Clinical course of coronavirus disease‐2019 in pregnancy

Autor: Tirso Pérez-Medina, Lucia Fuentes, Maria Adrien, Sara Cruz-Melguizo, Eugenia Marin, Augusto Pereira
Rok vydání: 2020
Předmět:
Zdroj: Acta Obstetricia et Gynecologica Scandinavica
ISSN: 1600-0412
0001-6349
DOI: 10.1111/aogs.13921
Popis: INTRODUCTION: The aim of this study is to report our clinical experience in the management of pregnant women infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) during the first thirty days of the Coronavirus disease (COVID-19) pandemic MATERIAL AND METHODS: We reviewed clinical data from the first 60 pregnant women with COVID-19 whose care was managed at Puerta de Hierro University Hospital, Madrid, Spain from March 14(th) to April 14(th) , 2020 Demographic data, clinical findings, laboratory test results, imaging findings, treatment received, and outcomes were collected An analysis of variance (Kruskal-Wallis test) was performed to compare the medians of laboratory parameters Fisher's exact test was used to evaluate categorical variables A correspondence analysis was used to explore associations between variables RESULTS: A total of 60 pregnant women were diagnosed with COVID-19 The most common symptoms were fever and cough (75 5%, each) followed by dyspnea (37 8%) Forty-one patients (68 6%) required hospital admission (18 due to disease worsening and 23 for delivery) of whom 21 patients (35%) underwent pharmacological treatment, including hydroxychloroquine, antivirals, antibiotics and tocilizumab No renal or cardiac failures or maternal deaths were reported Lymphopenia (50%), thrombocytopenia (25%), and elevated C-reactive protein (CRP) (59%) were observed in the early stages of the disease Median CRP, D-dimer and the neutrophil/lymphocyte ratio were elevated High CRP and D-dimer levels were the parameters most frequently associated with severe pneumonia The Neutrophil/lymphocyte ratio was found to be the most sensitive marker for disease improvement (relative risk: 6 65;95% CI: 4 1-5 9) During the study period, 18 of the women (78%) delivered vaginally All newborns tested negative for SARS-CoV-2 and none of them were infected during breastfeeding No SARS-CoV-2 was detected in placental tissue CONCLUSIONS: Most of the pregnant COVID-19 positive patients had a favorable clinical course However, one-third of them developed pneumonia, of whom 5% presented a critical clinical status CRP and D-dimer levels positively correlated with severe pneumonia and the neutrophil/lymphocyte ratio decreased as the patients improved clinically Seventy-eight percent of patients had a vaginal delivery No vertical or horizontal transmissions were diagnosed in the neonates during labor or breastfeeding
Databáze: OpenAIRE
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