Mrs. K, a 27-year-old pregnant woman at 27+4 weeks of gestation, presented to our obstetric emergency unit with tachypnea (RR 28×/min; saturation 92%) one day before admission. The patient also had a fever (103.1 °F) and cough 1 week before admission. Other than that, she also had chronic hypertension. A chest X-ray showed patchy consolidation that corresponded to bilateral pneumonia. A naso-oropharyngeal swab for SARS-CoV-2 was positive as tested by RT-PCR (RdRP Cq 35.15; E Gene Cq 32.10). The patient was taken care of in the High Care Unit (HCU) with oxygen therapy using 10 L per minute (Lpm) with a nonrebreathing mask (NRM), and O2 saturation maintained at 95–97%. She was diagnosed with acute respiratory distress and superimposed preeclampsia with severe features. The patient was treated with anti-hypertension (nifedipine 4 × 10 mg), MgSO4 for seizure prevention, and dexamethasone 2 × 6 mg for lung maturation for 2 days.\nOn hospital care day 2, tachypnea worsened (RR 32×/min), with a decreased O2 saturation to 90% while on oxygen therapy given at 10 Lpm with NRM. The patient had an emergency cesarean section, and a baby girl was born with a birthweight of 1150 g, birth length of 34 cm, and APGAR score (AS) 7/9. The baby was taken care of in the NICU isolation for COVID-19 as a naso-oropharyngeal swab for SARS-CoV-2 result was negative.\nFor postoperative observation, the patient was taken to HCU with no clinical improvement. On hospital care day 7 (HD 7), she was given Remdesivir protocol for 5 days. Tachypnea and saturation improved on HD 8 (RR 24×/min; O2 saturation 96% with NRM 6 Lpm). Both patient and baby were discharged on HD 12 after the SARS-CoV-2 swab came back negative.
Mrs. A, a 35-year-old at 27 weeks gestation, was referred to our institution with a fever (101.3 °F), flu-like syndrome, tachypnea (RR 28×/min; O2 saturation 94% room air), and anosmia. The patient had complained of symptoms for 4 days before admission. A chest X-ray was normal. A naso-oropharyngeal swab was positive for SARS-CoV-2 by real-time PCR (RdRP Cq 15.21; E Gene Cq 15.58) without abnormalities in a chest X-ray.\nThe patient was taken care of in an isolation ward for COVID-19 and given oxygen therapy 4 Lpm with a nasal cannula (saturation 96–97%). Remdesivir was given on HD 1 until HD 6. Daily fetal monitoring was performed using a fetal doppler and fetal kick count chart. During hospitalization, clinical symptoms improved. The patient was discharged after 7 days of hospitalization with a repeated naso-oropharyngeal swab for SARS-CoV-2 result which came back negative. The patient underwent vaginal delivery at 37 weeks gestation. A baby boy was born, 3100 g, 51 cm, A/S 8/9. Both mother and baby were in good condition after delivery.\nRemdesivir Protocol:\nDay 1: 200 mg IV single dose\nDay 2–5: 100 mg IV/daily