COVID-19 tanısıyla yatarak izlenen gebe hastalarda klinik, laboratuvar bulguları ve tedavi sonuçlarının değerlendirilmesi

Abstract

Amaç: Gebelerde COVID-19 infeksiyonunun klinik seyri ve fetüse olan etkilerine ilişkin sınırlı sayıda çalışma mevcuttur. Bu çalışmada, Ankara Eğitim ve Araştırma Hastanesinde, COVID-19 tanısıyla yatarak izlenen toplam 21 gebe hastanın semptomlar, fizik muayene bulguları, laboratuvar bulguları, tedavi sonuçları ve komplikasyonlar açısından değerlendirilmesi amaçlandı. Gereç ve Yöntem: Çalışmaya 22.04.2020 ile 27.09.2021 tarihleri arasında Ankara Eğitim ve Araştırma hastanesinde COVID-19 tanısı revers transkriptaz Polimeraz zincir reaksiyonu (RT-PZR) ile konan toplam 21 gebe hasta dahil edildi. Hastaların semptomları, fizik muayene bulguları,laboratuvar bulguları, uygulanan tedavi sonuçları, gebe ve yenidoğanın sağlık durumları retrospektif olarak değerlendirildi. Bulgular: Çalışmaya dahil edilen 21 gebe hastanın 10’u Türk vatandaşı, 11’i ise yabancı uyruklu bireylerden oluşmaktaydı. Gebelerin yaş aralığı 20-41 yıl arasında, yaş ortalaması 28,76 idi. Gebelerin tamamı aşısızdı. Gebe hastalarda altta yatan hastalıklar değerlendirildiğinde; bir hastada hipertansiyon, 1 hastada tiroid hastalığı mevcuttu. Gebe hastalarda görülen semptomlar sıklık sırasıyla; öksürük (n=10), halsizlik (n=8), boğaz ağrısı (n=6), dispne (n=5) , ateş (n=3), miyalji (n=3), eklem ağrısı (n=1), ve ishaldi (n=1) . Fizik muayenede; 3 hastada 37.4°C üzerinde ateş, bir hastada ise raller mevcuttu. Gebe hastaların biri COVID-19’a bağlı pnömoni nedeniyle yoğun bakım ünitesinde izlendi, hepsi şifa ile taburcu edildi. Gebe hastaların 6’sına klorokin tablet, 4’üne ritonavir (50 mg) ve lopinavir (200 mg) kombinasyonu, birine ise favipiravir başlandı. Gebelerin 9’una sezeryan, 12’sine ise normal doğum uygulandı. Sonuç: Bu çalışmada izlenen gebelerde COVID-19 infeksiyonunun klinik seyrinin hafif olduğunu, biri dışında tüm bebeklerin sağlıklı olarak doğduğunu gözlemledik. COVID-19 infeksiyonuna bağlı olarak gebelerde ve fetüste gelişebilecek komplikasyonların en aza indirilmesi için hastaların yakın takibinin gerekli olduğu düşüncesindeyiz. Ayrıca, gebelere COVID-19 aşısı uygulanması, hastalıktan korunmada önem taşımaktadır.

Keywords

• COVID-19
• gebelik
• yenidoğan
• klinik izlem

Exploring clinical and laboratory findings and treatment outcomes in pregnant inpatients with COVID-19: a single-center experience

Abstract

Aim: The literature seems to miss the clinical course of COVID-19 infection among the pregnant and its effects on the fetus. The present study aimed to evaluate a total of 21 pregnant inpatients in Ankara Training and Research Hospital with the diagnosis of COVID-19 in terms of symptoms, physical examination findings, laboratory findings, treatment results, and complications. Material and Method: A total of 21 pregnant patients diagnosed with COVID-19 by reverse transcriptase polymerase chain reaction (RT-PCR) in Ankara Training and Research Hospital between 22.04.2020 and 27.09.2021 were included in the study. The clinical symptoms, physical examination findings, laboratory findings, and treatment outcomes of the patients, and the health status of the pregnant and newborn were retrospectively evaluated. Results: Of the 21 pregnant patients, 10 were Turkish citizens, and 11 were foreign nationals. The patients were aged 20-41 years with a mean age of 28.76 years. All patients were unvaccinated. Considering underlying diseases among the patients, it was found that one patient had hypertension, and one patient had thyroid disease. In order of frequency, the symptoms in the patients were cough (n =10), fatigue (n=8), sore throat (n=6), dyspnea (n=5), fever (n=3), myalgia (n=3), joint pain (n=1), and diarrhea (n=1). Physical examinations of the patients yielded a fever of 37.4 °C above in 3 patients and rales in one patient. Although one patient with COVID-19 pneumonia was followed up in the intensive care unit, all were discharged upon recovery. Chloroquine tablets were started in 6 patients, a combination of ritonavir (50 mg) and lopinavir (200 mg) in 4 patients, and favipiravir in one patient. Cesarean section was performed in 9 patients, while 12 patients gave normal delivery. Conclusion: Overall, the clinical course of COVID-19 infection in the pregnant followed up in this study was mild, and all newborns were healthy except for one. It is thought that close follow-ups for the pregnant are needed to minimize complications that may develop in them and their fetuses due to COVID-19 infection. Finally, the COVID-19 vaccine seems to be a must for the pregnant to prevent all possible COVID-related complications.

Keywords

• COVID-19
• pregnancy
• newborn
• clinical follow-up

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