Coronavirus Disease 2019 (COVID-19)–Related Multisystem Inflammatory Syndrome in a Pregnant Woman

Gulersen, Moti; Staszewski, Cara; Grayver, Evelina; Tam Tam, Hima; Gottesman, Eric; Isseroff, Donnie; Rochelson, Burton; Bonanno, Clarissa

BACKGROUND: Recent reports have described a rare but severe complication of coronavirus disease 2019 (COVID-19) in nonpregnant adults that is associated with extrapulmonary organ dysfunction and appears to be secondary to a hyperinflammatory state. CASE: A multiparous woman at 28 weeks of gestation, diagnosed with COVID-19 4 weeks prior, was admitted with chest pain. Evaluation indicated myocarditis and marked elevations of inflammatory markers consistent with multisystem inflammatory syndrome in adults. The patient developed cardiogenic shock and required mechanical ventilation. Treatment with intravenous immunoglobulin and high-dose corticosteroids was associated with a favorable maternal and fetal outcome. CONCLUSION: Multisystem inflammatory syndrome in adults associated with COVID-19 in pregnancy is a critical illness, presenting several weeks after initial infection. Treatment with intravenous immunoglobin and corticosteroids was associated with a favorable outcome.