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CLINICAL AND GENETIC DETERMINANTS OF SEVERE COURSE OF COVID-19 IN PREGNANT WOMEN.
Reproductive Endocrinology ; 65:38-43, 2022.
Article in Ukrainian | EMBASE | ID: covidwho-2265344
ABSTRACT

Objectives:

to determine the clinical and genetic determinants of the severe course of COVID-19 in pregnant women in order to identify a risk group and search for therapeutic targets. Materials and methods. 21 patients (group 1) with a severe course of COVID-19 who required intensive care in the Anesthesiology and Intensive Care Unit (AICU) and 126 pregnant women with moderate severity treated in the Infectious-Obstetrics Unit (IOCU) were examined (group 2). Genomic DNA for molecular genetic analysis of gene variants ACE (I/D, rs 4340), PGR (Alu insertion), ESR1 (A351G, rs 9340799), PON1 (C108T, rs 705379) was isolated from the peripheral blood of patients using a commercial Quick-DNA Miniprep Plus Kit (Zymo Research, USA). Variants of ACE and PGR genes were determined using allele-specific polymerase chain reaction;polymerase chain reaction followed by restriction analysis was used to determine ESR1 and PON1 gene variants. Results. Severe course of COVID-19 is observed in 18.2% of pregnant women, critical condition in 7.5%. A third of AICU patients are over 35 years old. Somatic anamnesis was complicated in 23.8% of patients;thyroid gland pathology (14.3%) and varicose disease (19.0%) prevailed. A significant factor in the severe course of COVID-19 is obesity of the III-IV degree in 28.5% cases. The severe course of the disease was associated with complications of pregnancy (oligohydramnios - 52.4%, ahydramnios - 14.3%, fetal growth retardation syndrome - 33.3%, circulatory disorders - 57.1%, fetal distress - 47.6%, preeclampsia - 14.3%), labor (caesarean section - 57.1%, premature birth - 28.6%), disorders of newborns state (asphyxia - 35.6%). These patients are characterized by anemia (58.7%), thrombocytopenia (23.8%), leukocytosis (33.3%), lymphopenia (90.5%), a shift of the leukocyte formula to the left (an increase of rod-nuclear leukocytes by 85.7%). There were significantly increased levels of transaminases alanine aminotransferase in 47.6%, aspartate aminotransferase in 76.2%. Prothrombotic changes are indicated by a decrease in prothrombin time and activated partial thromboplastin time in 66.7%, which is confirmed by an increase in D-dimer in 85.7% of patients up to the maximum 15,000 ng/ml in 9.5% of women. An increase in inflammation markers (C-reactive protein and interleukin-6 in all AICU patients, procalcitonin in 66.7%) is a reflection of the destructive effect of inflammatory processes. The genetic determinants of the severe course of COVID-19 in pregnant women can be the ID genotype of the ACE I/D rs4340 polymorphism (81.0%), the T2/T2 PROGINS genotype (19.0%), the ESR1 A351G rs9340799 GG genotype (28.5%). Conclusions. The use of separate clinical, laboratory and genetic indicators in pregnant women with COVID-19 will contribute to the selection of the risk group of a coronavirus severe course and the determination of targets of therapeutic impact.Copyright © 2022 Trylyst. All rights reserved.
Keywords
covid-19, genetic markers, hemostasis system, inflammatory markers, pregnancy, abnormal value, activated partial thromboplastin time, allele specific polymerase chain reaction, anamnesis, anemia, anhydramnios, article, blood, cesarean section, clinical article, coronavirus disease 2019, critical illness, critically ill patient, disease course, disease severity, family history, female, fetus distress, genetic analysis, genetic marker, genetic variability, genotype, high risk population, high risk pregnancy, human, hypertransaminasemia, inflammation, intensive care, intrauterine growth retardation, ischemia, labor complication, leukocyte disorder, leukocytosis, lymphocytopenia, maternal age, maternal obesity, molecular genetics, newborn hypoxia, oligohydramnios, polymerase chain reaction, preeclampsia, pregnant woman, prematurity, prothrombin time, research, restriction mapping, risk factor, single nucleotide polymorphism, thrombocytopenia, thrombosis, thyroid disease, varicosis, alanine aminotransferase/ec [Endogenous Compound], aryldialkylphosphatase 1/ec [Endogenous Compound], aspartate aminotransferase/ec [Endogenous Compound], C reactive protein/ec [Endogenous Compound], D dimer/ec [Endogenous Compound], dipeptidyl carboxypeptidase/ec [Endogenous Compound], estrogen receptor alpha/ec [Endogenous Compound], genomic DNA/ec [Endogenous Compound], procalcitonin/ec [Endogenous Compound], progesterone receptor/ec [Endogenous Compound], nucleic acid isolation kit, Quick-DNA Miniprep Plus

Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Prognostic study Language: Ukrainian Journal: Reproductive Endocrinology Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Prognostic study Language: Ukrainian Journal: Reproductive Endocrinology Year: 2022 Document Type: Article