The Colloido-Osmotic Pressure as a useful biomarker of fatal outcome in pregnant COVID-19 patients

Abstract

Background: Pregnancy was considering a health condition that could support high severity in COVID-19, among others the cardiologic and respiratory systems express some physiologic change in the pregnant women and could specially affected in COVID-19. Pregnant women characteristically have an increase volume of blood, with a higher cardiac output and lower peripheral vascular resistance, these could be negative affected by hypoalbuminemia frequently observed in COVID-19. Then, an early recognition of hypoalbuminemia in pregnant women with COVID-19 would help us to predict fatal outcome. Objective: We conduct a study to analyzed the demographic, clinical, blood gas test results, laboratory and ultrasonographic doppler data in pregnant women with COVID-19 that demand medical attention for labor. Study design: Ninety-two pregnant women with COVID-19 were included in our study from may 30th 2020 to august 12th 2022, and data was analyzed in survival and fatal outcome patients. Normality test were applied to data and parametric or non-parametric test were used to determine statistical difference between or among data. Results: Demographic and clinical data were quite similar between survival and fatal outcome pregnant patients with COVID-19. Also, blood gas test shown similar results among groups (asymptomatic, mild, or severe patients who survive COVID-19 or fatal outcome patients). We observed that serum albumin was consistently low in pregnant patients with fatal outcome by COVID-19, then based on Total Protein concentration in serum we calculated the colloido-osmotic pressure and we evaluate its utility as predictor of fatal outcome. ROC analysis and Kaplan-Meier of survival curves suggest that the colloido-osmotic pressure could be a potential predictor. Also, we observed an association of low colloido-osmotic pressure and low amniotic fluid index. Conclusion: Our study suggests that early evaluation of pregnant with COVID-19 must include the calculation of colloido-osmotic pressure and the doppler analysis to early recognition of fatal outcome in pregnant women with COVID-19.