December 1st, 2023

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Dexamethasone and Remdesivir for the Mitigation of COVID-19 Symptoms in Pregnant Patients
Authors:  Manuel E. Rivera-Alsina, M.D., FACOG, FAIUM, Suresh J. Antony, M.D., Oscar Vega, M.D., Jacob Garcia, M.D., and Melissa Mendez, M.D., FACOG
  OBJECTIVE: To report a series that involves the use of dexamethasone and remdesivir to mitigate the effects of COVID-19 in pregnancy.

STUDY DESIGN: Patients in our series had moderate to severe disease and met the criteria for hospitalization. All patients had oxygen saturation <95% and chest CT changes compatible with COVID-19. All patients were treated with remdesivir and dexamethasone after extensive counseling and informed consent by the patient. All patients were also treated with low-molecular-weight heparin, and patients with suspected bacterial pneumonia were treated with ceftriaxone. Our objective was to mitigate the effect of COVID-19 and avoid further decompensation of the maternal-fetal unit.

RESULTS: On average, participants were 27.2 years old, the gestational age was 31.0 weeks, gravidity was 3, and BMI was 31.73. None of the patients had a history of diabetes, chronic hypertension, pulmonary disease, or other comorbidities. The average total hospital stay was 7.2 days (range, 6–10 days).

CONCLUSION: Nine pregnant patients hospitalized with moderate to severe COVID-19 were treated with dexamethasone and remdesivir, the use of which has yet to be established in pregnancy. All patients recovered and none displayed any lasting adverse effects from this treatment. None of the patients required anything other than supplemental oxygen at the beginning of their treatment. Patients with suspected bacterial pneumonia were treated with ceftriaxone and showed a good response. There were no cases of coagulopathy or other complications.
Keywords:  antiviral agents, coronavirus infections, COVID-19, dexamethasone, pregnancy, remdesivir, SARS-CoV-2
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