The National Hospital for Tropical Diseases in Hanoi successfully treated and discharged on Wednesday a severe COVID-19 patient, who was in her 29th week of pregnancy.

H.T.D., a 26-year-old resident of Hanoi, had poorly responded to COVID-19 treatment at a lower-level hospital, with increasing coughing and difficulty breathing, before being transferred to the National Hospital for Tropical Diseases on July 28.

At the hospital’s emergency department, D. was prescribed high-flow nasal cannula, a type of respiratory support, for two days, but her response remained limited. 

Doctors ordered intubation and mechanical ventilation for D. before transferring her to the intensive care unit on July 29, where the pregnant woman was mechanically ventilated with an endotracheal tube. 

She suffered severe impairment in pulmonary function and tachycardia, or a rapid heartbeat, and depended on vasopressors.

One day later, through examinations and lung ultrasound, doctors diagnosed the patient with a cytokine storm, where the body starts to attack its own cells and tissues rather than just fighting off the virus. 

Doctors prescribed the Oxiris filter set to enable adsorption of cytokines and toxins. 

Obstetricians also closely monitored the fetus every day.

On August 10, doctors gave her emergency tracheostomy at the bed and intensive respiratory care as D. was still on mechanical ventilation.

Due to the woman’s indigestion, nutritionists applied parenteral nutrition to ensure enough nutrients for both her and the child.

On August 19, D. became awake and regained muscle strength after 23 days on mechanical ventilation.

Doctors successfully weaned the patient off the ventilator by replacing it with a nasal cannula and having her practice breathing and movement in bed.

On Wednesday, D.’s health did improve after 28 days of intensive care and seven blood transfusions.

The pregnant woman then tested negative for the coronavirus using the real-time RT-PCR method.

As her fetus was completely healthy, the patient was discharged from the hospital.

Currently, the intensive care unit of the National Hospital for Tropical Diseases is treating 33 serious COVID-19 patients, including 22 cases on mechanical ventilation and six resorting to the support of extracorporeal membrane oxygenation (ECMO).

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