Management of Acute Severe Ulcerative Colitis in a Pregnant Woman With COVID-19 Infection: A Case Report and Review of the Literature

Inflamm Bowel Dis. 2020 Jun 18;26(7):971-973. doi: 10.1093/ibd/izaa109.

Abstract

First detected in Wuhan, China, the novel 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an enveloped RNA beta-coronavirus responsible for an unprecedented, worldwide pandemic caused by COVID-19. Optimal management of immunosuppression in inflammatory bowel disease (IBD) patients with COVID-19 infection currently is based on expert opinion, given the novelty of the infection and the corresponding lack of high-level evidence in patients with immune-mediated conditions. There are limited data regarding IBD patients with COVID-19 and no data regarding early pregnancy in the era of COVID-19. This article describes a patient with acute severe ulcerative colitis (UC) during her first trimester of pregnancy who also has COVID-19. The case presentation is followed by a review of the literature to date on COVID-19 in regard to inflammatory bowel disease and pregnancy, respectively.

Keywords: COVID-19; coronavirus; cyclosporine; inflammatory bowel disease; pregnancy; ulcerative colitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abortion, Spontaneous*
  • Adult
  • Antiviral Agents / administration & dosage
  • Betacoronavirus / isolation & purification
  • C-Reactive Protein / analysis
  • COVID-19
  • COVID-19 Testing
  • Clinical Laboratory Techniques / methods
  • Colitis, Ulcerative* / blood
  • Colitis, Ulcerative* / complications
  • Colitis, Ulcerative* / physiopathology
  • Colitis, Ulcerative* / therapy
  • Coronavirus Infections* / complications
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / physiopathology
  • Coronavirus Infections* / therapy
  • Cyclosporine / administration & dosage*
  • Female
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Methylprednisolone / administration & dosage*
  • Pandemics*
  • Patient Acuity
  • Pneumonia, Viral* / complications
  • Pneumonia, Viral* / physiopathology
  • Pneumonia, Viral* / therapy
  • Pregnancy
  • Pregnancy Complications* / physiopathology
  • Pregnancy Complications* / therapy
  • Remission Induction / methods*
  • SARS-CoV-2
  • Sigmoidoscopy / methods
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Immunosuppressive Agents
  • Cyclosporine
  • C-Reactive Protein
  • Methylprednisolone