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预测孕妇 COVID-19 严重程度的因素。

Predictors of COVID-19 severity among pregnant patients.

机构信息

Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland.

Department of Otolaryngology, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland.

出版信息

Bosn J Basic Med Sci. 2022 Oct 23;22(6):1005-1015. doi: 10.17305/bjbms.2022.7181.

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.

摘要

新型冠状病毒肺炎(COVID-19)被宣布为大流行,并在全球范围内传播,毫不留情地影响了弱势群体。对于特别受影响的孕妇,有效的预防措施包括早期识别那些有发生院内并发症风险的患者,以及不断改进母婴治疗策略,以确保有效利用卫生资源。我们的回顾性研究的目的是确定入院时的哪些患者生物标志物与疾病严重程度相关,这些严重程度可通过疾病过程分类、需要氧疗和更高的氧需求、需要机械通气、入住重症监护病房和住院时间来衡量。对 52 例 PCR SARS-CoV-2 阳性孕妇的分析表明,中位入院时间为妊娠 30 周,呼吸困难、咳嗽和发热是主要症状。糖尿病和高血压的存在使孕妇容易发生严重疾病。入院时 CT 扫描显示的肺部受累与更严重的临床严重程度相关。疾病进展的主要实验室预测因子是淋巴细胞减少症、低钙血症、总胆固醇低、总蛋白水平低以及 C 反应蛋白、铁蛋白、白细胞介素-6、葡萄糖、乳酸脱氢酶、降钙素原和肌钙蛋白 I 血清水平高。需要对更大的孕妇队列进行进一步研究,以确定这些结果在日常实践中的应用价值。

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