A 34-Year-Old Woman with a Diamniotic Dichorionic Twin Pregnancy Presenting with an Erythematous and Papular Skin Rash Associated with SARS-CoV-2 Infection

Abstract

BACKGROUND The damage caused by the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) has been extensive. Pregnant women are a group requiring special attention in medicine given the anatomical and physiological changes that occur during pregnancy. Skin rash is commonly associated with pregnancy, with the most common form of an erythematous maculopapular rash being pruritic urticarial papules and plaques of pregnancy. Skin rash is also an increasingly reported initial presentation in patients with coronavirus disease 2019 (COVID-19), due to infection with SARS-CoV-2. CASE REPORT A 34-year-old woman with a diamniotic dichorionic twin pregnancy presented with clinical picture characterized by dermatological manifestations, namely an erythematous and papular skin rash associated with SARS-CoV-2 infection. A real-time reverse transcription-polymerase chain reaction (GeneFinder) test was positive for SARS-CoV-2 detection. CONCLUSIONS Ten months after the onset of this pandemic, there is no conclusive evidence indicating that pregnant women represent a sector more or less vulnerable to severe forms of COVID-19 than the general population. This report has highlighted the importance of performing a reliable diagnostic test for SARS-CoV-2 infection in patients who present with a skin rash, particularly pregnant women.

Figure 1.

Disseminated dermatosis is observed predominantly in the (A) abdomen and (B) anterior thighs characterized by a maculopapular rash with an erythematous base, related to acute SARS-CoV-2 infection in a pregnant patient.

Figure 2.

Doppler ultrasound showing diamniotic dichorionic pregnancy. It is important to note that the middle cerebral artery and the umbilical artery have normal values of pulsatility index and flow present in diastole, which translates into adequate transplacental flow. (A) twin 1; (B) twin 2.