Kocaeli Med J. 2023; 12(2): 240-245 | DOI: 10.5505/ktd.2023.73658

What are the Factors Affecting the Clinical Course of COVID-19 Infected Pregnants Admitted to Intensive Care?

Arzu Yavuz, Erdem Gürkan, Gökçe Naz Küçükbaþ
University of Health Sciences, Kocaeli City Hospital, Department of Obstetrics and Gynecology, Kocaeli, Turkey

INTRODUCTION: The management of coronavirüs 2019 (COVID-19) infection in pregnancy is different from the normal population. Therefore, it is important to evaluate prognostic factors and inflammatory markers that may affect the clinical course of COVID-19 infection during pregnancy. Our aim in this study is to investigate inflammatory markers such as procalcitonin, ferritin, D-Dimer and fibrinogen that may affect the clinical outcomes of COVID-19 infected pregnant women who need intensive care unit (ICU).
METHODS: 53 pregnant women who needed ICU due to acute respiratory failure because of COVID-19 infection were included in our study. Pregnant patients followed up in the ICU were divided into two groups according to whether they were intubated or not. These two patient groups were compared according to lymphocyte count, C-reactive protein (CRP), D-Dimer, ferritin, fibrinogen, procalcitonin values and descriptive features.
RESULTS: The CRP results of the intubated group were higher (p=0.001; p<0.01). Lymphocyte count of the two groups were compared, the results of the intubated group were lower and this difference was statistically significant (p=0.002; p<0.01). A statistically significant difference was found between procalcitonin values (p=0.001; p<0.01) and ferritin values (p=0.033; p<0.05) in the intubated and non-intubated groups. Both laboratory parameters were higher in the intubated group. Fibrinogen results were high in intubated group but this was no statistically significant difference between the two groups (p=0.081; p>0.05).
DISCUSSION AND CONCLUSION: In conclusion, inflammatory parameters in pregnant patients may reflect the severity of the COVID-19 infection to some extent. Therefore, these markers can be used in the clinical management of the disease.

Keywords: COVID-19, pregnancy, inflammatory markers, intensive care unit

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Yoðunbakýma Yatan COVÝD-19 Enfekte Gebelerin Klinik Seyrini Etkileyen Faktörler Nelerdir?

Arzu Yavuz, Erdem Gürkan, Gökçe Naz Küçükbaþ
Saðlýk Bilimleri Üniversitesi, Kocaeli Þehir Hastanesi, Kadýn Hastalýklarý ve Doðum Kliniði, Kocaeli, Türkiye.

GÝRÝÞ ve AMAÇ: Gebelikte koronavirüs hastalýðý 2019 (COVID-19) yönetimi normal popülasyondan farklýdýr. Bu nedenle gebelikte geçirilen COVID-19 enfeksiyonunun klinik seyrini etkileyebilecek prognostik faktörleri ve inflamatuar belirteçleri deðerlendirmek son derece önemlidir. Bizim bu çalýþmadaki amacýmýz yoðun bakým ünitesi (YBÜ) ihtiyacý olan COVID-19 enfekte gebelerin klinik süreçlerine etki edebilecek prokalsitonin, ferritin, D-Dimer ve fibrinojen gibi inflamatuar belirteçleri incelemektir.
YÖNTEM ve GEREÇLER: Çalýþmamýza COVID-19 enfeksiyonu nedeniyle takip ve tedavi edilen gebelerden akut solunum yetersizliði nedeniyle YBÜ ihtiyacý olan 53 gebe dahil edilmiþtir. YBÜ’nde takip olan gebe hastalar entübe olup olmamalarýna göre iki ayrý gruba ayrýlmýþtýr. Bu iki hasta grubunun tanýmlayýcý özellikleri ile kan tahlillerindeki lenfosit sayýsý, C- reaktif protein (CRP), D-Dimer, ferritin, fibrinojen ve prokalsitonin deðerleri karþýlaþtýrýlmýþtýr.
BULGULAR: Entübe edilen grubun CRP sonuçlarý daha yüksek bulunmuþtur (p=0,001; p<0,01). Ýki grubun lenfosit deðerleri karþýlaþtýrýldýðýnda entübe edilen grubun sonuçlarý daha düþüktür ve bu fark istatistiksel olarak da anlamlýdýr (p=0,002; p<0,01). Entübe edilen ve edilmeyen grubun prokalsitonin deðerleri arasýnda (p=0,001; p<0,01) ve ferritin deðerleri arasýnda (p=0,033; p<0,05) istatistiksel olarak anlamlý farklýlýk saptanmýþtýr. Her iki laboratuvar parametresi de entübe edilen grupta daha yüksektir. Fibrinojen sonuçlarýna baktýðýmýzda ise iki grup arasýnda istatistiksel olarak anlamlý farklýlýk saptanmasa da (p=0,081; p>0,05); entübasyon yapýlan grubun fibrinojen deðerleri daha yüksek bulunmuþtur.
TARTIÞMA ve SONUÇ: Sonuç olarak gebe hastalarda kan tahlillerindeki inflamatuar parametreler; COVID-19 hastalýðýnýn þiddetini bir dereceye kadar yansýtabilir. Bu nedenle hastalýðýn klinik yönetiminde bu belirteçler dikkate alýnarak kullanýlabilir.

Anahtar Kelimeler: COVID-19, gebelik, inflamatuar belirteçler, yoðun bakým ünitesi

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