PREGNANCY COMPLICATIONS AND OUTCOMES IN WOMEN WITH COVID-19

Aim: Analysis of pregnancy complications and outcomes in women with COVID-19. Materials and methods: The retrospective study included 34 pregnant women aged 16–40 years, who underwent treatment for COVID-19 in hospital. The diagnosis of COVID-19 infection was confirmed by positive PCR test results for SARS-CoV-2 RNA detection in all pregnant women. Results: Most pregnant women (52.9%) had mild symptoms, 20.7% had moderate symptoms and 17.6% had severe symptoms. Pneumonia was diagnosed in 67.1% of pregnant women. Obesity was predominant in the structure of extragenital disorders. It was in 44.1% of women. With COVID-19, iron deficiency anemia (44.2%), preeclampsia (38.2%), risk of preterm birth (35.3%) were predominant in the structure of pregnancy complications. Preterm birth occurred in 36.8% of cases. Cesarean section was performed in 73.3% of cases. The incidence of complications in newborns was 11.6%. 8.8% of newborns were referred to the neonatal intensive care unit. Conclusion: It was found that most pregnant women had mild cases of COVID-19. Pregnant women with COVID-19 had high incidence of preeclampsia, preterm birth and cesarean section versus pregnant women without COVID-19. Intrauterine vertical transmission of infection was not detected. The incidence of complications in newborns was in compliance with general population indicators.

[Coronavirus infection and risk of postoperative venous thromboembolic events]. / Koronavirusnaya infektsiya i risk posleoperatsionnykh venoznykh tromboembolicheskikh sobytii u khirurgicheskikh bol'nykh.

OBJECTIVE: To determine whether patients with perioperative or previous coronavirus infection (CVI) have a greater risk of venous thromboembolic events (VTE). MATERIAL AND METHODS: A multiple-center regional prospective retrospective cohort study included elective and emergency patients who underwent surgery in November 2020. The primary endpoint was VTE (PE/DVT) within 30 days after surgery. CVI was stratified as perioperative (7 days before surgery - 30 days after surgery), recent (1-6 weeks before surgery) and remote (≥7 weeks before surgery) infection. There was no information about prevention or preoperative anticoagulation at baseline data collection. RESULTS: Incidence of postoperative VTE was 1.5% (10/650) in patients without CVI, 33.3% (3/9) in patients with perioperative CVI, 18.1% (2/11) in patients with recent CVI and 8.3% (1/12) in patients with remote CVI. After adjusting the confounders, patients with perioperative and recent CVI remained at a higher risk of VTE. In general, VTEs were independently associated with 30-day mortality. In patients with CVI, mortality rate among ones without VTE was 21.7% (5/23), with VTE - 44.4% (4/9). CONCLUSION: Patients with perioperative CVI have a higher risk of postoperative VTE compared to those without CVI and patients with previous CVI and no residual symptoms. Mortality in this group is also higher than in other cohorts.

[How long must be an elective surgery delayed after SARS-COV-2 diagnosis? (Multiple-center regional research)]. / Na skol'ko sleduet otlozhit' operatsiyu posle vyyavleniya SARS-COV-2? (Opyt mnogotsentrovogo regional'nogo issledovaniya).

OBJECTIVE: To determine the optimal postponement period for elective surgery in patients with SARS-COV-2 infection. MATERIAL AND METHODS: A multiple-center regional prospective cohort research included patients who underwent elective surgeries in November, 2020. We compared the outcomes in patients with preoperative COVID-19 and those without infection. The primary endpoint was 30-day mortality rate. This parameter was stratified depending on period after COVID-19 diagnosis using logistic regression. RESULTS: Preoperative COVID-19 was diagnosed in 32 (4.6%) out of 682 patients. Thirty-day mortality rate in patients without infection was 1.5%. Preoperative coronavirus infection increased mortality rate (odds ratio 20%, 25%, 18.1% and 8.3% for surgery within 0-2, 3-4, 5-6 and 7-8 weeks after infection, respectively). Surgeries after 7-8 weeks ensured the same result as in patients without infection (odds ratio 1.5%). After 7-8-week postponement of elective surgery, patients with COVID-19 and active symptoms had higher mortality rate compared to those without or resolved symptoms (50 vs. 13 vs 6.5%, respectively). CONCLUSION: If possible, elective surgery should be delayed for at least 7-8 weeks after COVID-19 diagnosis. In patients with active symptoms in 7-8 weeks after diagnosis of infection, further postponement of surgery is recommended.