-trimester stillbirth occurred during the course of an acute respiratory illness that was attributed to MERS-CoV on the basis of exposure history and positive results of MERS-CoV serologic testing. This is the first occurrence of stillbirth during an infection with MERS-CoV and may have bearing upon the surveillance and management of pregnant women in settings of unexplained respiratory illness potentially due to MERS-CoV. Future prospective investigations of MERS-CoV should ascertain pregnancy status and obtain further pregnancy-related data, including biological specimens for confirmatory testing.
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              The effect of Asian influenza on the outcome of pregnancy, Baltimore, 1957-1958.

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                Author and article information

                Contributors
                +966-12-6677777 , dr_al_serihi@hotmail.com
                GWali@kfshrc.edu.sa
                aalshukairi@kfshrc.edu.sa
                balraddadi@kfshrc.edu.sa
                Journal
                BMC Infect Dis
                BMC Infect. Dis
                BMC Infectious Diseases
                BioMed Central (London )
                1471-2334
                2 March 2016
                2 March 2016
                2016
                : 16
                : 105
                Affiliations
                [ ]Division of Infectious Diseases, Department of Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah, Kingdom of Saudi Arabia
                [ ]King Faisal Specialist Hospital and Research Centre, P.O BOX 40047, Jeddah, 21499 Saudi Arabia
                Article
                1437
                10.1186/s12879-016-1437-y
                4776369
                26936356
                f8407b42-59b8-4e3a-9894-a8c6701c5277
                © Alserehi et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 8 September 2015
                : 16 February 2016
                Funding
                Funded by: FundRef http://dx.doi.org/http://dx.doi.org/10.13039/501100002382, King Faisal Specialist Hospital and Research Centre (SA);
                Categories
                Case Report
                Custom metadata
                © The Author(s) 2016

                Infectious disease & Microbiology
                mers-cov,pregnancy,ards,perinatal outcome
                Infectious disease & Microbiology
                mers-cov, pregnancy, ards, perinatal outcome

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