Background
The novel coronavirus disease 2019 (COVID-19) has been declared as a
‘pandemic outbreak’ and public health emergency of utmost international
concern (1). Over 8.2 million confirmed cases and more than 446,392
deaths (as of 17/06/2020), the pandemic continues to harm significant
number of people worldwide. Approximately, 5% of the infected cases are
complicated by hypoxia and respiratory failure (2). The reported
prevalence of severe pneumonia among Chinese patients was as high as 5%
with an estimated mortality rate of 2.3 – 3.83% (3-5). Partial immune
suppression, physiological and anatomical changes and multiple
interaction with the healthcare system during pregnancy, presents an
unprecedented challenge in managing this vulnerable population (2,6,7).
Previous infectious outbreaks such as, H1N1 influenza virus, Zika virus,
severe acute respiratory syndrome corona virus (SARS-CoV) and Middle
East respiratory syndrome corona virus (MERSCoV) have had significant
adverse impact on maternal as well as perinatal outcomes (6,8). Data
collated from these patients demonstrated higher rates of intensive care
unit admission, intubation, and death compared with non-pregnant
patients (7,9). Anecdotal evidence demonstrates 0.1–0.2% of all
pregnancies are complicated by respiratory failure (10,11).
Till date, no pharmacological intervention has been proven effective to
treat COVID-19. Despite promising outcomes, no high-quality evidence
exists for the safety and efficacy of convalescent plasma in treating
SARS-COV2 infection. Inconclusive, limited clinical experience has been
reported supporting the use ECMO in the management of COVID-19 (12,13).
In the absence of any definitive therapy, the cornerstone of COVID-19
treatment varies from symptomatic ambulatory care management to
intensive care treatment (14).
Over the past decade, the healthcare system in Qatar has transformed to
a world class public health system providing free or highly subsidized
healthcare to all its citizens and residents (15-17). The tiny Arabian
Peninsula is also reported to have one of the lowest COVID-19 fatality
rates in the world estimating less than 0.07% (18).