Case series of COVID-19 infection in pregnancy complicated by ketoacidosis and symptomatic breathlessness
- Resource Type
- Authors
- Iona Thorne; Samantha Steele; Marcus Martineau; Joanna Girling
- Source
- Obstetric medicine. 15(1)
- Subject
- 2019-20 coronavirus outbreak
Pediatrics
medicine.medical_specialty
Pregnancy
Coronavirus disease 2019 (COVID-19)
business.industry
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Obstetrics and Gynecology
Metabolic acidosis
medicine.disease
Ketoacidosis
medicine
Differential diagnosis
Ketosis
business
- Language
- ISSN
- 1753-495X
Background The differential diagnosis of acute shortness of breath in a pregnant woman with COVID-19 is broad. Pregnancy is a ketosis-prone state, which can result in metabolic acidosis and tachypnoea. Methods We describe four pregnant women with COVID-19 and breathlessness where ketoacidosis was found to contribute to symptomatic tachypnoea. Results One patient did not have associated COVID-19 pneumonitis, but presented with severe tachypnoea and metabolic acidosis; three women had pneumonitis and metabolic acidosis. Corrective treatment for the metabolic abnormalities resulted in resolution of the ketoacidosis in all cases. No women had coexistent diabetes. Conclusion This is the first series of COVID-19 in pregnancy complicated by ketoacidosis and symptomatic tachypnoea. Ketoacidosis associated with COVID-19 is an important cause of tachypnoea requiring specific treatment, which should not be overlooked. Potential mechanisms for this are discussed with a framework for interpretation of blood gas results during pregnancy.