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Guleroglu FY, Atalmis HA, Bafali IO, Dikdere GB, Dikdere I, Ekmez M, Kaban A, Karasabanoglu F, Atas BS, Selvi E, Sumnu G, Topaktas M, Dayan MY, Dogu SY, Cetin A. Short-term outcomes of COVID-19 in pregnant women unvaccinated for SARS-CoV-2 in the first, second, and third trimesters: a retrospective study. SAO PAULO MED J 2022; 141:e2022323. [PMID: 36472869 PMCID: PMC10065103 DOI: 10.1590/1516-3180.2022.0323.r1.19082022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/19/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) may be asymptomatic or symptomatic in pregnant women. Compared to non-pregnant reproductive-aged women, symptomatic individuals appear to have a higher risk of acquiring severe illness sequelae. OBJECTIVES We assessed the clinical and laboratory characteristics and outcomes of pregnant COVID-19 patients unvaccinated for severe acute respiratory syndrome coronavirus 2 according to the trimester of pregnancy. DESIGN AND SETTING This was a retrospective observational study conducted in a tertiary-level hospital in Turkey. METHODS This retrospective study reviewed the clinical and laboratory characteristics and outcomes of 445 pregnant COVID-19 patients hospitalized during the first, second, and third trimesters of pregnancy and 149 other pregnant women as controls in a tertiary center from April 2020 to December 2021. All participants were unvaccinated. RESULTS Overall, the study groups were comparable in terms of baseline clinical pregnancy characteristics. There was no clear difference among the study participants with COVID-19 in the first, second, and third trimesters of pregnancy. However, a considerably high number of clinical and laboratory findings revealed differences that were consistent with the inflammatory nature of the disease. CONCLUSIONS The study results reveal the importance of careful follow-up of hospitalized cases as a necessary step by means of regular clinical and laboratory examinations in pregnant COVID-19 patients. With further studies, after implementing vaccination programs for COVID-19 in pregnant women, these data may help determine the impact of vaccination on the outcomes of pregnant COVID-19 patients.
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Affiliation(s)
- Filiz Yarsilikal Guleroglu
- MD. Perinatologist, Department of Obstetrics and Gynecology, Haseki Training and Research Hospital affiliated with Health Sciences University, Sultangazi, Istanbul, Turkey
| | - Hatice Argun Atalmis
- MD. Obstetrician and Gynecologist, Department of Obstetrics and Gynecology, Haseki Training and Research Hospital affiliated with Health Sciences University, Sultangazi, Istanbul, Turkey
| | - Icten Olgu Bafali
- MD. Obstetrician and Gynecologist, Department of Obstetrics and Gynecology, Haseki Training and Research Hospital affiliated with Health Sciences University, Sultangazi, Istanbul, Turkey
| | - Gulser Bingol Dikdere
- MD. Obstetrician and Gynecologist, Department of Obstetrics and Gynecology, Haseki Training and Research Hospital affiliated with Health Sciences University, Sultangazi, Istanbul, Turkey
| | - Irfan Dikdere
- MD. Obstetrician and Gynecologist, Department of Obstetrics and Gynecology, Haseki Training and Research Hospital affiliated with Health Sciences University, Sultangazi, Istanbul, Turkey
| | - Murat Ekmez
- MD. Obstetrician and Gynecologist, Department of Obstetrics and Gynecology, Haseki Training and Research Hospital affiliated with Health Sciences University, Sultangazi, Istanbul, Turkey
| | - Alpaslan Kaban
- MD. Gynecologic Oncologist, Department of Obstetrics and Gynecology, Haseki Training and Research Hospital affiliated with Health Sciences University, Sultangazi, Istanbul, Turkey
| | - Fatma Karasabanoglu
- MD. Obstetrician and Gynecologist, Department of Obstetrics and Gynecology, Haseki Training and Research Hospital affiliated with Health Sciences University, Sultangazi, Istanbul, Turkey
| | - Busra Seker Atas
- MD. Obstetrician and Gynecologist, Department of Obstetrics and Gynecology, Haseki Training and Research Hospital affiliated with Health Sciences University, Sultangazi, Istanbul, Turkey
| | - Esra Selvi
- MD. Obstetrician and Gynecologist, Department of Obstetrics and Gynecology, Haseki Training and Research Hospital affiliated with Health Sciences University, Sultangazi, Istanbul, Turkey
| | - Gulay Sumnu
- MD. Obstetrician and Gynecologist, Department of Obstetrics and Gynecology, Haseki Training and Research Hospital affiliated with Health Sciences University, Sultangazi, Istanbul, Turkey
| | - Merve Topaktas
- MD. Obstetrician and Gynecologist, Department of Obstetrics and Gynecology, Haseki Training and Research Hospital affiliated with Health Sciences University, Sultangazi, Istanbul, Turkey
| | - Merve Yasti Dayan
- MD. Obstetrician and Gynecologist, Department of Obstetrics and Gynecology, Haseki Training and Research Hospital affiliated with Health Sciences University, Sultangazi, Istanbul, Turkey
| | - Sevilay Yavuz Dogu
- MD. Obstetrician and Gynecologist, Department of Obstetrics and Gynecology, Haseki Training and Research Hospital affiliated with Health Sciences University, Sultangazi, Istanbul, Turkey
| | - Ali Cetin
- MD, PhD. Perinatologist, Department of Obstetrics and Gynecology, Haseki Training and Research Hospital affiliated with Health Sciences University, Sultangazi, Istanbul, Turkey
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Abstract
BACKGROUND The unresolved COVID-19 pandemic considerably impacts the health services in Iraq and worldwide. Consecutive waves of mutated virus increased virus spread and further constrained health systems. Although molecular identification of the virus by polymerase chain reaction is the only recommended method in diagnosing COVID-19 infection, radiological, biochemical, and hematological studies are substantially important in risk stratification, patient follow-up, and outcome prediction. AIM This narrative review summarized the hematological changes including the blood indices, coagulative indicators, and other associated biochemical laboratory markers in different stages of COVID-19 infection, highlighting the diagnostic and prognostic significance. METHODS Literature search was conducted for multiple combinations of different hematological tests and manifestations with novel COVID-19 using the following key words: "hematological," "complete blood count," "lymphopenia," "blood indices," "markers" "platelet" OR "thrombocytopenia" AND "COVID-19," "coronavirus2019," "2019-nCoV," OR "SARS-CoV-2." Articles written in the English language and conducted on human samples between December 2019 and January 2021 were included. RESULTS Hematological changes are not reported in asymptomatic or presymptomatic COVID-19 patients. In nonsevere cases, hematological changes are subtle, included mainly lymphocytopenia (80.4%). In severe, critically ill patients and those with cytokine storm, neutrophilia, lymphocytopenia, elevated D-dimer, prolonged PT, and reduced fibrinogen are predictors of disease progression and adverse outcome. CONCLUSION Monitoring hematological changes in patients with COVID-19 can predict patients needing additional care and stratify the risk for severe course of the disease. More studies are required in Iraq to reflect the hematological changes in COVID-19 as compared to global data.
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Affiliation(s)
| | - Marwa Ali Abdulnabi
- Department of pathology, Al-Kindy College of Medicine University of Baghdad, Baghdad, Iraq
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