COVID-19 complicated by hepatic dysfunction in a 28-week pregnant woman

Anness, A.; Siddiqui, Farah

doi:10.1136/bcr-2020-237007

Cited by 10 publications

(16 citation statements)

References 18 publications

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“…Clinical investigation of relevance consists of a full blood count (FBC), electrolyte, urea and creatinine (U&E) LFT, chest-Xray, and chest computerised tomography (CT). Results consistent with Covid-19 include lymphopenia, raised CRP, thrombocytopenia (mild), increased liver function and creatine phosphate [24,25]. The cases presented had the relevant diagnostic laboratory and radiological features of severe disease.…”

Section: Specific Pregnancy Outcomes Have Been Reported In Patientssupporting

confidence: 66%

Covid-19 in pregnancy: A case series of complexities and challenges in management, pregnancy outcome and review of literature at Northampton General Hospital UK

Ekanem¹

2022

J Clin Images Med Case Rep

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Section: Specific Pregnancy Outcomes Have Been Reported In Patientssupporting

confidence: 66%

Covid-19 in pregnancy: A case series of complexities and challenges in management, pregnancy outcome and review of literature at Northampton General Hospital UK

Ekanem¹

2022

J Clin Images Med Case Rep

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“…At time of admission at 28 weeks of gestational age, the patient presented with dyspnea and significantly elevated levels of ALT (571 UI/L) and BA (57 μmol/L), without itching. 27 The increased levels of BA in this patient raised the question of whether the cause was obstetric cholestasis or SARS‐CoV‐2 pneumonia. Both BA and ALT levels improved with the resolution of the infection.…”

Section: Discussionmentioning

confidence: 87%

“…Nor is it known whether prognostic markers used for the general population can be specifically applied to a pregnant population. 27 …”

Section: Discussionmentioning

confidence: 99%

“…Up to date, numerous studies have evaluated the outcome of pregnancies complicated by a SARS‐CoV‐2 infection, 1 , 3 , 18 , 19 however, only one case of a pregnancy complicated by obstetric cholestasis and a concurrent SARS‐CoV‐2 infection has been described in detail. 27 …”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, the literature lacks of evidence regarding whether increasing degrees of hepatic dysfunction determine an increased risk of adverse outcomes of pregnancy. Nor is it known whether prognostic markers used for the general population can be specifically applied to a pregnant population 27 …”

Section: Discussionmentioning

confidence: 99%

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Serum hepatic biomarkers in women with obstetric cholestasis and a concurrent SARS‐CoV‐2 infection

D’Ambrosi

Maso

Viscardi

et al. 2022

J of Obstet and Gynaecol

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Aim The aim of the study was to evaluate the association between SARS‐CoV‐2 infection and serum hepatic biomarker levels among women with obstetric cholestasis. Methods In this prospective study, we recruited all pregnant women admitted in our hospital with obstetric cholestasis. Among those with a concurrent SARS‐CoV‐2 infection, we evaluated the following serum hepatic biomarkers: aspartate aminotransferase (AST), alanine aminotransferase (ALT), and biliar acids (BA). Results Among the 88 women enrolled in the study, 20 presented with a SARS‐CoV‐2 infection while 68 were negative. SARS‐CoV‐2 infected women were younger (mean age 30.5 ± 5.7 vs. 34.3 ± 5.4; p < 0.01) and in a greater percentage of non‐Caucasian ethnicity when compared to noninfected women (60.0% vs. 17.6%; p < 0.01). Regarding levels of hepatic biomarkers, they showed higher levels of AST (111.5 ± 134.1 vs. 37.3 ± 43.4 UI/L; p = 0.02), ALT (132.2 ± 115.7 vs. 50.5 ± 73.173.1 UI/L; p < 0.01), and BA (41.4 ± 46.8 vs. 18.4 ± 13.4 μmol/L; p = 0.04) compared to noninfected patients. No significant differences in maternal or fetal outcomes were found between infected and noninfected women. Conclusion SARS‐CoV‐2 infection was associated with higher levels of liver enzymes in patients with obstetric cholestasis. This could be the result of a possible hepatic involvement in patients with SARS‐CoV‐2 infection.

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COVID-19 and pregnancy: A comparison of case reports, case series and registry studies

Young

Green

Stewart

et al. 2022

European Journal of Obstetrics & Gynecology and Reproductiv

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Background Selection, outcome and publication biases are well described in case reports and case series but may be less of a problem early in the appearance of a new disease when all cases might appear to be worth publishing. Objective To use a prospectively collected database of primary sources to compare the reporting of COVID-19 in pregnancy in case reports, case series and in registries over the first 8 months of the pandemic. Study Design : MEDLINE, Embase and Maternity and Infant Care databases were searched from 22 March to 5 November 2020, to create a curated list of primary sources. Duplicate reports were excluded. Case reports, case series and registry studies of pregnant women with confirmed COVID-19, where neonatal outcomes were reported, were selected and data extracted on neonatal infection status, neonatal death, neonatal intensive care unit admission, preterm birth, stillbirth, maternal critical care unit admission and maternal death. Results 149 studies comprising 41,658 mothers and 8,854 neonates were included. All complications were more common in case reports, and in retrospective series compared with presumably prospective registry studies. Extensive overlap is likely in registry studies, with cases from seven countries reported by multiple registries. The UK Obstetric Surveillance System was the only registry to explicitly report identification and removal of duplicate cases, although five other registries reported collection of patient identifiable data which would facilitate identification of duplicates. Conclusions Since it is likely that registries provide the least biased estimates, the higher rates seen in the other two study designs are probably due to selection or publication bias. However even some registry studies include self- or doctor-reported cases, so might be biased, and we could not completely exclude overlap of cases in some registries.

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COVID-19 complicated by hepatic dysfunction in a 28-week pregnant woman

Cited by 10 publications

References 18 publications

Covid-19 in pregnancy: A case series of complexities and challenges in management, pregnancy outcome and review of literature at Northampton General Hospital UK

Covid-19 in pregnancy: A case series of complexities and challenges in management, pregnancy outcome and review of literature at Northampton General Hospital UK

Serum hepatic biomarkers in women with obstetric cholestasis and a concurrent SARS‐CoV‐2 infection

COVID-19 and pregnancy: A comparison of case reports, case series and registry studies

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