Clinical findings, treatments and obstetric results of pregnant women diagnosed with coronavirus disease 2019

Yıl 2021, Cilt: 5 Sayı: 5, 395 - 399, 01.05.2021

Erkan Elçi , Ayşegül Çakmak Gülhan Elçi , Sena Sayan

https://doi.org/10.28982/josam.907597

Öz

Background/Aim: Coronavirus disease 2019 (COVID-19), which causes acute respiratory disease, is an emergency that concerns global public health. Limited data are available on coronavirus disease 2019 in pregnant women. We aimed to evaluate the characteristic features and perinatal results of pregnant women diagnosed with COVID-19.
Methods: This retrospective cohort study was conducted in a Training and Research Hospital. Clinical records and perinatal results of 84 pregnant women and 46 newborns diagnosed with coronavirus disease 2019 in a pandemic hospital on the Asian side of Istanbul between March 29-June 30, 2020, were retrospectively analyzed.
Results: The mean maternal age of the patients was 28.8 (5.6) (17-43) years. The most common symptoms were cough (41.7%), shortness of breath (26.2%), fever (19%), myalgia and malaise (19%). Fifteen percent of patients were in the first trimester, 20.2% were in the second and 64.3% were in the third trimester. Sixty-two percent of the pregnant women were PCR positive and 38.1% had clinical or radiological findings. CT was performed in 27 patients, and lung findings were observed in 23. Among all, 29.8% of the patients received inpatient treatment and 70.2% received outpatient treatment or follow-up. Medical treatment was given to 42.9% of the patients. Sixty percent of the hospitalized pregnant women were admitted to the adult intensive care unit and 3.6% (3/84) resulted in maternal death. Thirteen newborns (28.2%) were admitted to the neonatal intensive care unit. Fever was seen in 6.5% (3/46), dyspnea, in 15.2% (7/46), and pneumonia, in 13% (6/46) of the hospitalized newborns. PCR was performed only in newborns admitted to the neonatal unit. All neonatal PCR tests were negative. Death due to sepsis was seen in 3 newborns.
Conclusion: COVID-19 can cause preterm labor in pregnant women. Lymphocyte, thrombocyte, and CRP values may be useful in clinical follow-up and treatment. PCR positivity decrease and CT findings increase with clinical severity.

Anahtar Kelimeler

COVID-19, Pandemic, Pneumonia, Pregnancy, Pregnancy outcomes, Pregnant women, Preterm birth, SARS-CoV-2, Vertical transmission

Kaynakça

• 1. Littauer EQ, Esser ES, Antao OQ, Vassilieva EV, Compans RW, Skountzou I. H1N1 influenza virus infection results in adverse pregnancy outcomes by disrupting tissue-specific hormonal regulation. PLoS pathogens. 2017;13(11):e1006757.
• 2. Organization WH. Novel coronavirus–China; 12 Jan, 2020. 2020.
• 3. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The lancet. 2020;395(10223):507-13.
• 4. Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. The Lancet infectious diseases. 2020;20(4):425-34.
• 5. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. Jama. 2020;323(11):1061-9.
• 6. Shmakov RG, Prikhodko A, Polushkina E, Shmakova E, Pyregov A, Bychenko V, et al. Clinical course of novel COVID-19 infection in pregnant women. The Journal of Maternal-Fetal & Neonatal Medicine. 2020:1-7.
• 7. Naidu M, PharmD, Sreus AG, Clemens D, FIFT, CFS, FASN, FACN, CNS, FIAFST, Roger A, Pressman M, MS, FACN, Peter, Zaigham B, MD, PhD, Mehreen, Kadkhoda P, SM, Kamran, Davies P, DSc, MAE, FRSC, FRCP, FLS, FRI, Kelvin JA, et al. COVID-19 during Pregnancy and Postpartum: I) Pathobiology of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) at Maternal-Fetal Interface. Journal of Dietary Supplements. 2020:1-28.
• 8. Della Gatta AN, Rizzo R, Pilu G, Simonazzi G. COVID19 during pregnancy: a systematic review of reported cases. American Journal of Obstetrics and Gynecology. 2020.
• 9. Yan J. Mit dieser Frage beschäftigte sich ein chinesisches Forscherteam. Die Wissen-schaftler untersuchten die klinischen Be-sonderheiten von COVID-19 in der.
• 10. Saccone G, Sen C, Di Mascio D, Galindo A, Grünebaum A, Yoshimatsu J, et al. Maternal and perinatal outcomes of pregnant women with. Ultrasound in Obstetrics and Gynecology. 2021;57(2):232-41.
• 11. Yang Z, Wang M, Zhu Z, Liu Y. Coronavirus disease 2019 (COVID-19) and pregnancy: a systematic review. The Journal of Maternal-Fetal & Neonatal Medicine. 2020:1-4.
• 12. Alay I, Yildiz S, Kaya C, Yasar KK, Aydin OA, Karaosmanoglu HK, et al. The clinical findings and outcomes of symptomatic pregnant women diagnosed with or suspected of having coronavirus disease 2019 in a tertiary pandemic hospital in Istanbul, Turkey. Journal of Obstetrics and Gynaecology Research. 2020;46(12):2552-60.
• 13. Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. 2020. April.
• 14. Liu F, Li L, Xu M, Wu J, Luo D, Zhu Y, et al. Prognostic value of interleukin-6, C-reactive protein, and procalcitonin in patients with COVID-19. Journal of Clinical Virology. 2020;127:104370.
• 15. Brandt JS, Hill J, Reddy A, Schuster M, Patrick HS, Rosen T, et al. Epidemiology of coronavirus disease 2019 in pregnancy: risk factors and associations with adverse maternal and neonatal outcomes. American journal of obstetrics and gynecology. 2020.
• 16. Palmieri L, Palmer K, Noce CL, Meli P, Giuliano M, Floridia M, et al. Differences in the clinical characteristics of COVID-19 patients who died in hospital during different phases of the pandemic: national data from Italy. Aging clinical and experimental research. 2020:1-7.
• 17. Thachil J, Tang N, Gando S, Falanga A, Cattaneo M, Levi M, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID‐19. Journal of Thrombosis and Haemostasis. 2020;18(5):1023-6.
• 18. Richtmann R, Torloni MR, Otani ARO, Levi JE, Tobara MC, de Almeida Silva C, et al. Fetal deaths in pregnancies with SARS-CoV-2 infection in Brazil: a case series. Case reports in women's health. 2020;27:e00243.
• 19. Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller A-B, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. The lancet. 2012;379(9832):2162-72.
• 20. Yan J, Guo J, Fan C, Juan J, Yu X, Li J, et al. Coronavirus disease 2019 in pregnant women: a report based on 116 cases. American journal of obstetrics and gynecology. 2020;223(1):111. e1-. e14.
• 21. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The Lancet. 2020;395(10226):809-15.
• 22. Liu Y, Chen H, Tang K, Guo Y. Clinical manifestations and outcome of SARS-CoV-2 infection during pregnancy. The Journal of infection. 2020.
• 23. Mullins E, Evans D, Viner R, O'Brien P, Morris E. Coronavirus in pregnancy and delivery: rapid review. Ultrasound in Obstetrics & Gynecology. 2020;55(5):586-92.
• 24. Mehan A, Venkatesh A, Girish M. COVID‐19 in pregnancy: Risk of adverse neonatal outcomes. Journal of medical virology. 2020;92(11):2295-7.
• 25. Yang H, Hu B, Zhan S, Yang L-Y, Xiong G. Effects of severe acute respiratory syndrome coronavirus 2 infection on pregnant women and their infants. Archives of pathology & laboratory medicine. 2020;144(10):1217-22.
• 26. Breslin N, Baptiste C, Miller R, Fuchs K, Goffman D, Gyamfi-Bannerman C, et al. Coronavirus disease 2019 in pregnancy: early lessons. American journal of obstetrics & gynecology MFM. 2020;2(2):100111.