ABSTRACT
Aim: Coronavirus disease 2019 (COVID-19) pandemic is an ongoing emergency with limited data on perinatal outcomes. The aim of the study was to describe key maternal, perinatal, and neonatal outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection from low–middle income settings. Materials and methods: We conducted a retrospective observational study in a tertiary level public hospital in India. All pregnant women admitted from May 2020 to July 2020 were included in the study. Maternal demography, medical and obstetric complications, clinical characteristics, and investigations were described. Symptomatic infected women were compared with the asymptomatic group for important outcomes. Key perinatal outcomes such as early pregnancy losses, fetal distress, stillbirths, and placental changes were evaluated. Neonatal characteristics of SARS-CoV-2 positive and negative pregnancies were described and compared. Results: Among the 702 pregnant women enrolled, the incidence of SARS-CoV-2 infection was 16.2%, with the majority being asymptomatic. Infected women had an increased mortality, while symptomatic women had a significant risk of stillbirth. Mean placental weight of infected women was significantly higher. Neonatal infection rate was 9.1%, with 50% manifesting mild respiratory symptoms without any mortality. Conclusion: This study provides a comprehensive description of important antenatal, intrapartum and neonatal complications and outcomes in a low–middle income setting characterized by high disease burden and an overwhelmed health care system. Clinical significance: Incidence of SARS-CoV-2 infection in pregnancy was 16.2%. The symptomatic infected women had increased stillbirth and mortality. Neonatal transmission was seen in 9.1% with good survival.
ABSTRACT
Introduction and Aim: A novel beta-coronavirus emerged in Wuhan, China during the early December 2019 and spread globally. The clinical signs and symptoms and the disease severity in people infected with COVID-19 can be varied. The present study was conducted to study the biomarker profile and their association with disease severity in COVID-19. Materials and Methods: This was a single-centre Cohort study of data regarding epidemiological, clinical and biomarker parameters, and outcome of COVID-19 patients admitted in a tertiary care hospital in South India. CDC guidelines were followed for assessing disease severity. Results: A total of 336 COVID-19 patients were admitted during the study period. Of these 16 were excluded and 320 cases were analysed. Mean age of patients was 44.82 years. A male predominance was observed. Diabetes mellitus was the most common co-morbidity. Asymptomatic, Mild, moderate, severe and critical disease was seen in 15%, 52.5%, 20.3%, 6.3% and 5.9% patients respectively. ICU care was required in 15.3%. Overall mortality was 5.3%. The mean NLR, ALC, CRP, LCR, LDH, Ferritin and D-dimer in the severe group vs non-severe group were 19.03 vs 4.2, 1025cells/cu mm vs 1740cells/cu mm, 185.8mg/L vs 31.7mg/L, 17.1 vs 996.3, 552.8IU/L vs 252.7IU/L, 2531.9ng/ml vs 414.1ng/ml and 2245.5ng/ml vs 339.4ng/ml respectively. Conclusion: An increased NLR, CRP, LDH, Ferritin and D-dimer and a reduced ALC and LCR are significantly associated with disease severity, need for ICU and mortality. These biomarkers will be useful adjunct to clinical assessment in better categorising and management of COVID-19 patients.