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新型冠状病毒肺炎孕妇与非孕妇患者的临床对比分析:影像学、实验室和临床特征。

Comparative analysis of COVID-19 pneumonia in pregnant versus matched non-pregnant women: radiologic, laboratory, and clinical perspectives.

机构信息

Department of Radiology, School of Medicine, Imam Hussein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Sci Rep. 2024 Sep 30;14(1):22609. doi: 10.1038/s41598-024-73699-9.

Abstract

This study aimed to assess the severity and outcomes of COVID-19 in pregnant women, focusing on laboratory and radiological discrepancies between pregnant women and matched nonpregnant women. In this retrospective cross-sectional analysis, we matched 107 nonpregnant women with 66 pregnant women in terms of age, comorbidities, and the interval between symptom onset and hospital admission. Demographic, clinical, laboratory, and radiological data were collected, and chest CT scans were evaluated using a severity scale ranging from 0 to 5. Logistic regression and adjusted Cox regression models were used to assess the impact of various factors on pregnancy status and mortality rates. Differences in several laboratory parameters, including the neutrophil-to-lymphocyte ratio, liver aminotransferases, alkaline phosphatase, urea, triglycerides, cholesterol, HbA1c, ferritin, coagulation profiles, and blood gases, were detected. Radiologic exams revealed that nonpregnant women had sharper opacities, whereas pregnant women presented with hazy opacities and signs of crypt-organizing pneumonia. A notable difference was also observed in the pulmonary artery diameter. The mortality rate among pregnant women was 4.62%, which was comparable to the 5.61% reported in nonpregnant patients. Compared with nonpregnant patients, pregnancy did not significantly affect the severity or mortality of COVID-19. Our study revealed discernible differences in specific laboratory and imaging markers between pregnant and nonpregnant COVID-19 patients.

摘要

本研究旨在评估 COVID-19 孕妇的严重程度和结局,并重点关注孕妇与匹配的非孕妇之间的实验室和影像学差异。在这项回顾性的横断面分析中,我们根据年龄、合并症和症状出现与住院时间间隔,将 107 名非孕妇与 66 名孕妇进行了匹配。收集了人口统计学、临床、实验室和影像学数据,并使用从 0 到 5 的严重程度量表评估了胸部 CT 扫描。使用逻辑回归和调整后的 Cox 回归模型来评估各种因素对妊娠状态和死亡率的影响。检测到包括中性粒细胞与淋巴细胞比值、肝转氨酶、碱性磷酸酶、尿素、甘油三酯、胆固醇、HbA1c、铁蛋白、凝血谱和血气在内的几个实验室参数的差异。影像学检查显示,非孕妇的混浊影更锐利,而孕妇的混浊影更模糊,并出现隐匿性肺组织炎征象。在肺动脉直径方面也观察到显著差异。孕妇的死亡率为 4.62%,与非孕妇的 5.61%相近。与非孕妇相比,妊娠并没有显著影响 COVID-19 的严重程度或死亡率。我们的研究揭示了 COVID-19 孕妇与非孕妇在特定实验室和影像学标志物方面存在明显差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c104/11442658/dfe7cf5215c4/41598_2024_73699_Fig1_HTML.jpg

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