ABSTRACT
Coronavirus disease 2019 (COVID-19) is a worldwide health problem, particularly for pregnant women. This review assesses the effects of COVID-19 on pregnant women and their infants. A systematic search was performed of studies published on PubMed, Web of Science, Google Scholar, and Embase from January 2020 to January 2021, without restriction by language. This review included 27 studies (22 from China, one from the United States, one from Honduras, one from Italy, one from Iran, and one from Spain), which cumulatively evaluated 386 pregnant women with clinically confirmed COVID-19 and their 334 newborns. Of the 386 pregnant women, 356 had already delivered their infants, four had medical abortions at the time of research, 28 were still pregnant, and two died from COVID-19 before they were able to give birth. Cesarean sections were performed on 71% of pregnant women with COVID-19 to give birth. Fever and cough were common symptoms among women. Premature rupture of membranes, distress, and preterm birth were pregnancy complications. Low birth weight and a short gestational age were common outcomes for newborns. The common laboratory findings among pregnant women were lymphopenia, leukocytosis, and elevated levels of C-reactive protein. Chest computed tomography revealed abnormal viral lung changes in 73.3% of women. Eleven infants tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. There was no evidence of vertical transmission. Most infants were observed to have lymphopenia and thrombocytopenia. The clinical features of pregnant women were found to be similar to those of generally infected patients. There is evidence of adverse pregnancy and neonatal outcomes caused by COVID-19.
ABSTRACT
Objective: To detect biomarkers that can be used to predict COVID-19 severity to identify patients with high probability of disease progression and poor prognosis. Methods: Of the 102 patients with confirmed COVID-19 who were admitted to King Fahd General Hospital, Jeddah City, Saudi Arabia, from July 1, 2021 to August 5, 2021, 50 were included in this cross-sectional study to investigate the influence of serum amyloid A (SAA) on disease severity and survival outcomes of COVID-19 patients. Dynamic shifts in SAA, C-reactive protein (CRP), white blood cell (WBC), lymphocytes, neutrophils, biochemical markers, and disease progression were examined. At admission, and at three, five, and seven days after treatment, at least four data samples were collected from all patients, and they underwent clinical status assessments. Results: Critically ill patients showed higher SAA and CRP levels and WBC and neutrophil counts and significantly lower lymphocyte and eosinophil counts compared to the moderately/severely ill patients, especially with regard to disease progression. Similarly, nonsurvivors had higher SAA levels than survivors. The moderately/severely ill patients and the survivors had significantly higher dynamic changes in SAA compared to the critically ill patients and nonsurvivors, respectively, with differences clearly noticed on the fifth and seventh day of treatment. ROC curve analysis revealed that the combination of SAA and CRP was valuable in evaluating the disease progression and prognosis of COVID-19 patients at different time points; however, a combination of SAA and lymphocyte counts was more sensitive for disease severity prediction on admission. The most sensitive parameters for predicting survival on admission were the combination of SAA/WBC and SAA/neutrophil count. Conclusions: The study findings indicate that SAA can be used as a sensitive indicator to assess the degree of disease severity and survival outcomes of COVID-19 patients.