Abstract
Aim: Prediction of severity of COVID 19 infection in pregnant population is very important to management. The aim of this study was to investigate the relationship between COVID 19 infection severity and routine hematologic/biochemical laboratory tests.
Material and Method: In this retrospective study the hematologic parameters of pregnant women with COVID 19 were investigated. The patients were allocated into 5 subgroups as asymptomatic, mild, moderate, severe and critical. Presenting symptoms were identified. Laboratory test results detected at the first admission were compared between groups.
Results: A total of 343 patients were included in the study. The most common symptoms were cough (n=74, %21.6) and fatigue (n=46, %13.4). Statistically significant differences observed at following parameters. The mean Hb level was lower (p=0.001) and WBC, neutrophil, AST, ALT, GGT, LDH, direct bilirubin and total bilirubin levels were higher in critical group (p=, 0.005, 0.001, 0.000, 0.015, 0.000, 0.000, 0.000, 0.007 respectively). The mean lymphocyte and monocytes levels in the severe group were lower (p=0.000, 0.01, respectively). Furthermore, the mean eosinophil levels in the asymptomatic group was higher (p=0.002).
Conclusion
Low Hb, lymphocyte, monocyte, eosinophil levels and high WBC, neutrophil, ALT, AST, GGT, total bilirubin and LDH levels are associated with more severe disease. Monitoring of these tests may provide guidance for the prediction of the severity of the COVID 19 infection among pregnant women.
Key Words: Complete Blood Count, COVID 19, laboratory, pregnancy, symptom,
Conclusion
Low Hb, lymphocyte, monocyte, eosinophil levels and high WBC, neutrophil, ALT, AST, GGT, total bilirubin and LDH levels are associated with more severe disease. Monitoring of these tests may provide guidance for the prediction of the severity of the COVID 19 infection among pregnant women.
References
- WHO COVID-19 Dashboard. Geneva: World Health Organization, 2020. Available online: https://covid19.who.int/
- Male V. SARS-CoV-2 infection and COVID-19 vaccination in pregnancy. Nature review Immunology. 2022; 22(5), 277–82. https://doi.org/10.1038/s41577-022-00703-6
- Aslan MM, Hilal U, Köse O, Cevrioğlu S, Özden S. (2020). COVID-19 ve Gebelik. Journal of Biotechnology and Strategic Health Research, 4, 10-13.
- Rasmussen SA, Jamieson DJ. COVID-19 and Pregnancy. Infectious disease clinics of North America. 2022; 36(2), 423–33. https://doi.org/10.1016/j.idc.2022.01.002
- Halk Saglıgı Genel Mudurlugu. COVID-19 (SARS-CoV-2 Enfeksiyonu) Rehberi. Bilim Kurulu Çalısması. Ankara: Saglık Bakanlıgı.https://covid19bilgi.saglik.gov. tr/depo/rehberler/ COVID-19_Rehberi.pdf
- Sari T. (2021). Gebelikte COVID-19 hastalığının takip ve tedavisi. Turkish Journal of Clinics and Laboratory, 12(4), 473-6.
- Ochani R, Asad A, Yasmin F, Shaikh S, Khalid H, Batra Set al. COVID-19 pandemic: from origins to outcomes. A comprehensive review of viral pathogenesis, clinical manifestations, diagnostic evaluation, and management. Le infezioni in medicina. 2021; 29(1), 20–36.
- Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta obstetricia et gynecologica Scandinavica 2020; 99(7), 823–29.https://doi.org/10.1111/aogs.13867
- Nana, M, Nelson-Piercy C. COVID-19 in pregnancy. Clinical medicine (London, England). 2021; 21(5), e446 50. https://doi.org/10.7861/clinmed.2021-0503
- Hariyanto TI, Kurniawan A. Anemia is associated with severe coronavirus disease 2019 (COVID-19) infection. Transfusion and apheresis science: official journal of the World Apheresis Association: official journal of the European Society for Haemapheresis. 2020; 59(6), 102926. https://doi.org/10.1016/j.transci.2020.102926
- Smith ER, Oakley E, Grandner GW, Rukundo G, Farooq F, Ferguson K et al. Clinical risk factors of adverse outcomes among women with COVID-19 in the pregnancy and postpartum period: a sequential, prospective meta-analysis. American journal of obstetrics and gynecology. 2023; 228(2), 161–77. https://doi.org/10.1016/j.ajog.2022.08.038
- Wu X, Wang C, Li H, Meng H, Jie J, Fu M, et al. Circulating white blood cells and lung function impairment: the observational studies and Mendelian randomization analysis. Annals of medicine. 2021; 53(1), 1118–28. https://doi.org/10.1080/07853890.2021.1948603
- Vakili S, Savardashtaki A, Jamalnia S, Tabrizi R, Nematollahi MH, Jafarinia M, et al. Laboratory Findings of COVID-19 Infection are Conflicting in Different Age Groups and Pregnant Women: A Literature Review. Archives of medical research. 2020; 51(7), 603–7. https://doi.org/10.1016/j.arcmed.2020.06.007
- Liu H, Liu F, Li J, Zhang T, Wang D, Lan W. Clinical and CT imaging features of the COVID-19 pneumonia: Focus on pregnant women and children. The Journal of infection 2020; 80(5), e7–e13. https://doi.org/10.1016/j.jinf.2020.03.007
- Al-Saadi, EAKD, Abdulnabi MA. Hematological changes associated with COVID-19 infection. Journal of clinical laboratory analysis 2022; 36(1), e24064. https://doi.org/10.1002/jcla.24064
- Zhang L, Huang B, Xia H, Fan H, Zhu L, Zhang H, et al. Retrospective analysis of clinical features in 134 coronavirus disease 2019 cases. Epidemiology https://doi.org/10.1017/S0950268820002010
- Guo Z, Zhang Z, Prajapati M, Li Y. Lymphopenia Caused by Virus Infections and the Mechanisms Beyond. Viruses. 2021; 13(9), 1876. https://doi.org/10.3390/v13091876
- Schultze JL, Aschenbrenner AC. COVID-19 and the human innate immune system. Cell 2021; 184(7), 1671 92. https://doi.org/10.1016/j.cell.2021.02.029
- Kos I, Balensiefer B, Lesan V, Kaddu-Mulindwa D, Thurner L, Christofyllakis K, et al. Increased B-cell activity with consumption of activated monocytes in severe COVID-19 patients. European journal of immunology. 2021; 51(6), 1449–60. https://doi.org/10.1002/eji.202049163
- Rosenberg HF, Foster PS. Eosinophils and COVID-19: diagnosis, prognosis, and vaccination strategies. Seminars in immunopathology 2021; 43(3), 383–92. https://doi.org/10.1007/s00281-021-00850-3
- Malik P, Patel U, Mehta D, Patel N, Kelkar R, Akrmah M, et al. Biomarkers and outcomes of COVID-19 hospitalisations: systematic review and meta-analysis. BMJ evidence-based medicine 2021; 26(3), 107–8. https://doi.org/10.1136/bmjebm-2020-111536
- Wijarnpreecha K, Ungprasert P, Panjawatanan P, Harnois DM, Zaver HB, Ahmed A, et al. COVID-19 and liver injury: a meta-analysis. European journal of gastroenterology & hepatology 2021; 33(7), 990–5. https://doi.org/10.1097/MEG.0000000000001817
- Serrano-Lorenzo P, Coya ON, López-Jimenez A, Blazquez A, Delmiro A, Lucia A, et al. Plasma LDH: A specific biomarker for lung affectation in COVID-19?. Practical laboratory medicine. 2021; 25, e00226. https://doi.org/10.1016/j.plabm.2021.e00226
Abstract
Amaç: Gebe popülasyonda COVID 19 enfeksiyonunun şiddetinin öngörülmesi, yönetim için çok önemlidir. Bu çalışmanın amacı, COVID 19 enfeksiyon şiddeti ile rutin hematolojik/biyokimyasal laboratuvar testleri arasındaki ilişkiyi araştırmaktır.
Gereç ve Yöntem: Bu retrospektif çalışmada COVID 19'lu gebe kadınların hematolojik parametreleri araştırıldı. Hastalar asemptomatik, hafif, orta, şiddetli ve kritik olarak 5 alt gruba ayrıldı. Başvuru semptomları tespit edildi. İlk başvuruda tespit edilen laboratuvar test sonuçları ve gruplar arasında karşılaştırıldı.
Bulgular: Çalışmaya toplam 343 hasta dahil edildi. En sık görülen semptomlar öksürük (n=74, %21.6) ve halsizlik (n=46, %13.4) idi. Aşağıdaki parametrelerde istatistiksel olarak anlamlı farklılıklar gözlendi. Kritik grupta ortalama Hb düzeyi daha düşük (p=0,001), WBC, nötrofil, AST, ALT, GGT, LDH, direkt bilirubin ve total bilirubin düzeyleri daha yüksekti (p=, 0,005, 0,001, 0,000, 0,015, 0,000, 0,000) , 0.000, 0.007 sırasıyla). Şiddetli grupta ortalama lenfosit ve monosit seviyeleri daha düşüktü (sırasıyla p=0.000, 0.01). Ayrıca asemptomatik grupta ortalama eozinofil düzeyleri daha yüksekti (p=0,002).
Sonuç: Düşük Hb, lenfosit, monosit, eozinofil seviyeleri ve yüksek WBC, nötrofil, ALT, AST, GGT, total bilirubin ve LDH seviyeleri daha şiddetli hastalık ile ilişkilidir. Bu testlerin izlenmesi, hamile kadınlar arasında COVID 19 enfeksiyonunun ciddiyetinin tahmin edilmesi için rehberlik sağlayabilir.
Keywords
References
- WHO COVID-19 Dashboard. Geneva: World Health Organization, 2020. Available online: https://covid19.who.int/
- Male V. SARS-CoV-2 infection and COVID-19 vaccination in pregnancy. Nature review Immunology. 2022; 22(5), 277–82. https://doi.org/10.1038/s41577-022-00703-6
- Aslan MM, Hilal U, Köse O, Cevrioğlu S, Özden S. (2020). COVID-19 ve Gebelik. Journal of Biotechnology and Strategic Health Research, 4, 10-13.
- Rasmussen SA, Jamieson DJ. COVID-19 and Pregnancy. Infectious disease clinics of North America. 2022; 36(2), 423–33. https://doi.org/10.1016/j.idc.2022.01.002
- Halk Saglıgı Genel Mudurlugu. COVID-19 (SARS-CoV-2 Enfeksiyonu) Rehberi. Bilim Kurulu Çalısması. Ankara: Saglık Bakanlıgı.https://covid19bilgi.saglik.gov. tr/depo/rehberler/ COVID-19_Rehberi.pdf
- Sari T. (2021). Gebelikte COVID-19 hastalığının takip ve tedavisi. Turkish Journal of Clinics and Laboratory, 12(4), 473-6.
- Ochani R, Asad A, Yasmin F, Shaikh S, Khalid H, Batra Set al. COVID-19 pandemic: from origins to outcomes. A comprehensive review of viral pathogenesis, clinical manifestations, diagnostic evaluation, and management. Le infezioni in medicina. 2021; 29(1), 20–36.
- Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta obstetricia et gynecologica Scandinavica 2020; 99(7), 823–29.https://doi.org/10.1111/aogs.13867
- Nana, M, Nelson-Piercy C. COVID-19 in pregnancy. Clinical medicine (London, England). 2021; 21(5), e446 50. https://doi.org/10.7861/clinmed.2021-0503
- Hariyanto TI, Kurniawan A. Anemia is associated with severe coronavirus disease 2019 (COVID-19) infection. Transfusion and apheresis science: official journal of the World Apheresis Association: official journal of the European Society for Haemapheresis. 2020; 59(6), 102926. https://doi.org/10.1016/j.transci.2020.102926
- Smith ER, Oakley E, Grandner GW, Rukundo G, Farooq F, Ferguson K et al. Clinical risk factors of adverse outcomes among women with COVID-19 in the pregnancy and postpartum period: a sequential, prospective meta-analysis. American journal of obstetrics and gynecology. 2023; 228(2), 161–77. https://doi.org/10.1016/j.ajog.2022.08.038
- Wu X, Wang C, Li H, Meng H, Jie J, Fu M, et al. Circulating white blood cells and lung function impairment: the observational studies and Mendelian randomization analysis. Annals of medicine. 2021; 53(1), 1118–28. https://doi.org/10.1080/07853890.2021.1948603
- Vakili S, Savardashtaki A, Jamalnia S, Tabrizi R, Nematollahi MH, Jafarinia M, et al. Laboratory Findings of COVID-19 Infection are Conflicting in Different Age Groups and Pregnant Women: A Literature Review. Archives of medical research. 2020; 51(7), 603–7. https://doi.org/10.1016/j.arcmed.2020.06.007
- Liu H, Liu F, Li J, Zhang T, Wang D, Lan W. Clinical and CT imaging features of the COVID-19 pneumonia: Focus on pregnant women and children. The Journal of infection 2020; 80(5), e7–e13. https://doi.org/10.1016/j.jinf.2020.03.007
- Al-Saadi, EAKD, Abdulnabi MA. Hematological changes associated with COVID-19 infection. Journal of clinical laboratory analysis 2022; 36(1), e24064. https://doi.org/10.1002/jcla.24064
- Zhang L, Huang B, Xia H, Fan H, Zhu L, Zhang H, et al. Retrospective analysis of clinical features in 134 coronavirus disease 2019 cases. Epidemiology https://doi.org/10.1017/S0950268820002010
- Guo Z, Zhang Z, Prajapati M, Li Y. Lymphopenia Caused by Virus Infections and the Mechanisms Beyond. Viruses. 2021; 13(9), 1876. https://doi.org/10.3390/v13091876
- Schultze JL, Aschenbrenner AC. COVID-19 and the human innate immune system. Cell 2021; 184(7), 1671 92. https://doi.org/10.1016/j.cell.2021.02.029
- Kos I, Balensiefer B, Lesan V, Kaddu-Mulindwa D, Thurner L, Christofyllakis K, et al. Increased B-cell activity with consumption of activated monocytes in severe COVID-19 patients. European journal of immunology. 2021; 51(6), 1449–60. https://doi.org/10.1002/eji.202049163
- Rosenberg HF, Foster PS. Eosinophils and COVID-19: diagnosis, prognosis, and vaccination strategies. Seminars in immunopathology 2021; 43(3), 383–92. https://doi.org/10.1007/s00281-021-00850-3
- Malik P, Patel U, Mehta D, Patel N, Kelkar R, Akrmah M, et al. Biomarkers and outcomes of COVID-19 hospitalisations: systematic review and meta-analysis. BMJ evidence-based medicine 2021; 26(3), 107–8. https://doi.org/10.1136/bmjebm-2020-111536
- Wijarnpreecha K, Ungprasert P, Panjawatanan P, Harnois DM, Zaver HB, Ahmed A, et al. COVID-19 and liver injury: a meta-analysis. European journal of gastroenterology & hepatology 2021; 33(7), 990–5. https://doi.org/10.1097/MEG.0000000000001817
- Serrano-Lorenzo P, Coya ON, López-Jimenez A, Blazquez A, Delmiro A, Lucia A, et al. Plasma LDH: A specific biomarker for lung affectation in COVID-19?. Practical laboratory medicine. 2021; 25, e00226. https://doi.org/10.1016/j.plabm.2021.e00226
Details
| Primary Language | English |
|---|---|
| Subjects | Obstetrics and Gynaecology |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | June 10, 2024 |
| Submission Date | August 5, 2023 |
| Published in Issue | Year 2024 |