Clinical and laboratory characteristics of COVID-19 in pregnant women

Marynchak, Oleksandra Vasulivna; ,; Pryshliak, Oleksandra Yaroslavivna; ,; Kondryn, Oksana Yevgenivna; ,; Hryzhak, Ihor Hnatovych; ,; Henyk, Natalia Ivanivna; ,; Makarchuk, Oksana Mykhailivna; ,; Golovchak, Igor Stepanovych; ,; Boichuk, Oleksandr Petrovych; ,; Protsyk, Andriy Liubomyrovych; ,; Prokofiev, Mykola Valeriiovych; ,

doi:10.25122/jml-2023-0044

JMedLife

2023

DOI: 10.25122/jml-2023-0044

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Clinical and laboratory characteristics of COVID-19 in pregnant women

Oleksandra Vasulivna Marynchak,

Oleksandra Yaroslavivna Pryshliak,

Oksana Yevgenivna Kondryn

et al.

Abstract: This article discusses the distinct characteristics of COVID-19 in pregnant women and investigates potential early predictors of disease severity in this specific patient population. The study included 116 pregnant women with a confirmed diagnosis of COVID-19 in different trimesters of pregnancy. In addition to clinical features, we evaluated general clinical research methods, biochemical parameters (procalcitonin, C-reactive protein, D-dimer), and the leukocyte index of endogenous intoxication and lymphocytic… Show more

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Cited by 4 publications

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Hemostatic imbalance underlying preterm delivery in COVID-19 convalescent patients

Nikolaeva,

Korchagina,

Momot

et al. 2023

Akušerstvo, ginekologiâ i reprodukciâ

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Aim: to study the role of the hemostatic system in pretem delivery in pregnant women who have had COVID-19 in the gestation period from 14 to 16 weeks.Materials and Methods. A prospective single-center observational study was conducted by enrolling 63 pregnant women with verified COVID-19 at 14–16 weeks of gestation. The main group consisted of 37 patients with preterm birth (PB), comparison group – 26 patients labour activity that occurred at least at gestational age of 37 weeks. Clinical and anamnestic data and dynamic changes in fibrinogen and D-dimer level, activity of tissue factor (TF), tissue factor pathway inhibitor (TFPI), plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator (t-PA), urokinase plasminogen activator (u-PA) were analyzed; thrombin generation assay (TGA) was performed.Results. It was found that severity of COVID-19 infection did not determine the timing of delivery that depended on patient comorbid condition. All PB observations (37 out of 63, 58.7 %) were caused by decompensated placental function manifested by acute obstetrical complications: increasing intrauterine fetal hypoxia (64.9 %) along with intrauterine growth retardation (51.4 %), severe preeclampsia (13.5 %) and premature abruption of the normally located placenta (5.0 %). In both study groups, COVID-19 experienced at 14–16 weeks of pregnancy was associated with coagulation and fibrinolytic imbalances. At the same time, at least 6 weeks post-COVID-19 infection, patients with PB had higher level of the “Peak thrombin” vs. comparison group (3050 vs. 2527 pmol/L; p = 0.0433). Also, patients with term vs. preterm delivery had TF activity decreased significantly: by 47.1% and 28.1%, respectively (p = 0.0546). Patients in preterm delivery group were characterized by fibrinolytic imbalance. At the first time point, suppressed fibrinolysis (PAI-1 level – 18.4 vs. 12.5 ng/ml in the comparison group; p = 0.0209) was concomitant with elevated level of u-PA (1.5 vs. 0.55 ng/ml in comparison group, p = 0.0015), which suggests a potential prolonged immunoinflammatory response in patients with PB. Magnitude of fibrinogen concentration and D-dimer level during post-COVID-19 follow-up study was within the reference values specific to gestational age.Conclusion. A significant increase in coagulation potential was found and verified by elevated activity of tissue factor and potential to thrombin generation in COVID-19 convalescent patients. In the case of preterm delivery, there was an imbalance in fibrinolysis system revealed by decreased blood fibrinolytic activity elevating along with increasing gestational age.

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Hemostatic imbalance underlying preterm delivery in COVID-19 convalescent patients

Nikolaeva,

Korchagina,

Momot

et al. 2023

Akušerstvo, ginekologiâ i reprodukciâ

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Changes in Indicators of Endogenous Intoxication, Nonspecific Reactivity, and Inflammation Caused by Sars-Cov-2

Saienko,

Chemych

2024

EUMJ

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Introduction: Despite the fact that the entire scientific world is concerned about COVID-19, about 65 million people are living with Long COVID, suffering from general weakness, fatigue, cognitive dysfunction, and shortness of breath. This problem is global for humanity because of the decrease in the ability to work and mental activity of the population, which leads to economic losses. The problem remains open and requires further research. Materials and Methods: a total of 108 patients were examined and divided into three groups: group A – 31 patients with confirmed COVID-19, group B – 35 patients with Long COVID, and group C – 42 practically healthy individuals. Hematologic and nonspecific immunologic changes were studied. Statistical data processing was performed using STATA software by StataCorp (Texas, USA) with the calculation of parametric and non-parametric criteria. Results: middle-aged women predominated in the study groups. Among the hematologic parameters, an increase in leukocytes, erythrocytes, and ESR was observed in the COVID-19 group. Patients in group A had 2.5 times more rods of neutrophils than in group B and 2.3 times more than in group C. In patients with COVID-19, integrative indicators of endogenous intoxication exceeded the corresponding data compared to the Long COVID group (p<0.05). In patients with Long COVID, there was a tendency (p=0.055 – 0.588) to increased integrative indicators of endogenous intoxication (the intoxication index was 2.6 times higher (p<0.05)) compared to the group of practically healthy individuals. The indices of nonspecific reactivity in group A (resistance coefficient, lymphocyte index, eosinophil to lymphocyte ratio index, allergy index) and B (resistance coefficient, lymphocyte index) were lower than in group C (p<0.05). In patients with COVID-19, indices of inflammation activity (total inflammation index, Krebs index, leukocyte/ ESR ratio index) were higher than in the group of practically healthy individuals (p<0.05). Conclusions: patients with COVID-19 are characterized by a leftward shift of the leukocyte formula, increased integrative indicators of endogenous intoxication, a pronounced inflammatory process, and activation of tissue breakdown. For people with Long COVID, there is a slight increase in integrative indicators of endogenous intoxication, with a low degree of inflammation and increased nonspecific reactivity compared to the COVID-19 group.

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Assessing the Impact of COVID-19 on Pregnancy and Maternal Outcomes: A Slovak National Study

Goldbergerová,

Kováč,

Marčišová

et al. 2024

Reprod. Med.

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Background: The COVID-19 pandemic highlighted the global challenge of inadequate data on SARS-CoV-2’s effects on pregnant women and their infants. In response, Slovakia, along with other countries, launched a nationwide study to assess the incidence, characteristics, and outcomes of SARS-CoV-2 infection during pregnancy. Methods: We conducted a national observational descriptive study of SARS-CoV-2 positive cases among pregnant women from the pandemic’s onset to its conclusion. In collaboration with the Public Health Office of the Slovak Republic, we identified 1184 pregnant women who tested positive for SARS-CoV-2 and contacted them for participation. Results: Among the 240 participating SARS-CoV-2-positive pregnant women, 13 required hospitalizations, with an increased need for intensive care and respiratory support. However, the absolute risk of poor outcomes remained low. Higher maternal age and infection during the third trimester emerged as key risk factors for hospitalization. A symptomatic course was dominant, with fatigue (70%), headache (58%), and fever (56%) as the leading symptoms. While maternal and neonatal outcomes were generally favourable, a slight increase in caesarean sections and preterm births suggests an indirect impact on maternity care. Vaccination during pregnancy correlated with reduced symptoms and no hospitalizations. Elevated CRP levels were common among infected women, while ultrasound findings remained normal. Conclusions: This study offers a multi-dimensional view of pregnancy during the pandemic, capturing both the mother’s personal concerns and the objective insights from prenatal and labour care settings. The findings suggest that most pregnant women with SARS-CoV-2 experience mild to moderate illness, offering reassurance to clinicians about generally favourable maternal and neonatal outcomes while underscoring the need for vigilance in rare severe cases.

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Clinical and laboratory characteristics of COVID-19 in pregnant women

Cited by 4 publications

References 30 publications

Hemostatic imbalance underlying preterm delivery in COVID-19 convalescent patients

Hemostatic imbalance underlying preterm delivery in COVID-19 convalescent patients

Changes in Indicators of Endogenous Intoxication, Nonspecific Reactivity, and Inflammation Caused by Sars-Cov-2

Assessing the Impact of COVID-19 on Pregnancy and Maternal Outcomes: A Slovak National Study

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