Department of Anesthesiology and Reanimation, Health Sciences University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.
Department of Obstetrics and Gynaecology, Health Sciences University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.
J Obstet Gynaecol. 2023 Dec;43(2):2218915. doi: 10.1080/01443615.2023.2218915.
This study aims to examine the clinical characteristics and mortality-related factors of obstetric patients, who were taken to the intensive care unit due to Coronavirus Disease 2019 (COVID-19). This study included 31 patients in the peripartum period with COVID-19 pneumonia, followed up in the intensive care unit (ICU) from March 2020 to December 2020. Symptoms, laboratory values, intensive care unit duration of stay, complications, the requirement of non-invasive and invasive mechanical ventilation, and mortality were recorded. The mean age was 30.7 ± 6.2 years and the mean gestational age was 31.1 ± 6.4 weeks. Among the patients, 25.8% had a fever, 87.1% had a cough, 96.8% had dyspnoea and 77.4% had tachypnoea. Seventeen patients (54.8%) had mild, 6 (19.4%) had moderate and 8 (25.8%) had severe pulmonary involvement on computed tomography. Sixteen (51.6%) patients required high-frequency oscillatory ventilation, 6 (19.3%) patients required continuous positive airway pressure, and 5 (16.1%) patients required invasive mechanical ventilation. Sepsis complicated by septic shock and multiorgan failure occurred in 4 patients and all of them died. The ICU duration of stay was 4.9 ± 4.3 days. We have found that older maternal age, obesity, high LDH, AST, ALT, ferritin, leukocyte, CRP, and procalcitonin values, and severe lung involvement were mortality-related factors.Impact statement Pregnant women are in the high-risk group for Covid-19 disease and its complications. Although most pregnant women are asymptomatic, severe infection-related hypoxia can cause serious foetal and maternal problems. When we examined the literature, we found that the number of studies on pregnant women with severe Covid-19 infection was limited. For this reason, with our study results, we aim to contribute to the literature by determining the biochemical parameters and patient-related factors associated with severe infection and mortality in pregnant patients with severe Covid-19 infection. With our study results, predisposing factors for the development of severe Covid-19 infection in the pregnant patient population and biochemical parameters that are early indicators of severe infection were determined. In this way, pregnant women in the high-risk group can be followed closely and the necessary treatments can be started quickly so disease-related complications and mortality can be reduced.
本研究旨在探讨因 2019 年冠状病毒病（COVID-19）而转入重症监护病房的产科患者的临床特征和与死亡相关的因素。本研究纳入了 2020 年 3 月至 2020 年 12 月期间在重症监护病房（ICU）随访的 31 例围产期合并 COVID-19 肺炎的患者。记录了症状、实验室值、入住 ICU 的时间、并发症、无创和有创机械通气的需求以及死亡率。患者的平均年龄为 30.7±6.2 岁，平均孕龄为 31.1±6.4 周。其中 25.8%有发热，87.1%有咳嗽，96.8%有呼吸困难，77.4%有呼吸急促。17 例（54.8%）患者肺部 CT 轻度受累，6 例（19.4%）患者中度受累，8 例（25.8%）患者重度受累。16 例（51.6%）患者需要高频振荡通气，6 例（19.3%）患者需要持续气道正压通气，5 例（16.1%）患者需要有创机械通气。4 例患者并发脓毒症性休克和多器官功能衰竭，均死亡。入住 ICU 的时间为 4.9±4.3 天。我们发现，母亲年龄较大、肥胖、LDH、AST、ALT、铁蛋白、白细胞、CRP 和降钙素值较高以及肺部严重受累是与死亡相关的因素。
影响陈述 孕妇是 COVID-19 疾病及其并发症的高危人群。虽然大多数孕妇无症状，但严重的感染相关缺氧可导致严重的胎儿和母体问题。在我们查阅文献时，发现关于严重 COVID-19 感染孕妇的研究数量有限。因此，我们希望通过确定严重 COVID-19 感染孕妇与严重感染和死亡率相关的生化参数和患者相关因素，为文献做出贡献。通过我们的研究结果，确定了孕妇人群中发生严重 COVID-19 感染的易患因素和严重感染的早期生化指标。通过这种方式，可以对高危孕妇进行密切监测，并尽快开始必要的治疗，从而减少与疾病相关的并发症和死亡率。
