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

Yıl 2022, Cilt: 3 Sayı: 4, 347 - 353, 26.12.2022
https://doi.org/10.47582/jompac.1208244

Öz

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.

Destekleyen Kurum

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Proje Numarası

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Teşekkür

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Kaynakça

  • Velipaşaoğlu M. Gebelik ve COVID-19. https://www.solunum.org.tr/TusadData/Book/881/ 131020201672-bolum11.pdf
  • Sarı T. Gebelikte COVID-19 hastalığının takip ve tedavisi. Turk J Clin Lab 2021; 4: 458-72.
  • Sahin D, Tanacan A, Erol SA, et al. A pandemic center’s experience of managing pregnant women with COVID-19 infection in Turkey: A prospective cohort study. Int J Gynaecol Obstet 2020; 151: 74-82.
  • Oncel MY, Akın IM, Kanburoglu MK, et al. A multicenter study on epidemiological and clinical characteristics of 125 newborns born to women infected with COVID-19 by Turkish Neonatal Society. Eur J Pediatr 2021; 180: 733-42.
  • Shmakov RG, Prikhodko A, Polushkina E, et al. Clinical course of novel COVID-19 infection in pregnant women. J Maternal-Fetal Neonatal Med 2020; 35: 1-7.
  • Badr DA, Mattern J, Carlin A, et al. Are clinical outcomes worse for pregnant women at ≥20 weeks’ gestation infected with coronavirus disease 2019? A multicenter case-control study with propensity score matching. Am J Obstet Gynecol 2020; 223: 764.
  • Sağlık Bakanlığı, COVID-19 (SARS-COV-2 Enfeksiyonu) Erişkin tedavi rehberi, 31 Temmuz 2020, https://www.ekmud.org.tr/files/uploads/files/COVID-19_Rehberi_Eriskin_Hasta_Tedavisi.pdf
  • Lacroix I, Bénévent J, Damase-Michel C. Chloroquine and hydroxychloroquine during pregnancy: What do we know? Therapie. 2020; 75: 384.
  • 9. Marim F, Karadogan D, Eyuboglu TŞ, et al. Lessons Learned so Far from the Pandemic: A Review on Pregnants and Neonates with COVID-19. Eurasian J Med 2020; 52: 202–10.
  • Thachil J, Tang N, Gando S, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost 2020; 18: 1023-6.
  • Chen H, Guo J, Wang J, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020; 395: 809-15.
  • Mascio DD, Khalil A, Saccone G, et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM 2020; 2: 100107.
  • 13. Pettirosso E , Giles M , Cole S , Rees M. COVID-19 and pregnancy: A review of clinical characteristics, obstetric outcomes and vertical transmission. Aust N Z J Obstet Gynaecol 2020; 60: 640-59.
  • Allotey J, Stallings E, Bonet M, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ 2020; 370: m3320.
  • Rasmussen SA, Kelley CF, Horton JP, Jamieson DJ. Coronavirus disease 2019 (COVID-19) vaccines and pregnancy: What obstetricians need to know. Obstet Gynecol 2021; 137: 408-14.
  • Lefebvre M, Vignier N, Pitard B, et al. COVID-19 vaccines: Frequently asked questions and updated answers. Infect Dis Now 2021; 51: 319–33.

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

Yıl 2022, Cilt: 3 Sayı: 4, 347 - 353, 26.12.2022
https://doi.org/10.47582/jompac.1208244

Öz

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.

Proje Numarası

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Kaynakça

  • Velipaşaoğlu M. Gebelik ve COVID-19. https://www.solunum.org.tr/TusadData/Book/881/ 131020201672-bolum11.pdf
  • Sarı T. Gebelikte COVID-19 hastalığının takip ve tedavisi. Turk J Clin Lab 2021; 4: 458-72.
  • Sahin D, Tanacan A, Erol SA, et al. A pandemic center’s experience of managing pregnant women with COVID-19 infection in Turkey: A prospective cohort study. Int J Gynaecol Obstet 2020; 151: 74-82.
  • Oncel MY, Akın IM, Kanburoglu MK, et al. A multicenter study on epidemiological and clinical characteristics of 125 newborns born to women infected with COVID-19 by Turkish Neonatal Society. Eur J Pediatr 2021; 180: 733-42.
  • Shmakov RG, Prikhodko A, Polushkina E, et al. Clinical course of novel COVID-19 infection in pregnant women. J Maternal-Fetal Neonatal Med 2020; 35: 1-7.
  • Badr DA, Mattern J, Carlin A, et al. Are clinical outcomes worse for pregnant women at ≥20 weeks’ gestation infected with coronavirus disease 2019? A multicenter case-control study with propensity score matching. Am J Obstet Gynecol 2020; 223: 764.
  • Sağlık Bakanlığı, COVID-19 (SARS-COV-2 Enfeksiyonu) Erişkin tedavi rehberi, 31 Temmuz 2020, https://www.ekmud.org.tr/files/uploads/files/COVID-19_Rehberi_Eriskin_Hasta_Tedavisi.pdf
  • Lacroix I, Bénévent J, Damase-Michel C. Chloroquine and hydroxychloroquine during pregnancy: What do we know? Therapie. 2020; 75: 384.
  • 9. Marim F, Karadogan D, Eyuboglu TŞ, et al. Lessons Learned so Far from the Pandemic: A Review on Pregnants and Neonates with COVID-19. Eurasian J Med 2020; 52: 202–10.
  • Thachil J, Tang N, Gando S, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost 2020; 18: 1023-6.
  • Chen H, Guo J, Wang J, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020; 395: 809-15.
  • Mascio DD, Khalil A, Saccone G, et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM 2020; 2: 100107.
  • 13. Pettirosso E , Giles M , Cole S , Rees M. COVID-19 and pregnancy: A review of clinical characteristics, obstetric outcomes and vertical transmission. Aust N Z J Obstet Gynaecol 2020; 60: 640-59.
  • Allotey J, Stallings E, Bonet M, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ 2020; 370: m3320.
  • Rasmussen SA, Kelley CF, Horton JP, Jamieson DJ. Coronavirus disease 2019 (COVID-19) vaccines and pregnancy: What obstetricians need to know. Obstet Gynecol 2021; 137: 408-14.
  • Lefebvre M, Vignier N, Pitard B, et al. COVID-19 vaccines: Frequently asked questions and updated answers. Infect Dis Now 2021; 51: 319–33.
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Research Articles [en] Araştırma Makaleleri [tr]
Yazarlar

Metin Özsoy 0000-0003-1515-8129

Şebnem Erdinç 0000-0003-3918-564X

Salih Cesur 0000-0003-4960-7375

Gunay Tuncer Ertem 0000-0001-8760-0030

Cigdem Ataman Hatipoglu 0000-0002-1104-8232

Sami Kınıklı 0000-0002-9661-7851

Proje Numarası -
Yayımlanma Tarihi 26 Aralık 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 3 Sayı: 4

Kaynak Göster

AMA Özsoy M, Erdinç Ş, Cesur S, Tuncer Ertem G, Ataman Hatipoglu C, Kınıklı S. Exploring clinical and laboratory findings and treatment outcomes in pregnant inpatients with COVID-19: a single-center experience. J Med Palliat Care / JOMPAC / Jompac. Aralık 2022;3(4):347-353. doi:10.47582/jompac.1208244

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