Abnormal liver function tests in pregnant patients with COVID-19 — a retrospective cohort study in a tertiary center

Can, Esra; Oğlak, Süleyman Cemil; Ölmez, Fatma

doi:10.5603/gp.a2021.0182

Cited by 23 publications

(22 citation statements)

References 29 publications

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“…Similar findings were reported by Deng et al [ 7 ]. Contrary to our findings, Can et al reported significantly low birth weight in pregnant women with COVID-19 complicated by hepatic dysfunction than those without liver dysfunction [ 27 ]. Larger studies are required to further explore the effect of liver dysfunction on neonatal outcomes.…”

Section: Discussioncontrasting

confidence: 99%

“…Furthermore, deranged liver function was associated with severe COVID-19 with the extent of derangement being proportional to the severity of COVID-19 [ 29 ]. In their study, Can et al also reported that pregnant women with COVID-19-associated liver dysfunction had an increased frequency of severe disease and longer hospital stay than those without liver dysfunction [ 27 ]. Hence, it can be concluded that pregnancy with COVID-19 complicated by liver dysfunction is associated with a higher risk of disease severity and other maternal complications.…”

Section: Discussionmentioning

confidence: 99%

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Maternal and Neonatal Outcomes in Pregnant Women With SARS-CoV-2 Infection Complicated by Hepatic Dysfunction

Choudhary¹,

Singh²,

Bharadwaj³

2022

Cureus

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Background and objective The coronavirus disease 2019 (COVID-19) pandemic has caused one of the most devastating healthcare crises in recent times and presented many diagnostic challenges and uncertainties. COVID-19 complicated by acute hepatic dysfunction is a well-described phenomenon, but its impact on maternal and perinatal outcomes is not well documented. In this study, we aimed to evaluate the maternal and neonatal outcomes in pregnant women with COVID-19 complicated by liver dysfunction and compare those with pregnant women with COVID-19 and normal liver function. Methodology This was a retrospective observational cohort study conducted at the Tata Main Hospital, Jamshedpur, a tertiary care hospital in eastern India. All COVID-19-positive pregnant women (n=249) admitted to the hospital from May 15, 2020, to August 15, 2021, were included in this study. Retrospective data collection was done using the medical records of these COVID-19-positive pregnant women and included the baseline characteristics, past medical history, obstetric history, clinical presentation, laboratory results, management modalities, and maternal and neonatal outcomes. Of note, 107 women were found to have acute liver function abnormality on admission and 142 women had normal liver function tests (LFTs). Pregnant women with normal LFTs were classified as group one and those with deranged LFTs as group two. Characteristics such as age, period of gestation, symptoms, associated comorbidities, laboratory results, management, and outcomes were compared across both groups. Results Out of the total 249 pregnant women with COVID-19 admitted during the study period, 42.97% (n=107) women had laboratory findings consistent with liver dysfunction and 142 women (57.03%) had a normal liver function. Significantly higher levels of lactate dehydrogenase (LDH), C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), alanine transaminase (ALT), aspartate aminotransferase (AST), and total bilirubin levels were seen in pregnant women with hepatic dysfunction when compared to those with normal liver function. Among the 249 patients, the majority were asymptomatic or had mild disease, 12 women had moderate disease, and six women had severe COVID-19. All women with severe COVID-19 had deranged LFTs. There was no statistical difference in terms of obstetric management between pregnant patients with and without liver dysfunction. Out of the 107 women with deranged liver function, 18 women had a preterm birth, four had intrauterine fetal death, and one had neonatal death. Complications such as postpartum hemorrhage, the need for blood transfusions, sepsis and multiorgan failure, and mortality were more commonly seen in the group of pregnant women with hepatic dysfunction associated with COVID-19. Conclusion COVID-19 in pregnancy may cause deranged LFTs in these women. Pregnant women with COVID-19 complicated by liver dysfunction have been reported to have worse inflammation...

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Maternal and Neonatal Outcomes in Pregnant Women With SARS-CoV-2 Infection Complicated by Hepatic Dysfunction

Choudhary¹,

Singh²,

Bharadwaj³

2022

Cureus

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“…Due to the very rapid spread of the virus, almost the entire population of the country and the world has been infected. In fact, a serious public health emergency has reached the lethal level in communities where healthcare providers are underserved [21]. Therefore, it resulted in serious damages in terms of economic, psychological, education and health by causing restrictions on all continents in mass.…”

Section: Discussionmentioning

confidence: 99%

How the nitric oxide and antioxidant enzymes work in the placental tissues of pregnant women with COVID 19 disease?

BERKTAŞ

Tutar²,

Peker

et al. 2022

Aegean J Obstet Gynecol

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Objective: The aim of this study to examine the oxidative stress parameters in placental tissues and blood plasmas of pregnant women. Materials and Methods: The biochemical parameters were examined in 37 pregnant women with covid disease, 37 pregnant women who had covid, and 37 healthy pregnant women. The amounts of lipid peroxidation (LPO), glutathione (GSH), nitric oxide (NOx) and catalase (CAT), superoxide dismutase (SOD) enzyme activities were measured in each tissue and blood plasma. Results:The LPO levels increased in the pregnant woman who has had covid 19 compared with healthy pregnant. Likewise, the LPO levels increased in pregnant women who were negative at the time of delivery. While the amount of glutathione was high in healthy placental tissues, it was found to be quite low in covid 19 positive tissues. While the enzyme activities of SOD and NOx are quite high in placental tissues of healthy pregnant women, they are significantly low in covid positive and negative pregnant tissues. While the CAT enzymes activities, another antioxidant enzyme, was at a very low level in healthy placental tissues compared to SOD enzyme, it was significantly increased in positive pregnant placental tissues. Conclusion: The antioxidant enzyme activities and amounts show significant differences between groups in placental tissues. The changes in enzyme rates in placental tissues are proportional to blood plasma results.

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“…The pregnant women included in the study were classified under the categories asymptomatic, mild, moderate, severe, and critical, in compliance with the guidelines of the National Institutes of Health as per the diagnosis based on physical examinations and vital findings, PCR tests from nasopharyngeal swab samples, chest X-rays, and, if necessary, a thorax computerized tomography (CT). [20,21] Cases that were asymptomatic or classified in the mild disease group (who presented with flu-like symptoms) and the moderate disease group (who had pneumonia, SpO2≥94% in room air, and did not need oxygen therapy) were followed up as outpatients, whereas those in the moderate disease group who required oxygen therapy and those in the severe and critical disease groups were treated as inpatients. During the study period, a total of 501 pregnant women who were COVID-19 positive were hospitalized due to COVID-19 symptoms, obstetric reasons, or both.…”

Section: Methodsmentioning

confidence: 99%

Maternal mortality cases due to COVID-19 pandemic in a tertiary referral hospital

Tunç¹,

Oğlak²,

Göklü³

et al. 2022

Perinat J

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Objective: This study aimed to report the clinical prognoses, laboratory findings, treatment procedures, and neonatal outcomes, from hospitalization to death, of Coronavirus Disease 2019 (COVID-19)-related cases of maternal mortality at our clinic. Methods: Fifteen cases of COVID-19-related maternal mortality, between April 2020 and October 2021, in the Department of Obstetrics & Gynecology of a Training and Research Hospital were retrospectively analyzed for the purpose of the study. Results: During the study period, a total of 501 symptomatic pregnant women received inpatient treatment for COVID-19. In our case group, 93.3% of maternal deaths due to COVID-19 occurred as a result of the worsening of the clinical condition of third-trimester pregnant women. In these patients whose clinical condition deteriorated, delivery was performed after the decision to give birth, and 86.6% of mortalities occurred in the postpartum period and 13.4% before delivery. There was at least one risk factor in 60% of the cases, with obesity being the most prevalent. In all mortality cases, there were pulmonary complaints (shortness of breath and cough) at admission, and bilateral lung involvement was observed during lung imaging; furthermore, there was a corresponding increase in the mean leukocytosis, AST, ALT, LDH, D-dimer, ferritin, procalcitonin, IL-6, and pro-BNP levels with the worsening of the clinical prognosis. The duration of hospitalization and intensive care unit stays were 6.87±3.18 and 5.33±3.27 days, respectively. The mean period of the delivery-to-mortality for mothers was 5.92±3.48 days and the mean period of the intubation-to-mortality for mothers was 3.33±3.15 days. Conclusion: The risks of severe illness and death associated with COVID-19 increased in the third trimester compared to the first and second trimesters. All mortality cases involved unvaccinated pregnant women, of which most had at least one risk factor, obesity being the most prevalent. There was no COVID-19-related mortality in the newborns, and it was found that prematurity rates increased due to maternal disease.

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Abnormal liver function tests in pregnant patients with COVID-19 — a retrospective cohort study in a tertiary center

Cited by 23 publications

References 29 publications

Maternal and Neonatal Outcomes in Pregnant Women With SARS-CoV-2 Infection Complicated by Hepatic Dysfunction

Maternal and Neonatal Outcomes in Pregnant Women With SARS-CoV-2 Infection Complicated by Hepatic Dysfunction

How the nitric oxide and antioxidant enzymes work in the placental tissues of pregnant women with COVID 19 disease?

Maternal mortality cases due to COVID-19 pandemic in a tertiary referral hospital

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