Lipińska-Gediga Małgorzata, Goździk Waldemar, Śmiechowicz Jakub, Adamik Barbara
Clinical Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
Viruses. 2024 Dec 31;17(1):51. doi: 10.3390/v17010051.
This study compares organ dysfunction, treatment strategies, and unfavorable outcome rates between pregnant and nonpregnant women admitted to the ICU with severe COVID-19, highlighting the increased susceptibility of pregnant women to respiratory infections due to physiological changes.
A retrospective, age-matched study was conducted at a referral center specializing in critical care for pregnant women. Data from 14 pregnant/postpartum and 11 nonpregnant women were analyzed at ICU admission and on days 3, 5, and 7.
Acute respiratory distress syndrome was diagnosed in 100% of the pregnant/postpartum group and 64% of the nonpregnant group ( = 0.026). Inflammatory parameters were similar between groups, except for lower ferritin levels in the pregnant/postpartum group compared to the nonpregnant (120 vs. 568 µg/L at admission and 90 vs. 616 µg/L on day 3). Creatinine, lactate, and lactate dehydrogenase levels were significantly lower in the pregnant/postpartum group. A reduction in the SOFA score was observed over time in the pregnant/postpartum group (from 7.0 to 4.0 points, = 0.009), while no change was noticed in the nonpregnant group (from 3.0 to 2.5 points, = 0.181). Unfavorable outcome rates were similar, with two patients from each group succumbing to the disease ( = 0.604).
The findings suggest that pregnancy does not increase the risk of unfavorable outcomes among women with severe COVID-19 receiving ICU treatment. However, additional studies with larger sample sizes are needed to validate these observations.
本研究比较了因重症新型冠状病毒肺炎（COVID-19）入住重症监护病房（ICU）的孕妇和非孕妇的器官功能障碍、治疗策略及不良结局发生率，强调了孕妇因生理变化对呼吸道感染更易感性增加的情况。
在一家专门为孕妇提供重症监护的转诊中心进行了一项年龄匹配的回顾性研究。分析了14名孕妇/产后妇女和11名非孕妇在ICU入院时以及第3、5和7天的数据。
孕妇/产后组100%被诊断为急性呼吸窘迫综合征，非孕妇组为64%（P = 0.026）。两组间炎症指标相似，但孕妇/产后组铁蛋白水平低于非孕妇组（入院时分别为120 vs. 568 μg/L，第3天分别为90 vs. 616 μg/L）。孕妇/产后组肌酐、乳酸和乳酸脱氢酶水平显著较低。孕妇/产后组随时间观察到序贯器官衰竭评估（SOFA）评分降低（从7.0分降至4.0分，P = 0.009），而非孕妇组无变化（从3.0分降至2.5分，P = 0.181）。不良结局发生率相似，每组各有两名患者死于该疾病（P = 0.604）。
研究结果表明，妊娠并未增加接受ICU治疗的重症COVID-19女性出现不良结局的风险。然而，需要更多样本量更大的研究来验证这些观察结果。
