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COVID-19 and HELLP: Overlapping Clinical Pictures in Two Gravid Patients
Itamar Futterman1, Miriam Toaff1, Liel Navi1
1Department of Obstetrics and Gynecology, New York Medical College, Valhalla, New York.
Insights
Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) can mimic HELLP syndrome in pregnancy. Pregnant patients with COVID-19 may present with overlapping symptoms, necessitating careful differential diagnosis for optimal maternal and fetal outcomes.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Critical Care Medicine
Background:
- The impact of SARS-CoV-2 on pregnancy is under investigation.
- Clinical findings in COVID-19 overlap with HELLP syndrome.
- Differential diagnosis is crucial for pregnant patients during the pandemic.
Abstract:
Background The impact of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) on pregnancies is currently under investigation. There is a significant overlap between the clinical findings in novel coronavirus disease 2019 (COVID-19) and hemolysis, elevated liver enzymes, and low platelets syndrome (HELLP). Cases Patients presented at 22 and 29 weeks of gestation with suspected COVID-19 pneumonia. While the patient at 22 weeks of gestation subsequently had an intrauterine fetal demise, the patient at 29 weeks of gestation delivered via an emergency cesarean delivery for nonreassuring fetal status. Both patients also developed transaminitis, thrombocytopenia, and disseminated intravascular coagulation with a proof of hemolysis on peripheral smear. Conclusion Clinicians are encouraged to consider both of these diagnoses when caring for pregnant women during the COVID-19 pandemic to assure that both maternal and fetal concerns are addressed and treated appropriately.
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