Laboratory changes and clinical correlates of disease severity in hospitalized pregnant women with COVID-19
Seyyedeh Neda Kazemi1,2, Hanieh Najafiarab3, Hamidreza Didar4
1Clinical Research Development Center, Imam Hossein Educational Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran.
Insights
Severe COVID-19 in pregnant women is linked to specific lab changes like lymphopenia and anemia. Monitoring these can help identify severe cases and distinguish them from conditions like preeclampsia.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Clinical Pathology
Background:
- COVID-19, caused by SARS-CoV-2, rapidly became a global pandemic.
- Pregnant women represent a vulnerable population with potential for severe disease.
- Understanding laboratory alterations in pregnant COVID-19 patients is crucial for management.
Purpose of the Study:
- To evaluate laboratory changes in pregnant women hospitalized with COVID-19.
- To determine the association between these laboratory findings and disease severity.
Main Methods:
- A cross-sectional study of 59 pregnant women with confirmed COVID-19.
- Data collected from medical records, including clinical signs and laboratory results.
- Analysis categorized by disease severity (mild, moderate, severe).
Main Results:
- Common symptoms included dry cough, fever, fatigue, shortness of breath, and myalgia.
- Disease severity correlated with fever, dyspnea, sore throat, vomiting, myalgia, headache, and fatigue.
- Laboratory markers associated with severe COVID-19 included lymphopenia, anemia, elevated liver enzymes (AST, ALP, LDH), hypoalbuminemia, and proteinuria.
Conclusions:
- Severe COVID-19 in pregnant women is characterized by lymphopenia, anemia, elevated liver enzymes, hypoalbuminemia, and proteinuria.
- These laboratory findings may mimic pregnancy complications such as preeclampsia.
- Monitoring these parameters can assist in identifying severe COVID-19 cases and guiding clinical decisions.
Background:
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan, China, in December 2019 and rapidly spread globally. This study aimed to evaluate laboratory changes in pregnant women hospitalized with COVID-19 and their association with disease severity.
Methods:
This cross-sectional study, conducted from 21 to 30 February November 2020, included 59 pregnant women with reverse-transcriptase-polymerase chain reaction-confirmed COVID-19 at teaching hospitals of Shahid Beheshti University of Medical Sciences. Clinical signs and laboratory findings were extracted from medical records, categorized by disease severity (mild, moderate, and severe), and analyzed using GraphPad Prism (version 8).
Results:
Main reasons for admission included possible ICU need due to severe symptoms (n = 13), labor pain (n = 10), and premature rupture of membranes (n = 6). Common symptoms were dry cough (n = 58), fever (n = 40), fatigue (n = 40), shortness of breath (n = 39), and myalgia (n = 38). COVID-19 severity was significantly associated with fever, dyspnea, sore throat, vomiting, myalgia, headache, and fatigue. Laboratory findings linked to increased severity included lower initial, minimum, and average lymphocyte counts (P = 0.007, 0.006, 0.052, respectively), lymphopenia (P = 0.005), anemia (P = 0.01), elevated prothrombin time (P = 0.001), aspartate aminotransferase (P < 0.05), alkaline phosphatase (P < 0.05), lactate dehydrogenase (P < 0.05), direct bilirubin, hypoalbuminemia, and elevated 24-hour urine protein.
Conclusions:
Severe COVID-19 in pregnant women is associated with lymphopenia, anemia, elevated liver enzymes, hypoalbuminemia, and proteinuria, which can mimic pregnancy complications like preeclampsia. These findings suggest that monitoring these laboratory parameters may aid in identifying severe cases and differentiating them from pregnancy-related conditions, guiding timely clinical management.
Related Concept Videos
01:30Pneumonia III: Complications and Assessment
01:29Pneumonia II: Pathophysiology
01:18Factors Affecting Illness
For instance, risk factors are connected to illness,...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
01:20COPD: Pathogenesis and Clinical Features
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
01:19Pericarditis II: Clinical Features and Diagnostic Tests