Thrombotic Markers in Pregnant Patients with and without SARS-CoV-2 Infection.
| Autor: | Bruno AM; Department of Obstetrics & Gynecology, University of Utah Health, Salt Lake City, Utah.; Department of Obstetrics & Gynecology, Intermountain Health, Salt Lake City, Utah., Allshouse AA; Department of Obstetrics & Gynecology, University of Utah Health, Salt Lake City, Utah., Benson AE; Department of Obstetrics & Gynecology, Oregon Health and Science University, Portland, Oregon., Yost CC; Department of Obstetrics & Gynecology, University of Utah Health, Salt Lake City, Utah.; Molecular Medicine Program, Molecular Medicine Program, University of Utah, Salt Lake City, Utah., Metz TD; Department of Obstetrics & Gynecology, University of Utah Health, Salt Lake City, Utah.; Department of Obstetrics & Gynecology, Intermountain Health, Salt Lake City, Utah., Varner MW; Department of Obstetrics & Gynecology, University of Utah Health, Salt Lake City, Utah., Silver RM; Department of Obstetrics & Gynecology, University of Utah Health, Salt Lake City, Utah., Branch DW; Department of Obstetrics & Gynecology, University of Utah Health, Salt Lake City, Utah.; Department of Obstetrics & Gynecology, Intermountain Health, Salt Lake City, Utah. |
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| Jazyk: | angličtina |
| Zdroj: | American journal of perinatology [Am J Perinatol] 2024 May; Vol. 41 (S 01), pp. e3202-e3209. Date of Electronic Publication: 2023 Nov 15. |
| DOI: | 10.1055/a-2211-5052 |
| Abstrakt: | Background: Coronavirus disease 2019 (COVID-19) is associated with coagulation abnormalities and increased risk for venous and arterial thrombi. This study aimed to evaluate D-dimer levels and lupus anticoagulant (LAC) positivity in pregnant individuals with and without Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Study Design: This was a prospective cohort study of pregnant individuals delivering at a single academic institution from April 2020 to March 2022. Individuals with a positive SARS-CoV-2 result during pregnancy were compared with a convenience sample of those without a positive SARS-CoV-2 result. For individuals with SARS-CoV-2 infection, severity was assessed based on the National Institutes of Health classification system. The primary outcome was D-dimer level measured during delivery admission. The secondary outcomes were LAC positivity and thromboembolic events. Outcomes were compared between individuals with and without a positive SARS-CoV-2 result, and further by disease severity. Results: Of 98 participants, 77 (78.6%) were SARS-CoV-2 positive during pregnancy. Among individuals with SARS-CoV-2 infection, severity was asymptomatic in 20 (26.0%), mild in 13 (16.9%), moderate in 4 (5.2%), severe in 38 (49.4%), and critical in 2 (2.6%). The D-dimer concentration at delivery did not significantly differ between those with a SARS-CoV-2 positive result compared with those without (mean 2.03 µg/mL [95% confidence interval {CI} 1.72-2.40] vs. 2.37 µg/mL [95% CI 1.65-3.40]; p = 0.43). Three individuals (4%) with SARS-CoV-2 infection and none (0%) without infection were LAC positive ( p = 0.59). There were no clinically apparent thromboses in either group. D-dimer concentrations and LAC positive results did not differ by COVID-19 severity. Conclusion: Thrombotic markers did not differ in pregnant individuals by SARS-CoV-2 infection; however, high rates of LAC positivity were detected. Key Points: · Thrombotic markers did not differ in pregnant individuals by SARS-CoV-2 infection.. · Higher than expected rates of LAC positivity were detected.. · There were no clinically apparent thromboses.. Competing Interests: C.C.Y. has authored a U.S. patent (patent no. 10,232,023 B2, “Methods for treatment of and prophylaxis against inflammatory disorders”) held by the University of Utah for the use of neonatal neutrophil extracellular traps (NET)-inhibitory factor, for which PEEL Therapeutics Inc. holds the exclusive license. (Thieme. All rights reserved.) |
| Databáze: | MEDLINE |
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