Detailed immune monitoring of a pregnant woman with critical Covid-19

N A du Fossé; K Bronsgeest; M S Arbous; M Zlei; S K Myeni; M Kikkert; Jjm van Dongen; Fjt Staal; Mlp van der Hoorn; T van den Akker

doi:10.1016/j.jri.2020.103243

Detailed immune monitoring of a pregnant woman with critical Covid-19

J Reprod Immunol. 2021 Feb:143:103243. doi: 10.1016/j.jri.2020.103243. Epub 2020 Oct 29.

Authors

N A du Fossé¹, K Bronsgeest², M S Arbous³, M Zlei⁴, S K Myeni⁵, M Kikkert³, Jjm van Dongen⁴, Fjt Staal⁴, Mlp van der Hoorn², T van den Akker²

Affiliations

¹ Department of Obstetrics and Gynaecology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands. Electronic address: n.a.du_fosse@lumc.nl.
² Department of Obstetrics and Gynaecology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands.
³ Department of Intensive Care Medicine, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands.
⁴ Department of Immunology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands.
⁵ Department of Medical Microbiology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands.

Abstract

A primigravid woman with Covid-19 related respiratory insufficiency was admitted into a tertiary Intensive Care Unit at 23 3/7 weeks' gestation. Highly sensitive flow cytometry of peripheral leukocytes indicated significantly suppressed naïve T- and B-cell compartments. The suppressed immune cell responses led us keep the initially started administration of corticosteroids for fetal and maternal indication at a low dose. After three weeks her B-cell response peaked, SARS-CoV-2 was cleared and clinical improvement ensued a week later. At 28 weeks' gestation, a son of 1570 g was born by cesarean section. She was extubated two days postpartum and discharged from hospital 5.5 weeks postpartum.

Keywords: Covid-19; Flow cytometry; Immune monitoring; Pregnancy.

Publication types

Case Reports

MeSH terms

Adult
B-Lymphocytes / immunology*
COVID-19 / diagnosis*
COVID-19 / immunology
Cesarean Section
Critical Care
Female
Flow Cytometry
Gravidity
Humans
Immunosuppression Therapy
Pregnancy / immunology*
Pregnancy Complications, Infectious / diagnosis*
Respiratory Insufficiency / diagnosis*
SARS-CoV-2 / physiology*
T-Lymphocytes / immunology*