Ebrahim Babai Mahtab, Kabiri Azita, Movahedi Minoo, Ghahiri Ataollah, Hajhashemi Maryam, Dehghan Maryam
Department of Obstetrics and Gynecology, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2024 Sep 23;13:76. doi: 10.4103/abr.abr_257_23. eCollection 2024.
In the SARSCov2 virus epidemic, pregnant women are more susceptible to infectious diseases due to changes in biochemical parameters and are at higher risk of severe respiratory disease and pneumonia. This study aimed to evaluate the biochemical, inflammatory and coagulation parameters in pregnant women with severe disease conditions (as one of the high-risk groups) as well as prognosis and outcome.
This cross-sectional study was performed on 135 pregnant women with COVID-19 admitted to ICU. Demographic and clinical information and laboratory parameters of the patients were evaluated and recorded at the time of admission and in the next follow-up until discharge or death in addition to the outcome and also the pregnancy outcome.
The mortality rate of pregnant women with COVID-19 was 9.6%. The mortality rate decreases with increasing Hb (OR (95% CI): 0.68 (0.47-0.99); value = 0.043) and lymphocytes (OR (95% CI): 0.92 (0.85-0.96); value = 0.028) and will increase significantly with increasing PT (OR (95% CI): 1.24 (1.01-1.51); value = 0.037), INR (OR (95% CI): 1.89 (1.26-2.25); value = 0.004), D-dimer (OR (95% CI): 1.68 (1.10-2.08); value = 0.027), and LDH (OR (95% CI): 1.20 (1.01-1.61); value = 0.010).
According to the results of the present study, inflammatory factors such as leukocytes, neutrophils, NLR, CRP have an increasing and lymphocytes have a decreasing trend, so that lymphocytopenia is more common in non-survivors. In addition, increase of PT, INR, D-dimer and LDH and decrease of Hb were significantly associated with increased chance of mortality. But fibrinogen, ferritin, ALT and AST were not significantly associated with mortality in these women.
在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒流行期间，孕妇由于生化参数的变化更容易感染传染病，且患重症呼吸道疾病和肺炎的风险更高。本研究旨在评估重症疾病孕妇（作为高危群体之一）的生化、炎症和凝血参数以及预后和结局。
本横断面研究对135例入住重症监护病房（ICU）的新型冠状病毒肺炎（COVID-19）孕妇进行。除结局以及妊娠结局外，在患者入院时和下次随访直至出院或死亡时评估并记录患者的人口统计学和临床信息以及实验室参数。
COVID-19孕妇的死亡率为9.6%。死亡率随血红蛋白（Hb）升高（比值比（OR）（95%置信区间）：0.68（0.47 - 0.99）；P值 = 0.043）和淋巴细胞计数升高（OR（95%置信区间）：0.92（0.85 - 0.96）；P值 = 0.028）而降低，随凝血酶原时间（PT）升高（OR（95%置信区间）：1.24（1.01 - 1.51）；P值 = 0.037）、国际标准化比值（INR）升高（OR（95%置信区间）：1.89（1.26 - 2.25）；P值 = 0.004）、D-二聚体升高（OR（95%置信区间）：1.68（1.10 - 2.08）；P值 = 0.027）和乳酸脱氢酶（LDH）升高（OR（95%置信区间）：1.20（1.01 - 1.61）；P值 = 0.010）而显著升高。
根据本研究结果，白细胞、中性粒细胞、中性粒细胞与淋巴细胞比值（NLR）、C反应蛋白（CRP）等炎症因子呈升高趋势，淋巴细胞呈降低趋势，因此淋巴细胞减少在非存活者中更为常见。此外，PT、INR、D-二聚体和LDH升高以及Hb降低与死亡几率增加显著相关。但纤维蛋白原、铁蛋白、谷丙转氨酶（ALT）和谷草转氨酶（AST）与这些女性的死亡率无显著相关性。
