ABSTRACT
Objective:This study aims to investigate the perinatal outcomes in COVID-19 pregnant women with intrahepatic cholestasis of pregnancy (ICP) and elevated liver enzymes.Methods: Present study was carried on pregnant women with COVID-19 between March 11, 2020 and August 11, 2021. Patients with liver enzyme levels higher than twice the upper limit of the reference range for Aspartate Aminotransferase (AST) and/or Alanine Transferase (ALT) were included. Cases with elevated Fasting Biliary Acid (FBA) levels were regarded as ICP. Remaining cases were used as the control group. A receiver operating characteristics (ROC) analysis was performed to assess the predictive value of ALT and AST for ICP.Results: There were a total of 1751 patients in the study period. Among them 126 had elevated liver enzymes. Nineteen of these cases had also ICP. AST and ALT values were statistically higher in the ICP group. Demographic features, clinical characteristics and perinatal outcomes were similar between the groups. The rate of ICP in pregnant women with COVID-19 was similar to the literature in this study. Although the rates of preterm delivery were higher than the current literature for both groups, study and control groups were comparable in terms of preterm delivery. The optimal cut-off values were 109.5 IU/L (specificity: 59.2%, sensitivity: 63.3%) and 89.5 IU/L (specificity: 68.4%, sensitivity: 67.3%) for ALT and AST ,respectively according to the results of the ROC analysis.Conclusion: Similar perinatal outcomes were observed between the ICP and control groups. However, relatively higher rates of maternal mortality, intensive care unit admission, neonatal intensive care unit admission, and preterm birth were observed for COVID-19 pregnant women with elevated liver enzymes compared to the previous literature. Thus, physicians dealing with pregnant women with COVID-19 should be cautious about the management of cases with elevated liver enzymes.
Subject(s)
COVID-19ABSTRACT
PURPOSE: To determine the effect of SARS-CoV-2 infection on the fetal pulmonary system using the acceleration time (AT), ejection time (ET), and acceleration/ejection time ratio (PATET) of the fetal main pulmonary artery Doppler waveform. METHODS: We prospectively studied pregnant women attending our hospital with confirmed SARS-CoV-2 infection by RT-PCR test and an age-matched control group who admitted for routine prenatal care. An ultrasound examination that included measurements of the AT, ET, and AT/ET ratio (PATET) were performed and the results were compared. RESULTS: Fifty-five SARS-CoV-2-infected and 93 control group pregnant women were included in this study. AT found higher in the COVID-19 positive group when compared with controls. When the ET and PATET parameters were compared, no differences were detected between the groups. Eleven neonates had Neonatal Intensive Care Unit (NICU) requirement in the COVID-19 positive group while there were none in the control group. All fetal pulmonary artery Doppler values were decreased in NICU admitted fetuses. The mean gestational week of this group was lower than non-NICU COVID-19 positive group and the control group. CONCLUSION: COVID-19 infection increases fetal pulmonary blood flow, which appears high AT values on Doppler parameters. NICU admission only occurred in the COVID-19 group and their Doppler values were found significantly lower than non-NICU COVID-19 group. The clinical significance of this result must be evaluated with further studies.
Subject(s)
COVID-19 , SARS-CoV-2 , Female , Fetus , Humans , Infant, Newborn , Pregnancy , Prenatal Care , Prospective Studies , Pulmonary Artery/diagnostic imaging , Ultrasonography, PrenatalABSTRACT
Background: SARS CoV-2 is a novel coronavirus which cause recent pandemia and many deaths. This study aimed to determine zinc, copper and magnesium status on pregnant women with COVID-19.Methods: Totally 200 pregnants were included in the study, 100(34/33/33) were pregnants with COVID-19 infection and 100(33/32/35) were healthy pregnants and each group was divided into trimesters. Blood samples for trace element measurements were obtained from the patients along with the initial laboratory tests for clinical outcomes upon their first admission to hospital.Zinc, copper and magnesium levels were analyzed with atomic absorption spectroscopy.Results: In the first/third trimesters, serum zinc level was lower (p:0,004)/(p:0,02), serum copper level was higher (p:0,006)/(p:0,008), Zn/Cu ratio was decreased (p<0,0001)/(p<0,0001) and serum magnesium level was also higher (p<0,0001)/(p<0,0001) in COVID-19 group compared to control. Pregnants with COVID-19 in their second trimester had lower serum zinc level (p:0,05) and also copper level was decreased (p:0,0003) compared to control. Our correlation results showed that serum zinc and Zn/Cu ratio levels had negative relation with acute phase markers such as IL-6, Erythrocyte Sedimentation Rate, procalcitonin and Creactive Protein. Also, increased serum magnesium level might have role on decreased white blood cell, neutrophil, lymphocyte cell concentrations and there was correlation between serum magnesium and CRP level in the third trimester.Conclusion: This study indicated that trace element status changed in pregnants with COVID-19. With the further studies,it will be clarified that the effects of trace elements on COVID-19 in pregnant and in general population which was shown with this study first time to date.