ABSTRACT
Introduction: The pandemic of coronavirus disease 2019 caused bythe SARS-CoV-2 is affecting many women during pregnancy and inthe postpartum period worldwide. A peculiar characteristic ofCOVID-19 is the release of a large amount of inflammatory cytokines. Some biomarkers have been considered as tools to monitor theevaluation of COVID-19, namely CRP, LDH, D-dimer and ferritin.Currently the neutrophil lymphocyte ratio constitutes a new stronginflammatory marker for the detection of inflammation. Neutrophillymphocyte ratio has also been used as a predictor of complication ofpregnancy, such as pre-eclampsia, gestational diabetes mellitus,hyperemesis gravidarum, premature labour and ectopic pregnancy.Aims &Objectives: To study the neutrophil lymphocyte ratio (NLR)and ferritin levels in COVID-19 positive pregnancy and correlate itwith the severity of the disease.Materials &Methods: This is an observational study conducted inthe obstetrics ward of a tertiary care center. The inclusion criteriawere all the pregnant females admitted in the obstetrics ward with adiagnosis of COVID-19 by RT PCR in the period of 3 months. Theexclusion criteria were patients with non reactive rapid test results.Clinical and demographic data were extracted from electronic medical records.Result: In our study, 32 out of 70 patients showed ferritin valuesabove 400 ng/ml. Lymphocytopenia, increased neutrophil lymphocyte ratio and increased ferritin had all been linked with diseaseseverity or mortality. Decreased lymphocyte value was associatedwith an increased likelihood of receiving oxygen supplementationduring hospitalization. These markers show abnormal values inobstetrics patients and reflects the course of the disease. It suggestedthat additional care should be reserved to patients presenting withdecreased value of these blood cells. Pregnancy is a physiologicanemic state and high levels of ferritin, especially in third trimesterare associated with negative outcomes like preterm delivery andgestational diabetes mellitus.Conclusions: Both neutrophil lymphocyte ratio and ferritin levels canact as independent markers in assessing the disease severity ofCOVID-19 in obstetrics patients.