Correlation of systemic inflammation biomarkers and disease severity in pregnant women with COVID-19

Abstract

SUMMARY OBJECTIVE: The aim of this study was to evaluate the prognostic value of whole blood parameters, systemic inflammatory indices, and systemic inflammatory markers in pregnant women with COVID-19. METHODS: In this cross-sectional study, the demographic, clinical, and laboratory data (i.e., whole blood parameters, C-reactive protein, procalcitonin, ferritin, and D-dimer) of 464 pregnant women with COVID-19 who attended a tertiary hospital between January and April 2021 were reviewed. Systemic inflammatory indices (i.e., neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, platelet/neutrophil ratio, and systemic immune inflammation index) were calculated. Asymptomatic and mildly symptomatic pregnant women were classified as Group 1 (n=413), and those with severe disease were classified as Group 2 (n=51). RESULTS: Lymphocyte count and lymphocyte percentage in whole blood parameters were significantly lower (p<0.05), and C-reactive protein, ferritin, and procalcitonin values were higher in Group 2 (p<0.05). Systemic inflammatory indices [neutrophil/lymphocyte ratio (4.7±2.9 (1.1–21.2) vs 7.5±4.7 (2.13–23.2)), platelet/lymphocyte ratio (191.1±104.3 (53.0–807.1) vs 269.5±118.9 (105.0–756.0)), systemic immune inflammation index (1,000±663 (209–5,231) vs 1,630±1,314 (345–7,006))] were found statistically significantly higher in severe disease group (p<0.001). CONCLUSION: Evidence in this study indicates that neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and systemic immune inflammation index at first admission are simple, rapid, and inexpensive indices in predicting the prognosis of COVID-19 in pregnant women.

Inflammation Indexes PLR, SII, AISI, MLR, NLPR and MCVL in Peripartum Treated Thrombophilia Patients Undergoing Cesarean Section at Term-STROBE Compliant

“…In children presenting with abdominal pain, high SIRI and SII values alone support the diagnosis of acute appendicitis at a rate of 95% [42]. The systemic immune inflammation index was significantly higher in the severe COVID-19 and pregnant patient group than in the mild COVID-19 and pregnant patient group [43]. SII proved to be a good predictor of inflammation and abortion in those with ongoing pregnancy [44,45].…”

Is it possible to identify COVID-19 infection-related biomarkers during pregnancy?: A prospective study in Turkish population

“…[9] Therefore, such laboratory parameters are considered effective indicators of systemic inflammation and immune balance in COVID-19 patients. [6,13] T-cell activation antigen cluster of differentiation 26 (CD26), also called dipeptidyl peptidase 4 (DPP4), is a serine peptidase seen on the membranes of various cell types, mainly in the respiratory system. [14,15] An interaction between DPP4 and SARS-CoV-2 has been reported in the literature in different populations, such as diabetic patients and patients with advanced age.…”

“…It is possible to assess and predict the severity of COVID-19 infection using widely available blood count parameters. [ 6 ] Among them are several peripheral blood-based systemic inflammatory indices, such as platelet-to-lymphocyte ratio (PLR), platelet-to-neutrophil ratio (PNR), and neutrophil-to-lymphocyte ratio (NLR) which can indirectly assess the platelet function in an inflammatory process that causes endothelial damage. [ 7 , 8 ] Additionally, in severe cases of COVID-19, levels of pro-inflammatory cytokines such as interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-1 beta (IL-1β), and tumor necrosis factor-alpha (TNF-α) are often elevated.…”

“…[ 9 ] Therefore, such laboratory parameters are considered effective indicators of systemic inflammation and immune balance in COVID-19 patients. [ 6 , 13 ]…”

Inflammatory markers as outcome predictors of COVID-19 in pregnant women

“…We read with interest the article by Gündüz et al on a cross-sectional study of 464 pregnant women with asymptomatic/mild (group 1) or severe (respiratory rate >24 and saturation <93%) SARS-CoV-2 infection (group 2) regarding the prognostic value of blood inflammatory markers for the outcome of COVID-19 1 . The neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR), and the systemic inflammatory index (SII) were found to predict the outcome of COVID-19 1 . The study is excellent but has limitations that should be discussed.…”