A case of severe COVID-19 pneumonia in pregnancy managed with tofacitinib and review of literature

Abstract

The incidence of coronavirus disease (COVID-19) is increasing each day worldwide and its clinico-pharmacological dynamics of it are also changing with time. Pregnant women do also get infected though mostly mild to moderate in nature. To date, there is no specific drug against the severe acute respiratory syndrome coronavirus disease-2 (SARS-CoV-2), more so its drug management in pregnancy in view of adverse maternal and fetal effects. There are different treatment modalities described in the literature. Here, we present a case of severe COVID-19 pneumonia in second trimester pregnancy managed successfully with “off-label” use of tofacitinib along with steroid pulse therapy in preventing her from going to invasive mechanical ventilation and probable catastrophe due to hyperinflammatory syndrome characterised by a surge of cytokines.

Keywords

• covid-19
• cytokine strome
• pneumonia
• teratogenicity
• tofacitinib