Predictors of COVID-19 severity among pregnant patients

Abstract

Coronavirus disease 2019 (COVID-19) was declared a pandemic and has spread around the globe, unsparingly affecting vulnerable populations. Effective prevention measures for pregnant women, who are particularly affected, include early identification of those patients at risk of developing in-hospital complications, and the continuous improvement of maternal-fetal treatment strategies to ensure the efficient use of health resources. The objective of our retrospective study was to determine which patient biomarkers on hospital admission correlate with disease severity as measured by disease course classification, the need for oxygen supplementation and higher demand for oxygen, the need for mechanical ventilation, intensive care unit admission, and length of hospital stay. Analysis of 52 PCR SARS-CoV-2 positive pregnant women revealed that the median date of hospital admission was the 30th gestational week, with dyspnoea, cough, and fever as the leading symptoms. The presence of diabetes and hypertension predisposed pregnant women to the severe course of illness. Lung involvement shown by CT scans on admission correlated with the greater clinical severity. The main laboratory predictors of disease progression were lymphocytopenia, hypocalcemia, low total cholesterol, low total protein levels, and high serum levels of C-reactive protein, ferritin, interleukin-6, glucose, lactate dehydrogenase, procalcitonin, and troponin I. Further research with a larger cohort of pregnant women is needed to determine the utility of these results for everyday practice.

Association of D-Dimer, C-Reactive Protein, and Ferritin with COVID-19 Severity in Pregnant Women: Important Findings of a Cross-Sectional Study in Northern Brazil

“…In the present study, no difference was found between the CRP levels of pregnant women hospitalized in the ward and ICU with and without COVID-19, similar to what was observed in Poland [34]. Among the maternal deaths recorded in the present study, most pregnant women had increased CRP values, which was also observed in Turkey [32] and in other studies [35].…”

Association of serum vitamin D concentration with the final course of hospitalization in patients with COVID-19

“…Our study is one of the first to look at the association of vitamin D with adult mortality in the Polish population. Based on current knowledge, there are only a few published studies from Poland on vitamin concentrations in patients with COVID-19 ( 29 , 30 ). In the study by Ziuzia-Janiszewska et al.…”

“…( 29 ) found that, among others, obesity, comorbidities, higher levels of CRP, IL-6, creatinine, urea, and also lower eGFR value, albumin, calcium, and vitamin D concentration may be associated with poor COVID-19 outcomes. In another study from Poland, vitamin D concentrations were analyzed in 45 out of 52 pregnant women with confirmed SARS-CoV infection ( 30 ). It was shown that approximately 62% of pregnant women with COVID-19 had a decreased concentration of vitamin D (mean value – 27.15 ng/ml) ( 30 ).…”

“…In another study from Poland, vitamin D concentrations were analyzed in 45 out of 52 pregnant women with confirmed SARS-CoV infection ( 30 ). It was shown that approximately 62% of pregnant women with COVID-19 had a decreased concentration of vitamin D (mean value – 27.15 ng/ml) ( 30 ).…”