RESUMEN
Catatonia during pregnancy is rare and presents unique challenges due to the potential ramifications to mom and baby of the overall disease state and of potential treatment options. The purpose of this case report is to highlight the complexities in the workup and management of a catatonic patient with concurrent acute obstetric concerns requiring urgent intervention. We report a case of acute catatonia due to underlying major depressive disorder in a patient who presented in spontaneous preterm labor, with a twin pregnancy of unknown chorionicity with no known prenatal care. She underwent an extensive workup with no significant findings on lumbar puncture, brain MRI, metabolic labs, and EEG. After exclusion of several acute underlying conditions, a presumptive diagnosis of catatonia secondary to exacerbation of underlying major depressive disorder was made. She was transferred to an inpatient psychiatric facility postdelivery and treated with a course of lorazepam, aripiprazole, and escitalopram with good effect.
RESUMEN
This is a descriptive study of pregnant patients who received nirmatrelvir-ritonavir therapy from April 16, 2022, through May 18, 2022. Patients were eligible to receive nirmatrelvir-ritonavir if they were diagnosed with mild-to-moderate coronavirus disease 2019 (COVID-19) with symptom onset within 5 days, did not require oxygen therapy or hospital admission, and had no contraindications to nirmatrelvir-ritonavir. During the study time frame, 11 patients were identified as candidates for nirmatrelvir-ritonavir treatment. All patients agreed to nirmatrelvir-ritonavir treatment after a telehealth consultation; seven patients completed the treatment. All patients who received nirmatrelvir-ritonavir experienced symptom resolution without the need for additional care. All but one patient tolerated nirmatrelvir-ritonavir without immediate adverse effects, and no adverse fetal or neonatal effects were observed.