‘Miracle Mateo’: How critically ill, pregnant woman and her baby survived COVID-19
Katrina and her newborn, Mateo, shouldn’t be alive.
But they survived Katrina’s intensive care stay with COVID-19 pneumonia and respiratory failure 31 weeks into her pregnancy.
“This is Miracle Mateo,” 39-year-old Katrina said while cuddling the tiny infant. She asked that her last name not be used due to concerns about mistreatment on social media.
She attributes being alive to her faith and her Kaiser Modesto medical care. “The nurses did an amazing job. They put their love, their heart and time into making me better,” Katrina said.
The medical professionals also incorporated technology, teamwork and requests for divine intervention into her care.
“We were all so worried about Katrina and the baby. We were doing everything, working with the ICU team and praying for her,” said Lorena Acevedo, nurse and director of maternal and child health at Kaiser Modesto Medical Center.
Against all odds, the combination worked.
‘Staying safe’ didn’t protect family
Before COVID-19 changed her life, Katrina was an in-home caregiver and self-described “glue that holds the family together.” Her household in Stockton had nine other people, including her life partner, Johnny, their three children, her mother and her brother, Larry, with his family of three.
“We were staying safe. I only went to the grocery,” said Katrina.
She said 41-year-old Larry had poor health, including diabetes. He was fighting a foot infection that wouldn’t heal. In mid-January, his doctors decided he needed surgery for his foot and he was admitted to a hospital in Stockton. His COVID-19 test at admission was negative. After surgery, Larry was discharged with home intravenous antibiotics, but he wasn’t getting better.
Katrina recalled at the end of January, she and her mother started having flu-like symptoms, including coughing and weariness, but they thought it was allergies. They were sure it wasn’t COVID because Larry’s test was negative.
Larry got worse and on Jan. 29 suffered cardiac arrest in their living room. He was taken by ambulance to the hospital, and about two hours later, Katrina got a call that he had tested positive for the coronavirus.
Larry died Feb. 1.
Everyone in the house tested positive for the coronavirus. They got better, but not Katrina. She said, “At that point, I was starting to feel worse.”
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Pregnant women are at higher risk for complications with COVID-19, similar to immunocompromised individuals and the elderly, according the the Centers for Disease Control and Prevention.
Though she already had COVID-19, Katrina said she was afraid to go to the hospital, thinking conditions there could worsen her illness. She borrowed an oximeter to monitor her oxygen levels, as suggested by doctors.
On Feb. 4, Katrina was having difficulty breathing, and her oxygen level dropped to 88%, less than the normal 94% to 100%.. The COVID Helpline doctor told her to go to Kaiser Manteca right away. Upon arrival, she was given oxygen and transported to the Kaiser Modesto hospital for a higher level care for a pregnant patient.
“I didn’t even say goodbye to my kids or to my other half,” Katrina said. “I was confident, confident that I was going to be OK.”
She had just lost her only brother and couldn’t leave her mother alone, so she promised her she would pull through.
The doctors weren’t so certain.
A crushing message for her partner
“She was our sickest patient,” said Dr. Jane Brady, “She was our only pregnant, intubated due to COVID, patient. We were all scared for her.”
Brady is the chief of obstetrics and gynecology at Kaiser Modesto. She had cared for Katrina during her first pregnancy with her now 4-year-old son and again during this hospitalization.
Pregnant at 31 weeks, Katrina had COVID pneumonia. With worsening lungs, she required support from a ventilator and was placed in a medically induced coma.
Katrina said, “They had no plans to deliver the baby (unless) my heart stopped.”
She does not remember any events after being intubated.
The ICU team of doctors, nurses and respiratory therapists worked closely with the maternal child health teams, which include the OB/GYN doctors and the neonatal intensive care unit (NICU) team, to coordinate care for Katrina and her unborn baby.
“We were concerned about the obstetrical aspect of her stay. We had a nurse monitoring the baby 24 hours a day,” said Acevedo.
The maternal child health team helped the ICU team place Katrina face down while on the ventilator, which is extra challenging during pregnancy. But prone positioning has proven to result in higher oxygen levels for patients with COVID pneumonia.
Katrina said she recently was listening to old voicemails and heard this message her ICU doctor left for Johnny, “She’s on her stomach. She’s not doing too good. I’m not sure she’s going to make it through the night.”
Born in the ICU
Because Katrina was so critical, the doctors knew that if the baby needed to be delivered, she wasn’t stable enough to transfer to the operating room for a Cesarean section. So they practiced a mock C-section in Katrina’s ICU room.
“We did simulations to prepare not only the ICU team, but our OB and NICU teams, so we could come together in a tight space,” Acevedo said.
Her ICU room had to accommodate 12 medical professionals, including the ICU team, the obstetrics surgical team, anesthesiology, a respiratory therapist, the NICU team and the additional surgical equipment needed for a C-section, while maintaining COVID-19 precautions.
An ICU bay generally has space for one patient with a bed, ventilator, and monitoring equipment with two or three medical providers. They aren’t designed to be an operating suite.
Their practices paid off, because the feared worst-case scenario happened.
“About three or four days after she was intubated, the baby showed signs of distress,” Brady said.
Overnight on Feb. 11, the fetal heart monitor showed the baby was in trouble and he had to be delivered immediately.
“They were able to get the baby out in less than five minutes,” Acevedo said. “Mateo came out screaming. Both he and mom did very well from the C-section in her room.”
Mateo was born early the morning of Feb. 12. “I had no idea that I gave birth, none at all,” Katrina said.
Her baby was handed to a second NICU team in clean, COVID-free personal protective equipment waiting outside of the room, and then taken to the NICU. He required ventilator support for only two days.
Brady thinks the steroids given to Katrina for her COVID pneumonia likely helped Mateo’s immature lungs prepare for breathing on their own.
Mom and baby recovering
Katrina required ventilator support for almost two weeks. Her hospital course was complicated with Guillain Barre syndrome, a rare condition that happens when a person’s immune system attacks the nerve fibers. It’s be associated with infections, including the SARS-CoV-2 coronavirus.
Katrina was hospitalized for four weeks. The Guillain Barre worsened her weakness from COVID-19 and she required physical therapy, including at home after discharge.
Although she is recovering, she has lingering symptoms, including weakness in her arms, poor appetite and hair loss.
“Things are a lot better,” Katrina said. “I think I’m about 90% back to my normal activities.”
She said she challenged herself to get her strength back quickly because she has four little ones who need her.
Mateo also stayed in the hospital four weeks, which is typical for an infant as premature as he. He has a small heart murmur, which is not expected to impact his health long term.
“Mateo is growing; he’s already 12 pounds,” said Katrina, nuzzling him during the interview.
She said her three older boys are madly in love with Mateo and are very protective of him, and of her. She also knows they miss their uncle.
Pregnant? Consider vaccination
“I want everybody to know the coronavirus is real. It’s not a joke,” Katrina said. “Everybody protect themselves and if you’re pregnant, take extra precautions.”
She also made a plea for everyone to read vaccine information from legitimate sources and to get vaccinated.
Tearfully, she said, “I’m going to get it because look at what we’ve been through. I lost my only brother.”
Her medical providers shared her message.
“We follow the American College of Obstetrics and Gynecology and the Society of Maternal and Fetal Medicine recommendations, both of which do recommend (COVID) vaccines in pregnancy,” Brady said.
Those two professional organizations recommend that pregnant women have access to vaccines because of the increased risk of severe COVID-19 during pregnancy.
“We want you to be healthy when you come in to have your baby and not have to go through what Katrina had to go through,” Acevedo said.
Katrina and Mateo exceeded everyone’s expectations, not just for surviving, but in how well they are both doing in their recovery just three months later.
“I told my family when I came home that I don’t care what happened yesterday, just what happens today. It could’ve been so much worse,” Katrina said, “ If I’m healthy and happy, that’s all that matters.”
This story was produced with financial support from The Stanislaus County Office of Education and the Stanislaus Community Foundation, along with the GroundTruth Project’s Report for America initiative. The Modesto Bee maintains full editorial control of this work. To help fund The Bee’s children’s health and economic development reporters with Report for America, go to bitly.com/ModbeeRFA.
