Gebe olan ve gebe olmayan kadınlarda COVID-19'un klinik seyri

Abstract

Amaç: Gebelik, kadınları viral enfeksiyonların solunum yolu komplikasyonlarına yatkınlaştıran ve böylece daha şiddetli hastalık geliştirme riskini getiren fizyolojik bir durumdur. Bu araştırmanın amacı, çocuk doğurma çağındaki gebe olan ve gebe olmayan kadınlarda COVID-19'un klinik seyrini araştırmaktı. Her iki grupta mortalite hızı, laboratuvar parametreleri, sitokin fırtınası oluşumu ve tedaviye yanıt araştırıldı. Gereç ve Yöntemler: COVID-19 hastalığı tanısı almış doğurganlık çağındaki toplam 88 kadın hastanın dosyası retrospektif olarak incelendi. Hastaların yaşı, ek hastalıkları, yoğun bakımda kalış süreleri ve tedavi rejimleri hastane veri tabanından elde edildi. Ferritin, IL-6, CRP, prokalsitonin, D-dimer, üre, kreatinin, GFR, ALT, AST, LDH, lenfosit sayısı, nötrofil sayısı, beyaz küre sayısı değerlendirildi. Tedavi öncesi ve sonrası oksijen ihtiyacında azalma ve vazopresör kullanımı gibi klinik yanıtlar incelendi. Bulgular: Gebelerde RT – PCR pozitif sonuç oranı istatistiksel olarak anlamlı derecede yüksekti (p=0,003). Gebe hastaların medyan WBC, lenfosit ve lökosit değerleri daha yüksekti (sırasıyla, p=0,038, p=0,006 ve p=0,035). Gebelerin medyan hemoglobin, LDH ve ferritin değerleri gebe olmayanlara göre daha düşüktü (sırasıyla p=0,032, p<0,001 ve p=0,010). İkinci trimesterde %17,5, üçüncü trimesterde %15 ölüm oranı gözlenirken, ikinci trimesterde kadınların %22,5'i ve üçüncü trimesterde kadınların %45'i COVID-19 enfeksiyonundan kurtuldu. Sonuç: Bu çalışmanın sonuçlarına bakıldığında, gebe olan ve gebe olmayan hastalar arasında WBC, lenfosit, lökosit, medyan hemoglobin, LDH ve ferritin değerlerinde farklılıklar gözlemlendi. Ek olarak, karşılaştırılabilir ölüm oranı da vardı.

Keywords

• COVID-19
• D-dimer
• Gebelik
• Mortalite

The clinical course of COVID-19 in pregnant and non-pregnant women

Abstract

Aims: Pregnancy is a physiological condition that predisposes women to respiratory complications of viral infections thus, bringing the risk of developing more severe disease. The aim of this research was to elucidate the clinical course of COVID-19 in pregnant and non-pregnant women of childbearing age. Mortality rate, laboratory parameters, the occurence of cytokine storm in both groups and the response to treatment have been investigated. Methods: A total of 88 women of childbearing age with a diagnosis of COVID-19 disease has been retrospectively analyzed. Age, comorbidity, length of stay in the intensive care unit and treatment regimen of patients have been obtained from hospital database. Ferritin, IL-6, CRP, procalcitonin, D-dimer, urea, creatinine, GFR, ALT, AST, LDH, lymphocyte count, neutrophil count, white blood cell count were evaluated. Clinical response such as reduction in oxygen requirement and vasopressor utilization before and after treatment were examined Results: The rate of RT - PCR positive results were statistical significantly higher in pregnant women (p=0.003). The median WBC, lymphocyte and leukocyte values of the pregnant patients were higher (p=0.038, p=0.006 and p=0.035, respectively). The median hemoglobin, LDH and ferritin values of pregnant women were lower than those of non-pregnant individuals (p=0.032, p<0.001 and p=0.010, respectively). Mortality has been observed wit a rate of 17.5% in second trimester and 15% in the third trimester while 22.5% of women in the second trimester and 45% of women in the third trimester have survived COVID-19 infection. Conclusion: Regarding the results of this study, we have observed differences in WBC, lymphocyte and leukocyte, median hemoglobin, LDH and ferritin values of pregnant women and non-pregnant individuals. Additionally, mortality rate was also comparable.

Keywords

• COVID-19
• pregnancy
• mortality
• D-dimer

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