Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Department of Respiratory Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
J Obstet Gynaecol Res. 2022 Apr;48(4):938-945. doi: 10.1111/jog.15181. Epub 2022 Feb 15.
To make effective use of the limited available hospital space during the Coronavirus disease 2019 (COVID-19) pandemic, we conducted this study to investigate the laboratory indices that identify pregnant women with SARS-CoV2 infection who require medical intervention.
We carried out a retrospective analysis of pregnant women positive for COVID-19 who were admitted to Hokkaido University Hospital from September 2020 to June 2021. Medical interventions included oxygen supplementation, systemic corticosteroids, or supplemental liquids to treat infection-related symptoms.
Forty-two infected pregnant patients were admitted to the hospital, half of whom required medical intervention (n = 21). Fever, C-reactive protein (CRP), and platelet count are all associated with need for medical intervention. Of the 32 patients with a fever of ≥37.5°C on days 0-3 after onset of syndromes, 22 (69%) continued to have a fever on days 4-6, of which 19 (86.4%) required medical intervention. CRP level on days 4-6 predicted the presence or absence of medical intervention (area under the receiver operating characteristic curve = 0.913), with a sensitivity of 81% and specificity of 100% at a CRP cutoff of 1.28 mg/dL.
The need for medical intervention in pregnant patients can be predicted with high accuracy using a CRP cutoff of 1.28 mg/dL on days 4-6 after onset of syndromes. The presence of fever also may be an easy marker for selecting subjects who need or will need therapeutic intervention. These could be an effective triage method to determine appropriate indications for the hospitalization of pregnant women in future outbreaks.
在 2019 年冠状病毒病（COVID-19）大流行期间，为了有效利用有限的医院空间，我们进行了这项研究，以调查识别需要医疗干预的 SARS-CoV2 感染孕妇的实验室指标。
我们对 2020 年 9 月至 2021 年 6 月期间入住北海道大学医院的 COVID-19 阳性孕妇进行了回顾性分析。医疗干预包括吸氧、全身皮质类固醇或补充液体以治疗与感染相关的症状。
42 名感染孕妇住院，其中一半需要医疗干预（n=21）。发热、C 反应蛋白（CRP）和血小板计数均与需要医疗干预有关。在症状出现后 0-3 天内发热≥37.5°C 的 32 名患者中，22 名（69%）在 4-6 天仍有发热，其中 19 名（86.4%）需要医疗干预。4-6 天的 CRP 水平预测是否需要医疗干预（受试者工作特征曲线下面积=0.913），CRP 截断值为 1.28mg/dL 时，灵敏度为 81%，特异性为 100%。
在症状出现后 4-6 天，使用 CRP 截断值 1.28mg/dL 可以高度准确地预测孕妇是否需要医疗干预。发热的存在也可能是选择需要或将要接受治疗干预的患者的一个简单标志物。这可能是一种有效的分诊方法，以确定在未来疫情中孕妇住院的适当指征。
