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1.
Geburtshilfe Frauenheilkd ; 82(3): 326-332, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1778662

ABSTRACT

Introduction To evaluate the association of serum electrolytes with disease severity and obstetric complications in pregnant women with Coronavirus disease 2019 (COVID-19). Materials and Methods This prospective cohort study was conducted on pregnant women with confirmed COVID-19. Study population was divided into two groups: 1) Mild COVID-19 group (n = 811) and 2) Moderate/severe COVID-19 group (n = 52). Demographic features, clinical characteristics, obstetric complications, and serum electrolytes were compared between the groups. Afterward, a correlation analysis was performed to investigate the association between serum electrolyte disturbances with COVID-19 severity and obstetric complications. Results Highest serum sodium, hypernatremia, potassium replacement, hypopotassemia, hyperchloremia, initial serum magnesium, hypermagnesemia, and hypocalcemia were significantly higher in the moderate/severe COVID-19 group. The lowest serum sodium, lowest serum potassium, and initial serum calcium were significantly higher in the mild COVID-19 group (p < 0.05). Statistically significant positive weak correlations were found between hypernatremia, hypopotassemia, hyperchloremia, hypermagnesemia, hypocalcemia and COVID-19 severity (r values were 0.27, 0.20, 0.12, 0.18 and 0.12, p values were < 0.001, < 0.001, 0.02, 0.03 and 0.03, respectively). Furthermore, statistically significant positive weak correlations were found between hypopotassemia, hypochloremia, hypermagnesemia, and obstetric complications (r values were 0.10, 0.10, and 0.28, p values were 0.004, 0.03, and 0.001, respectively). A statistically significant negative weak correlation was found between hypomagnesemia and obstetric complications (r = - 0.23 and p = 0.01, respectively). Conclusion Electrolyte disturbances in pregnant women with COVID-19 seem to be associated with disease severity and obstetric complications.

2.
Tuberk Toraks ; 70(1): 44-53, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1776526

ABSTRACT

Introduction: The aim of the study was to determine the cost of Coronavirus disease-19 (COVID-19) patients who were treated as outpatients and inpatients at Düzce University Health Application and Research Center (DUHARH) Chest Diseases Clinic before and after the pandemic from the perspective of the Social Security Institution (SSI). Materials and Methods: The study included 26.438 patients who applied to the Chest Diseases clinic in DUHARH before the COVID-19 pandemic (March 10 2019-March 10 2020) and after (March 11 2020-March 11 2021) and 2.971 patients who were hospitalized in the service. A sample was not selected in the research, and the entire universe was included in the study. The data obtained retrospectively were analyzed from bottom to top and through document analysis management. Frequency and percentage calculations, Spearman Correlation analysis, and Mann-Whitney U tests were used to evaluate the data. Result: Before the COVID-19 pandemic, the average unit cost in the policlinic was 46.14 TL/patient ($8.14/patient), and the average unit cost was 64.69 TL/ patient ($9.23/patient) after the COVID-19 pandemic. The average cost of the pre-COVID-19 pandemic service was calculated as 1.139,64 TL/patient ($200/patient). After the COVID-19 pandemic, the average unit cost in the service was 2.136,27 TL/patient ($304.75/patient). A statistically significant difference in terms of costs was found between the two periods. It was determined that the costs of COVID-19 patients changed in terms of length of stay, age, and sex (p<0.05). Conclusions: Even though the number of patients in the Chest Diseases clinic has decreased during the pandemic process, the costs have increased due to the high cost of COVID-19 patients and the patients needing advanced examination and treatment in this period. For this reason, patients need to apply to the relevant unit early.


Subject(s)
COVID-19 , COVID-19/epidemiology , Health Care Costs , Hospitals, University , Humans , Pandemics , Retrospective Studies
3.
Turk J Obstet Gynecol ; 19(1): 21-27, 2022 Mar 28.
Article in English | MEDLINE | ID: covidwho-1766065

ABSTRACT

Objective: It is thought that oxidative stress, free radicals, reactive oxygen species and reactive nitrogen species affect the pathophysiology of coronavirus disease-2019 (COVID-19). This study aimed to evaluate the oxidative status in pregnant patients with COVID-19 infection according to the changes seen in the levels of maternal serum thiol-disulfide and ischemia-modified albumin (IMA). Materials and Methods: A study group was formed of 40 pregnant women with confirmed COVID-19 infection (study group) and a control group of 40 healthy pregnant women with no risk factors determined. In this prospective, case-controlled study, analyses were made of the maternal serum native thiol, total thiol, disulfide, IMA, and disulfide/native thiol concentrations. Results: The maternal serum native thiol and total thiol concentrations in the study group were determined to be statistically significantly lower (p=0.007 and p=0.006, respectively), and the disulfide/native thiol ratio was higher but not to a level of statistical significance (p=0.473). There was no difference between the two groups regarding IMA levels (p=0.731). Conclusion: The thiol-disulfide balance was seen to shift in the oxidant direction in pregnancies with COVID-19, which might support the view that ischemic processes play a role in the etiopathogenesis of this novel disease.

4.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-329638

ABSTRACT

Aim: We aimed to examine fetal cardiac output (CO) in patients who recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Materials: This prospective study included 48 pregnant women recovered from SARS-CoV-2 infection and 50 control cases. SARS-CoV-2 infection was diagnosed by polymerase chain reaction (PCR) test in patients. Fetal echocardiographic evaluations were performed at 24-37 weeks of gestation in pregnant women who recovered from the infection and control group. Results: The median value of ultrasound evaluation was 34 (2.6) weeks of gestation in the recovery from the SARS-CoV-2 infection (RSI) group, and 32 (7.6) weeks in the control group (p=0.565). Left cardiac output (LCO) z score was significantly lower in the RSI group than the control group (p=0,041). LCO and combine cardiac output (CCO) z score were significantly lower in the severe disease group than mild, moderate disease groups, and controls (p=0,019 and p=0,013). CCO (mL/min/kg) was decreased in the severe disease group when compared with control and mild disease groups (p=0,044). Fetal distress, preterm delivery rate, and neonatal intensive care unit (NICU) admission were found to be higher in the severe disease group compared to the control group (p=0,010, p=0,009, and p<0,001 respectively). Conclusion: In the present study, fetal cardiac output in pregnant women with recovery from SARS-CoV-2 infection was found significantly decreased, especially in whom had severe diseases. Placental dysfunction and inflammatory cytokines might cause fetal cardiac changes. Further studies could be clarified on the impact of SARS-CoV-2 infection on fetal cardiac function.

5.
J Obstet Gynaecol ; : 1-8, 2022 Mar 12.
Article in English | MEDLINE | ID: covidwho-1740556

ABSTRACT

The aim of the present study is to share the experience of a tertiary reference pandemic centre on the labour and delivery of pregnant women with coronavirus disease 2019 (COVID-19). This prospective cohort study was conducted on pregnant women with COVID-19 (n = 337). Patients were divided into two groups based on their severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) positivity (n = 103 positive and n = 234 negative) during the delivery. Thereafter, clinical characteristics and perinatal outcomes were compared between the groups. Moreover, delivery characteristics and clinical features were compared between primary caesarean section (n = 117) and normal spontaneous vaginal delivery cases (n = 100). Labour induction was performed in 16% of cases with a failure rate of 35%. Caesarean rate was 70% and the most common indication was worsening in maternal condition. Significant, positive and moderate correlations were observed between COVID-19 severity at admission (r = 0.422, p<.001), radiologic findings consistent with COVID-19 (r = 0.400, p<.001), the necessity for oxygen support during the delivery (r = 0.406, p<.001) and postpartum worsening in maternal condition. A significant, positive weak correlation was found between caesarean delivery and postpartum worsening in maternal condition (r = 0.176, p<.001). COVID-19 seems to be associated with increased rates of obstetric complications and caesarean delivery.Impact StatementWhat is already known on this subject? Increased rates of foetal distress and caesarean section were reported in pregnant women with COVID-19. Appropriate management of labour and delivery in infected pregnant women is crucial to obtain favourable perinatal outcomes.What do the results of this study add? COVID-19 seems to be associated with increased rates of obstetric complications and caesarean delivery. PCR positive group had significantly higher primary and prelabor caesarean delivery rates. Severe/critic COVID-19 infection rate was significantly higher in the primary caesarean group. Significant, positive and moderate correlations were observed between COVID-19 severity at admission, radiologic findings consistent with COVID-19, the necessity for oxygen support during the delivery and postpartum worsening in maternal condition. A significant, positive weak correlation was found between caesarean delivery and postpartum worsening in maternal condition.What are the implications of these findings for clinical practice and/or further research? Management and delivery of pregnant women with COVID-19 should be individualised. The findings of the present study may lead to the establishment of future obstetric protocols in this special population.

6.
Arch Gynecol Obstet ; 2022 Mar 07.
Article in English | MEDLINE | ID: covidwho-1729287

ABSTRACT

PURPOSE: To compare the clinical features and perinatal outcomes of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the pre-variant and post-variant periods. METHODS: This prospective cohort study includes pregnant women with SARS-CoV-2 who were followed-up at Ankara City Hospital between 11, March 2020 and 15, September 2021. Demographic features, clinical characteristics and pregnancy outcomes were compared between the pre-variant (n = 1416) and post-variant (n = 519) groups. RESULTS: The rates of severe and critical cases significantly increased in the post-variant group (9.7% vs 2%, p < 0.001). The rates of respiratory support (26.8% vs 7.3%, p < 0.001), ICU admission (12.9% vs 1.8%, p < 0.001) and maternal mortality (2.9% vs 0.4%, p < 0.001) were significantly higher in the post-variant group. A significant increase was observed for pregnancy complications in the post-variant group (45.6% vs 18.8%, p = 0.007). The rates of preterm delivery (26.4% vs 4.4%, p < 0.001) and NICU admission (34% vs 18.8%, p < 0.001) were significantly higher in the post-variant group. Positive, weak, statistically significant correlations were observed between the post-variant period, disease severity and maternal mortality (r = 0.19, r = 0.12 and p < 0.001). CONCLUSION: Post-variant COVID-19 period was associated with a severe course of the disease and increased rates of adverse obstetric outcomes in pregnant patients.

7.
Turk J Med Sci ; 51(SI-1): 3312-3326, 2021 12 17.
Article in English | MEDLINE | ID: covidwho-1726142

ABSTRACT

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has alarmed the world since its first emergence. As pregnancy is characterized by significant changes in cardiovascular, respiratory, endocrine, and immunological systems, there are concerns on issues like the course of disease in pregnant women, safety of medications, route of delivery and risk of obstetric complications. The aim of this review is to summarize the current literature in the management of pregnant women during the COVID-19 pandemic. Although more than 90% of pregnant women with COVID-19 recover without serious morbidity, rapid deterioration of disease and higher rates of obstetric complications may be observed. The risk of vertical transmission has not been clearly revealed yet. Decreasing the number of prenatal visits, shortening the time allocated for the examinations, active use of telemedicine services, limiting the number of persons in healthcare settings, combining prenatal tests in the same visit, restricting visitors during the visits, providing a safe environment in healthcare facilities, strict hygiene control, and providing personal protective equipment during the visits are the main strategies to control the spread of disease according to current guidelines. Although new medication alternatives are being proposed every day for the treatment of COVID-19, our knowledge about the use of most of these drugs in pregnancy is limited. Preliminary results are promising for the administration of SARS-CoV-2 vaccines in the pregnant population. Timing of delivery should be decided based on maternal health condition, accompanying obstetric complications and gestational age. Cesarean delivery should be performed for obstetric indications. Breast feeding should be encouraged as long as necessary precautions for viral transmission are taken. In conclusion, an individualized approach should be provided by a multidisciplinary team for the management of pregnant women with COVID-19 to achieve favorable outcomes.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19 , Pregnancy Complications/virology , COVID-19/diagnosis , COVID-19/prevention & control , COVID-19/therapy , Female , Humans , Pandemics , Pregnancy , Pregnancy Complications/prevention & control , SARS-CoV-2 , Vaccination
8.
J Med Virol ; 2021 Oct 29.
Article in English | MEDLINE | ID: covidwho-1718372

ABSTRACT

The aim of this study is to share the comprehensive experience of a tertiary pandemic center on pregnant women with COVID-19 and to compare clinical outcomes between pregnancy trimesters. The present prospective cohort study consisted of pregnant women with COVID-19 who were followed up at Ankara City Hospital between March 11, 2020 and February 20, 2021. Clinical characteristics and perinatal outcomes were compared between the pregnancy trimesters. A total of 1416 pregnant women (1400 singletons and 16 twins) with COVID-19 were evaluated. Twenty-six (1.8%) patients were admitted to the intensive care unit (ICU) and maternal mortality was observed in six (0.4%) cases. Pregnancy complications were present in 227 (16.1%) cases and preterm labor was the most common one (n = 42, 2.9%). There were 311, 433, and 672 patients in the first, second, and third trimesters of pregnancy, respectively. Rates of mild and severe/critic COVID-19 were highest in the first and second trimesters, respectively. The hospitalization rate was highest in the third trimester. Pregnancy complications, maternal mortality, and NICU admission rates were similar between the groups. The course of the disease and obstetric outcomes may be different among pregnancy trimesters. A worse course of the disease may be observed even in pregnant women without any coexisting health problems.

9.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-305663

ABSTRACT

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.

10.
J Perinat Med ; 50(2): 139-143, 2022 Feb 23.
Article in English | MEDLINE | ID: covidwho-1561422

ABSTRACT

OBJECTIVES: To investigate the long-term effects of the SARS-CoV-2 infection on the fetal immune system by fetal thymus size measurements with ultrasound (USG). METHODS: This prospective study was conducted in the Turkish Ministry of Health Ankara City Hospital between November 1, 2020 and April 1, 2021, with recovered, pregnant women, four weeks after they had been confirmed for the SARS-CoV-2 infection by real-time polymerase-chain-reaction (RT-PCR). COVID-19 recovered (CR) pregnant women compared with age-matched pregnant controls in terms of demographic features, fetal thymic-thoracic ratio (TTR), and laboratory parameters. RESULTS: There was no difference in demographic features between the two groups. TTR found significantly lower in the CR group than the control group (p=0.001). The fetal TTR showed a significant and moderate correlation with maternal monocyte counts, monocyte to lymphocyte ratio (MLR), and red cell distribution width (RDW); while it did not correlate with lymphocyte counts, c-reactive protein (CRP), and procalcitonin levels. CONCLUSIONS: The 2019 novel coronavirus disease (COVID-19) reduces fetal thymus size in pregnant women with mild or moderate symptoms after recovery from the infection.


Subject(s)
COVID-19/pathology , Fetus/pathology , Pregnancy Complications, Infectious/pathology , Thymus Gland/pathology , Adult , COVID-19/diagnostic imaging , Female , Fetus/diagnostic imaging , Humans , Organ Size , Pregnancy , Pregnancy Complications, Infectious/diagnostic imaging , Prospective Studies , Thymus Gland/diagnostic imaging , Ultrasonography, Prenatal , Young Adult
12.
Ear Hear ; 43(1): 41-44, 2021 11 19.
Article in English | MEDLINE | ID: covidwho-1528197

ABSTRACT

OBJECTIVE: Viral infections are known to be a risk factor for neonatal hearing loss. COVID-19 infection has been reported to affect hearing test results in one small sample sized study. We aimed to investigate the incidence the risk of neonatal hearing loss in infants of mothers who had COVID-19 infection during pregnancy, regarding their trimesters, by evaluating the neonatal hearing screening results. DESIGN: In this retrospective case-control study, neonatal hearing test results of 458 women with a history of COVID-19 infection in pregnancy were compared with 339 women who gave birth before the pandemic. Data of pregnant women who attended the COVID-19 outpatient clinic of the emergency service of a tertiary pandemic hospital and who had confirmed infection with a reverse transcriptase-polymerase chain reaction (RT-PCR) test were determined from the hospital's records and their neonatal hearing screening results were analyzed from the national database. Neonates born before <34 weeks, and with reported risk factors in the database such as congenital anomaly or known TORCH infection during pregnancy were excluded. The screening tests, Automated Auditory Brainstem Response or Transient Evoked Otoacoustic Emission (TEOAE), were used for screening, and patients who failed the first screening were reevaluated at least 2 weeks apart with a second screening. RESULTS: The incidence of failed second screening was 1.3% in the COVID-19 group and 2.9% in controls, and no significant difference was observed between the two groups according to the final screening results on the second test. Among the 458 mothers, 8 were infected in first trimester, 126 in second trimester, 127 in third trimester but did not deliver within 15 days after infection and 197 were positive at birth. Six neonates in the infected group failed the second screening (3 [2.4%] in the second trimester, 1 [0.8%] third trimester, and 2 [1.0%] positive at birth). CONCLUSIONS: COVID-19 infection during pregnancy was not found to be a risk factor for hearing loss, according to the newborn hearing screening results.


Subject(s)
COVID-19 , Case-Control Studies , Evoked Potentials, Auditory, Brain Stem , Female , Hearing Tests , Humans , Infant , Infant, Newborn , Mothers , Neonatal Screening , Otoacoustic Emissions, Spontaneous , Pregnancy , Retrospective Studies , SARS-CoV-2
13.
J Matern Fetal Neonatal Med ; : 1-6, 2021 Nov 23.
Article in English | MEDLINE | ID: covidwho-1528083

ABSTRACT

OBJECTIVE: To evaluate the relationship between 25-hydroxy vitamin D (25(OH)D) levels and disease severity in hospitalized COVID-19 positive pregnant women. METHODS: The COVID-19 (+) pregnant women (confirmed by PCR test) were classified as asymptomatic, mild symptomatic, and severe disease according to their symptoms and laboratory results. Severe COVID-19 criteria were respiratory symptoms and/or findings. The following laboratory results were considered as poor prognostic factors: the number of lymphocytes <800/µl and/or CRP value >10 times the upper limit of the normal range and/or ferritin value >500 ng/ml and/or D-Dimer value >1000 µg/l. The patients were divided into two groups; asymptomatic or mild symptomatic group (Group 1), and severe disease and/or poor prognostic factor group (Group 2). The 25(OH)D levels were compared between groups. ROC curve analysis was used to analyze the cutoff value for vitamin D to predict the severity of COVID-19. RESULTS: 25(OH)D levels were found to be statistically significantly lower in group 2 (15.5 (10.25) ng/ml in Group 1, 13 (12) ng/ml in Group 2, p = .010). The 25(OH)D level under 14.5 ng/ml was associated with severe COVID-19 and/or poor prognostic factors (p = .010). The risk of severe COVID-19 and/or having poor prognostic factors was 1.87 times higher among pregnant women who had 25(OH)D levels below 14.5 ng/ml. This value was found to have 54.1% sensitivity and 61.3% specificity in predicting severe COVID-19 and/or poor prognostic laboratory findings in pregnant women. CONCLUSION: There is a relationship between vitamin D status and the severity of COVID-19 in pregnant women. During the pandemic period, vitamin D supplementation for pregnant women should gain more importance.

14.
Hum Vaccin Immunother ; 17(11): 4043-4047, 2021 Nov 02.
Article in English | MEDLINE | ID: covidwho-1488127

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) has spread rapidly around the world, causing massive morbidity and mortality. Vaccination during puerperium protects both the mother and the newborn and is important to keep the pandemic under control. METHODS: Women who gave birth at Ankara City Hospital between February 11, 2021 and March 21, 2021 were included. Data were collected through a face-to-face questionnaire. RESULTS: We asked 412 postpartum women were surveyed about their acceptance of the COVID-19 vaccine; 137 (33.3%) of them wanted to be vaccinated, while 275 (66.7%) of them did not want to be vaccinated. Reasons for vaccination rejection; 209 (76%) of them stated that there was not enough information about the safety of the vaccine for the postpartum period, and 89 (32.4%) of them thought that the vaccine would not be effective for the disease. Three of the answers in the survey were found significantly different in high-risk pregnancy (HRP) group compared to low-risk pregnancy (LRP) group; 1) Having their babies to be vaccinated, 2) To be vaccinated if it will be recommended to the puerperal women, and 3) Feeling anxious about being infected by SARS-CoV-2 (p < .05). CONCLUSIONS: Health authorities recommend the COVID-19 vaccine to breastfeeding mothers. However, a relatively low vaccination acceptance rate was observed in the present study. For newly developed vaccines, concern over vaccine safety is the biggest obstacle to vaccine administration. Therefore, the reasons that influence acceptance or refusal of vaccines are important for developing targeted communication strategies and healthcare policies.


Subject(s)
COVID-19 Vaccines , COVID-19 , Female , Humans , Infant, Newborn , Pandemics , Postpartum Period , Pregnancy , SARS-CoV-2 , Vaccination
15.
Cytokine ; 149: 155751, 2022 01.
Article in English | MEDLINE | ID: covidwho-1487680

ABSTRACT

BACKGROUND: New biomarkers for diagnosis and monitoring the COVID-19 disease are the most important topics to be studied recently. We aimed to investigate the association between midkine levels and disease severity in pregnant women with COVID-19. METHODS: Totally 186 pregnant women were participated in this study. 96 of them were healthy pregnant women, 90 of them were pregnant women with COVID19. Pregnant women were evaluated according to their trimesters. Serum midkine level, biochemical profile clinical and disease severity outcomes of pregnant women were obtained. RESULTS: Our results showed that pregnant women with COVID19 have significantly increased serum midkine level compared to healthy pregnant women (1.801 ± 0.977 vs 0.815 ± 0.294 ng/dL). According to the data among each trimester, it was shown that there were significant increase in serum midkine level during all pregnancy trimesters (1st trimester Control Group: 0.714 ± 0.148, COVID-19 group 1.623 ± 0.824, p < 0.0001; 2nd trimester Control Group: 0.731 ± 0.261, COVID-19 group 2.059 ± 1.146, p < 0.0001; 3rd trimester Control Group: 1.0 ± 0.35, COVID-19 group 1.723 ± 0.907, p = 0.001). Serum midkine levels were significantly different between disease severity subgroups of pregnant women with COVID19; moderate and severe/critic groups had significantly higher serum midkine level than mild group. There was also significant correlation between serum midkine level and severity status (p:0.0001, r: 0.468). The most striking results of serum midkine levels were corelation between length of hospitalization (p: 0.01, r: 0.430) and O2 saturation (p < 0.0001, r: -0.521). ROC curve analysis showed that serum midkine level might be a tool for predicting COVID-19 in pregnant women with COVID-19 (AUC: 0.912, 95% CI: [0.871, 0.952], p < 0.0001) CONCLUSION: Our data showed that there is an obvious relation between COVID19 progression and serum midkine level for the first time which might be used for monitoring the disease process.


Subject(s)
COVID-19/blood , COVID-19/diagnosis , Midkine/blood , Adult , Biomarkers/blood , COVID-19/pathology , Case-Control Studies , Disease Progression , Female , Hospitalization , Humans , Pregnancy , Pregnancy Trimesters , ROC Curve , Severity of Illness Index , Young Adult
16.
Women Health ; 61(9): 872-879, 2021 10.
Article in English | MEDLINE | ID: covidwho-1434248

ABSTRACT

Anakinra, which is an Interleukin-1 (IL-1) receptor antagonist with the advancing disease process, has started to be considered as an alternative treatment for Covid-19 patients with cytokine storms. We evaluated the effect of corticosteroids and IL-1 receptor blockage with anakinra on pregnant patients with Covid-19 at high risk for respiratory distress, ongoing fever, deterioration in their general condition and consequently maternal and fetal complications. Fourteen pregnant women who received anakinra (median dosage: 400 mg) and corticosteroid (methylprednisolone-median dosage: 80 mg) treatment were evaluated retrospectively. Patients were assessed according to the World Health Organization (WHO) scale. The mortality rate of the cohort was 7.1%, the median hospitalization period of the patients was 15 days and 2 patients had premature births. Covid-19 was found to have a similar spectrum of symptoms in pregnant and non-pregnant women, such as dyspnea, cough and fever. Our study was the first to analyze the combined treatment of corticosteroid and anakinra in pregnant patients with pneumonia from Covid-19 based on the WHO scoring system. Due to the obscurity in the treatment process in pregnant patients, studies are ongoing on managing Covid-19 infection in these patients. We presume that the early use of anakinra and corticosteroid treatments in patients severely infected with Covid-19 may have positive effects on disease progression and survival.


Subject(s)
COVID-19 , Interleukin 1 Receptor Antagonist Protein , Adrenal Cortex Hormones , Female , Humans , Pregnancy , Pregnant Women , Retrospective Studies , SARS-CoV-2
17.
J Steroid Biochem Mol Biol ; 213: 105964, 2021 10.
Article in English | MEDLINE | ID: covidwho-1433601

ABSTRACT

OBJECTIVE: We aimed to evaluate the vitamin D status of pregnant women with COVID-19, and the association between vitamin D level and severity of COVID-19. METHODS: In this case control study, 159 women with a single pregnancy and tested positive for SARS-CoV-2, and randomly selected 332 healthy pregnant women with similar gestational ages were included. COVID-19 patients were classified as mild, moderate, and severe. Vitamin D deficiency was defined as 25-hydroxycholecalciferol <20 ng/mL (50 nmol/L), and 25-OH D vitamin <10 ng/mL was defined as severe vitamin D deficiency, also 25-OH D vitamin level between 20-29 ng/mL (525-725 nmol/L) was defined as vitamin D insufficiency. RESULTS: Vitamin D levels of the pregnant women in the COVID-19 group (12.46) were lower than the control group (18.76). 25-OH D vitamin levels of those in the mild COVID-19 category (13.69) were significantly higher than those in the moderate/severe category (9.06). In terms of taking vitamin D supplementation, there was no statistically significant difference between the groups. However, it was observed that all of those who had severe COVID-19 were the patients who did not take vitamin D supplementation. CONCLUSION: The vitamin D levels are low in pregnant women with COVID-19. Also, there is a significant difference regarding to vitamin D level and COVID-19 severity in pregnant women. Maintenance of adequate vitamin D level can be useful as an approach for the prevention of an aggressive course of the inflammation induced by this novel coronavirus in pregnant women.


Subject(s)
COVID-19/diet therapy , Cytokine Release Syndrome/diet therapy , Dietary Supplements , Pregnancy Complications, Infectious/diet therapy , Vitamin D Deficiency/diet therapy , Vitamin D/administration & dosage , Adult , COVID-19/blood , COVID-19/pathology , COVID-19/virology , Calcifediol/blood , Case-Control Studies , Cytokine Release Syndrome/blood , Cytokine Release Syndrome/pathology , Cytokine Release Syndrome/virology , Female , Gestational Age , Humans , Pregnancy , Pregnancy Complications, Infectious/blood , Pregnancy Complications, Infectious/pathology , Pregnancy Complications, Infectious/virology , SARS-CoV-2/pathogenicity , Severity of Illness Index , Treatment Outcome , Vitamin D/analogs & derivatives , Vitamin D/blood , Vitamin D Deficiency/blood , Vitamin D Deficiency/pathology , Vitamin D Deficiency/virology
18.
J Med Virol ; 93(10): 5864-5872, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1432419

ABSTRACT

The aim was to investigate the association of the delivery mode and vertical transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) through the samples of vaginal secretions, placenta, cord blood, or amniotic fluid as well as the neonatal outcomes. This cross-sectional study presents an analysis of prospectively gathered data collected at a single tertiary hospital. Sixty-three pregnant women with confirmed coronavirus disease 2019 (COVID-19) participated in the study. Vertical transmission of SARS-CoV-2 was analyzed with reverse transcriptase-polymerase chain reaction (RT-PCR) tests and blood tests for immunoglobulin G (IgG)-immunoglobulin M (IgM) antibodies. All patients were in the mild or moderate category for COVID-19. Only one placental sample and two of the vaginal secretion samples were positive for SARS-CoV-2. Except for one, all positive samples were obtained from patients who gave birth by cesarean. All cord blood and amniotic fluid samples were negative for SARS-CoV-2. Two newborns were screened positive for COVID-19 IgG-IgM within 24 h after delivery, but the RT-PCR tests were negative. A positive RT-PCR result was detected in a neof a mother whose placenta, cord blood, amniotic fluid, and vaginal secretions samples were negative. He died due to pulmonary hemorrhage on the 11th day of life. In conclusion, we demonstrated that SARS-CoV-2 can be detectable in the placenta or vaginal secretions of pregnant women. Detection of the virus in the placenta or vaginal secretions may not be associated with neonatal infection. Vaginal delivery may not increase the incidence of neonatal infection, and cesarean may not prevent vertical transmission. The decision regarding the mode of delivery should be based on obstetric indications and COVID-19 severity.


Subject(s)
COVID-19/transmission , SARS-CoV-2/isolation & purification , Adolescent , Adult , COVID-19/diagnosis , COVID-19/epidemiology , Cesarean Section , Cross-Sectional Studies , Female , Humans , Infant, Newborn , Infant, Newborn, Diseases/diagnosis , Infant, Newborn, Diseases/epidemiology , Infant, Newborn, Diseases/virology , Infectious Disease Transmission, Vertical/statistics & numerical data , Male , Placenta/virology , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/virology , Pregnancy Outcome , Prospective Studies , SARS-CoV-2/genetics , SARS-CoV-2/immunology , Tertiary Care Centers , Vagina/virology , Young Adult
19.
Turk J Med Sci ; 51(SI-1): 3312-3326, 2021 12 17.
Article in English | MEDLINE | ID: covidwho-1431003

ABSTRACT

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has alarmed the world since its first emergence. As pregnancy is characterized by significant changes in cardiovascular, respiratory, endocrine, and immunological systems, there are concerns on issues like the course of disease in pregnant women, safety of medications, route of delivery and risk of obstetric complications. The aim of this review is to summarize the current literature in the management of pregnant women during the COVID-19 pandemic. Although more than 90% of pregnant women with COVID-19 recover without serious morbidity, rapid deterioration of disease and higher rates of obstetric complications may be observed. The risk of vertical transmission has not been clearly revealed yet. Decreasing the number of prenatal visits, shortening the time allocated for the examinations, active use of telemedicine services, limiting the number of persons in healthcare settings, combining prenatal tests in the same visit, restricting visitors during the visits, providing a safe environment in healthcare facilities, strict hygiene control, and providing personal protective equipment during the visits are the main strategies to control the spread of disease according to current guidelines. Although new medication alternatives are being proposed every day for the treatment of COVID-19, our knowledge about the use of most of these drugs in pregnancy is limited. Preliminary results are promising for the administration of SARS-CoV-2 vaccines in the pregnant population. Timing of delivery should be decided based on maternal health condition, accompanying obstetric complications and gestational age. Cesarean delivery should be performed for obstetric indications. Breast feeding should be encouraged as long as necessary precautions for viral transmission are taken. In conclusion, an individualized approach should be provided by a multidisciplinary team for the management of pregnant women with COVID-19 to achieve favorable outcomes.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19 , Pregnancy Complications/virology , COVID-19/diagnosis , COVID-19/prevention & control , COVID-19/therapy , Female , Humans , Pandemics , Pregnancy , Pregnancy Complications/prevention & control , SARS-CoV-2 , Vaccination
20.
Int J Gynaecol Obstet ; 155(3): 450-454, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1400847

ABSTRACT

OBJECTIVE: To evaluate fetal lung development using pulmonary artery Doppler in pregnant women who had recovered from COVID-19. METHODS: The prospective case-control study included 41 pregnant women who had recovered from COVID-19 and 43 healthy pregnant women (control group). All the women in the study group had been diagnosed with COVID-19 and had completed a quarantine period. RESULTS: The demographic data of patients were similar in the groups (P > 0.05). Main pulmonary artery peak systolic velocity was higher and pulsatility indices were lower in pregnant women who recovered from COVID-19 compared to the controls (P < 0.001, P = 0.001). Acceleration time, ejection time, and acceleration/ejection time ratio (PATET) of the fetal MPA Doppler were significantly decreased in pregnant women who recovered from COVID-19 (P < 0.001, P = 0.036, and P = 0.002, respectively). The patients who had recovered from COVID-19 were divided into two groups: those treated with expectant management and those treated in hospital. The pulmonary artery acceleration time and PATET ratio were significantly lower in the group treated in the hospital (P = 0.023 and P = 0.045, respectively). CONCLUSION: Detailed Doppler evaluations of the pulmonary artery may help in evaluating the fetal adverse effects of COVID-19 disease.


Subject(s)
COVID-19 , Pulmonary Artery , Blood Flow Velocity , Case-Control Studies , Female , Humans , Pregnancy , Pregnant Women , Prospective Studies , Pulmonary Artery/diagnostic imaging , SARS-CoV-2 , Ultrasonography, Doppler , Ultrasonography, Prenatal
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