Clinical features and risk factors associated with acute respiratory distress syndrome in pregnant women diagnosed with COVID-19: a multi-center case-control study

Aski, Soudabeh Kazemi; Norooznezhad, Amir Hossein; Shamshirsaz, Amir A.; Mostafaei, Shayan; Aleyasin, Ashraf; Nabavian, Seyedeh Maedeh; Alimohammadi, Shohreh; Ahangari, Roghaye; Ariana, Shideh; Ghotbizadeh, Fahimeh; Tara, Fatemeh; Pooransari, Parichehr; Laki, Mahboobeh Gharib; Zarean, Elaheh; Soleimani, Zahra; Saliminia, Alireza; Havaei, Arash; Akbari, Razieh; Ramezani, Masoud; Soleimani, Azam; Naemi, Mahsa; Shamshirsaz, Alireza A.; Hantoushzadeh, Sedigheh

doi:10.1080/14767058.2021.1872062

Cited by 9 publications

(4 citation statements)

References 14 publications

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“…In this regard, we agree with the notion that these results appear to be related to respiratory limitation due to changes caused by pregnancy rather than immunosuppressive aspects. As previously reported, we also found that maternal age > 35 years was another independent risk factor for severe–critical disease (OR 5.76) [ 13 , 19 , 20 , 21 , 22 , 23 ].…”

Section: Discussionsupporting

confidence: 84%

Risk Factors for Severe–Critical COVID-19 in Pregnant Women

Berumen-Lechuga,

Leaños-Miranda,

Molina-Pérez

et al. 2023

JCM

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Risk factors associated with severe–critical COVID-19 (coronavirus disease 2019) are based on findings in the general population. Pregnant women are at increased risk of severe–critical infection, and few reports are based on these women. A multicentric case–control study was conducted at the Mexican Institute of Social Security, State of Mexico, during the COVID-19 pandemic. We included pregnant women who were consecutively admitted to respiratory care units and were followed until 30 days after the resolution of pregnancy. A total of 758 pregnant women with a positive RT-PCR test for SARS-CoV-2 were enrolled from June 2020 to July 2021. We defined groups using the World Health Organization Severity Classification; cases were pregnant women with severe–critical COVID-19 (n = 123), and controls were subjects with non-severe COVID-19 (n = 635). Data was gathered from clinical files. A multivariate logistic regression analysis was used to adjust odds ratios and their 95% confidence intervals of factors associated with severe–critical COVID-19. Risk factors associated with severe–critical COVID-19 in pregnancy were non-vaccination (OR 10.18), blood type other than O (OR 6.29), maternal age > 35 years (OR 5.76), history of chronic hypertension (OR 5.12), gestational age at infection ≥ 31 weeks (OR 3.28), and multiparity (OR 2.80).

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Section: Discussionsupporting

confidence: 84%

Risk Factors for Severe–Critical COVID-19 in Pregnant Women

Berumen-Lechuga,

Leaños-Miranda,

Molina-Pérez

et al. 2023

JCM

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“…Since further variants may be more invasive than common ones, focusing on potential COVID-19 treatments are still required. COVID-19 has different signs and symptoms in the patients, however, the most common of them is pneumonia [ 3 ] In cases with more disease severity, pneumonia will turn to acute respiratory distress syndrome (ARDS) which is a critical condition and patients mostly need critical care [ 4 , 5 ]. In the patients who are critically ill, different findings such as septic shock [ 6 ] and (multi-)organ failure [ 7 ] are common which of their causes/consequences could be hypoxia and/or hypoxemia [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

How could perfluorocarbon affect cytokine storm and angiogenesis in coronavirus disease 2019 (COVID-19): role of hypoxia-inducible factor 1α

et al. 2021

Self Cite

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Coronavirus disease 2019 (COVID-19) pandemic is still a world-class challenge. Inflammation, especially its severe form with excess release of pro-inflammatory cytokines (cytokine storm) which is a life-threatening condition, is among the most important suspects involved in COVID-19 pathogenesis. It has been shown that cytokine storm could cause notable morbidities such as acute respiratory distress syndrome (ARDS) which leads to hypoxia which is significantly associated with mortality of patients with COVID-19. Hypoxia-inducible factor 1α (HIF-1α) which activates following ARDS-induced hypoxia plays a crucial role in pathogenesis of cytokine storm. The expression of tumor necrosis factor α (TNF-α), interleukin 1 β (IL-1β), and IL-6 which are key elements of cytokine storm are by nuclear factor κβ (NFκB). Interestingly, during the hypoxia, HIF-1α activates NFκB to induce expression of pro-angiogenic and pro-inflammatory factors. These released factors starts a autocrine/paracrine loop and causes deterioration of their etiological pathways of expression: cytokine storm and ARDS. To sum up, it seems HIF-1α is an important target to hit to ameliorate the mentioned pathways. Herein, we suggest perfluorocarbons (PFCs) which are among the organofluorine compounds as a possible co-treatment to reduce hypoxemia and then hypoxia. These substances are known for their high gas solving potential that make them able to be used as a synthetic artificial blood product. Due to the potential of PFCs to affect the fountain of important physiopathological pathway such as inflammation a hypoxia through affecting NFκB, they could be considered as multi-target co-treatment for ARD individuals with COVID-19. It is highly suggested to evaluate this hypothesis in following researches.

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“…In another study, it is suggested that having NLR cutoff as 3.3 to show disease progression from mild to severe in adult group (25). In pregnant with COVID-19 infection, NLR is found to be significantly higher than normal pregnant population (35), also in a multi-center study comparing ARDS having COVID-19 pregnant ones with non-ARDS COVID-19 infection ones, significantly difference have been found when NLR>7.5 was studied as cut-off between two groups (21). Also, it is determined in our results that NLR with a cut-off value of 5.…”

Section: Discussionmentioning

confidence: 96%

One Year Analysis of Hematological and Inflammatory Parameters to Predict the Severity of COVID-19 Infection in Pregnant Women

Keskın

Keskin

2022

Middle Black Sea Journal of Health Science

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Objective:The study aims to demonstrate the usability of admission hematological parameters in the prognosis of COVID-19 infection in pregnant population and to introduce the cut-offs values of these parameters for pregnant women. Methods:The cohort of this retrospective study consisted of 71 COVID-19 PCR positive pregnant women who were hospitalized in Ordu University Medical Faculty Training and Research Hospital between 1 May 2020 and 1 May 2021.The pregnant women were divided into two groups based on the severity of the disease.Results: White blood cell count, neutrophil count and C-reactive protein (CRP) levels was significantly higher (p=0.000, p=0.000), whereas red blood cell count and lymphocyte count were significantly lower (p=0.002, p=0.002) in severe group. High NLR (neutrophil-to-lymphocyte ratio) (p=0.000), dNLR (derived neutrophil-to-lymphocyte ratio) (p=0.000), MLR (monocyte-to-lymphocyte ratio) (p=0.004), PLR (platelet-to-lymphocyte ratio) (p=0.008), NPR (neutrophil-to-platelet ratio) (p=0.005), NLRNPR (neutrophil-to-lymphocyte ratio/neutrophil-to-platelet ratio) (p=0.008) and SII (Systemic immune inflammation index) (p=0.000) were found in severe group. Conclusion:This paper revealed that severe COVID-19 disease in pregnant women is mainly associated with hematological parameters. Among these parameters NLR, dNLR and SII have largest AUC in ROC, with cutoff values 5.3, 3.52 and 994.8 respectively. Further investigations regarding the use of hematologic tests as prognostic factor of COVID-19 disease severity in pregnant women are needed to assess the risk of serious disease, to predict the prognosis of COVID-19 and to reduce perinatal and maternal morbidity/mortality.

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Clinical features and risk factors associated with acute respiratory distress syndrome in pregnant women diagnosed with COVID-19: a multi-center case-control study

Cited by 9 publications

References 14 publications

Risk Factors for Severe–Critical COVID-19 in Pregnant Women

Risk Factors for Severe–Critical COVID-19 in Pregnant Women

How could perfluorocarbon affect cytokine storm and angiogenesis in coronavirus disease 2019 (COVID-19): role of hypoxia-inducible factor 1α

One Year Analysis of Hematological and Inflammatory Parameters to Predict the Severity of COVID-19 Infection in Pregnant Women

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