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Published on: June 13, 2021
Predictors of COVID-19 severity among pregnant patients
Marcin Januszewski1, Laura Ziuzia-Januszewska2, Alicja A Jakimiuk3
1Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland.
Insights
Certain biomarkers like C-reactive protein and lymphocytopenia indicate severe COVID-19 in pregnant women. Identifying these markers aids in managing the pandemic
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Critical Care Medicine
Background:
- Coronavirus disease 2019 (COVID-19) pandemic disproportionately affects vulnerable populations, including pregnant women.
- Effective prevention and management strategies are crucial for maternal-fetal health and efficient resource utilization.
- Identifying pregnant women at risk for severe COVID-19 is essential for timely intervention.
Purpose of the Study:
- To identify patient biomarkers on hospital admission that correlate with COVID-19 severity in pregnant women.
- To analyze the relationship between biomarkers and disease course, oxygen requirements, mechanical ventilation, ICU admission, and hospital stay.
- To inform clinical practice and resource allocation for pregnant patients with COVID-19.
Main Methods:
- Retrospective study analyzing 52 pregnant women with PCR-confirmed SARS-CoV-2 infection.
- Assessment of clinical data, symptoms (dyspnea, cough, fever), comorbidities (diabetes, hypertension), and CT scan findings.
- Evaluation of laboratory markers including lymphocytopenia, hypocalcemia, cholesterol, total protein, C-reactive protein, ferritin, interleukin-6, glucose, lactate dehydrogenase, procalcitonin, and troponin I.
Main Results:
- Pregnant women were admitted at a median of 30 gestational weeks, with common symptoms including dyspnea, cough, and fever.
- Diabetes and hypertension were associated with a more severe disease course.
- Lung involvement on CT scans correlated with increased clinical severity.
- Laboratory predictors of severe disease included lymphocytopenia, hypocalcemia, low total cholesterol/protein, and elevated C-reactive protein, ferritin, IL-6, glucose, LDH, procalcitonin, and troponin I.
Conclusions:
- Specific laboratory and imaging findings on admission can predict severe COVID-19 outcomes in pregnant women.
- Biomarkers such as C-reactive protein, ferritin, and lymphocytopenia are key indicators of disease progression.
- Further research with larger cohorts is needed to validate these findings for clinical application in managing pregnant patients with COVID-19.
Abstract:
Coronavirus disease 2019 (COVID-19) was declared a pandemic and has spread around the globe, unsparingly affecting vulnerable populations. Effective prevention measures for pregnant women, who are particularly affected, include early identification of those patients at risk of developing in-hospital complications, and the continuous improvement of maternal-fetal treatment strategies to ensure the efficient use of health resources. The objective of our retrospective study was to determine which patient biomarkers on hospital admission correlate with disease severity as measured by disease course classification, the need for oxygen supplementation and higher demand for oxygen, the need for mechanical ventilation, intensive care unit admission, and length of hospital stay. Analysis of 52 PCR SARS-CoV-2 positive pregnant women revealed that the median date of hospital admission was the 30th gestational week, with dyspnoea, cough, and fever as the leading symptoms. The presence of diabetes and hypertension predisposed pregnant women to the severe course of illness. Lung involvement shown by CT scans on admission correlated with the greater clinical severity. The main laboratory predictors of disease progression were lymphocytopenia, hypocalcemia, low total cholesterol, low total protein levels, and high serum levels of C-reactive protein, ferritin, interleukin-6, glucose, lactate dehydrogenase, procalcitonin, and troponin I. Further research with a larger cohort of pregnant women is needed to determine the utility of these results for everyday practice.
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