Risk Factors, Clinical Symptoms, Laboratory Findings and Imaging of Pregnant Women Infected with COVID-19 in North of Iran

Abstract

Background: Due to the physiological changes in the body during pregnancy, the increased susceptibility to viral infections during this period and also the high prevalence of coronavirus disease 2019 (COVID-19) in the Guilan province, Iran, this study aimed to evaluate risk factors, clinical symptoms, laboratory findings and imaging of pregnant mothers with COVID-19. Methods: In this descriptive study, 70 pregnant women aged 17–41 years with COVID-19 who were hospitalized from early March to late April 2020 were enrolled. Sampling was performed by census and from all hospitals in Guilan. The research instruments included a researcher-made questionnaire, including demographic characteristics, clinical symptoms, medical examinations, and paraclinical results. Data were analyzed with SPSS version 16. Frequency and percent were used to describe qualitative variables; for quantitative variables, if they were normally distributed, mean and standard deviation were used, and if they were non-normal, median and interquartile range (IQR) were used. Results: The most severe symptoms recorded in mothers at the time of hospitalization were fever (47%), shortness of breath (16%) and cough (15%), respectively. One of 68 (1%) was in the severe stage of the disease and two mothers (2%) were in critical condition and admitted to the intensive care unit and finally died. Fifty-five of 66 women (83%) had lymphopenia, 22 of 42 (52%) tested positive on PCR, and 30 of 33 (90%) had an increase in lactate dehydrogenase (LDH) levels.Results showed that 15 of 32 patients who gave birth had preterm delivery (46%). Conclusion: The most common manifestations of the disease in pregnant women were fever, cough and shortness of breath, and in some cases muscle pain. The most common laboratory finding in infected mothers was lymphopenia. Complications of pregnancy and childbirth in women included an increase in cesarean delivery.

COVID-19 em gestantes: uma revisão de literatura

“…As complicações de parto mais prováveis de acontecer são: parto prematuro e parto cesariano de urgência 8,12,13,21,28,31,32 . Sendo este último o tipo de parto que mais está sendo feito durante a pandemia da COVID-19, tanto em sua forma leve como na moderada e na grave, apesar dos vaginais também ocorrerem 44 .…”

“…Em gestantes, pneumonia por infecção advinda de qualquer etiologia tem significativa importância na morbidade e mortalidade, e é a infecção não obstétrica que mais comumente ocorre 7 . Devido às mudanças fisiológicas que ocorrem no organismo da mulher gestante, como enfraquecimento do sistema imunológico e alterações do trato respiratório, ela torna-se mais propícia a quadros de pneumonias mais severas 8 . O rebaixamento imunológico fisiológico se dá nos primeiros trimestres da gestação e é revertido no terceiro trimestre com ótima ativação e funcionalidade, esse evento ocorre com o objetivo de permitir o feto desenvolver-se 9,10 .…”

“…Os sintomas mais comuns são febre, tosse, dispneia, dor muscular, cefaleia e diarreia, porém os de maior significância para possível severidade de danos respiratórios maternos são febre e dispneia. Já sobre o perinatal, parto prematuro é a consequência mais prevalente 8,14 .…”

Prognosis of COVID-19 in the middle eastern population, knowns and unknowns

“…This is in accordance with other studies in the Middle East as well as in other worldwide countries such as the United States ( Hirshberg et al, 2020 ) and China ( Chen H et al, 2020 ). In Iranian pregnant women, the most common reported symptoms of COVID-19 were fever, cough, and dyspnea ( Kazemi Aski et al, 2020 , 2021 ; Motlagh et al, 2020 ; Pirjani et al, 2020 ; Sattari et al, 2020 ; Akbarian-Rad et al, 2021 ; Alipour et al, 2021 ; Samadi et al, 2021 ; Vaezi et al, 2021 ; Vizheh et al, 2021 ; Abedzadeh-Kalahroudi et al, 2021b ). Lymphopenia and elevated C-reactive protein levels ( Pirjani et al, 2020 ; Akbarian-Rad et al, 2021 ; Vaezi et al, 2021 ; Abedzadeh-Kalahroudi et al, 2021a , b ), in addition to Elevated lactate dehydrogenase (LDH; Kazemi Aski et al, 2020 ; Abedzadeh-Kalahroudi et al, 2021a ), were the most common laboratory findings observed.…”

“…Lymphopenia and elevated C-reactive protein levels ( Pirjani et al, 2020 ; Akbarian-Rad et al, 2021 ; Vaezi et al, 2021 ; Abedzadeh-Kalahroudi et al, 2021a , b ), in addition to Elevated lactate dehydrogenase (LDH; Kazemi Aski et al, 2020 ; Abedzadeh-Kalahroudi et al, 2021a ), were the most common laboratory findings observed. The SARS-CoV-2 infection in this population presented mainly as a mild-to-moderate disease ( Kazemi Aski et al, 2020 ; Vizheh et al, 2021 ). Samadi et al found that the presence of underlying medical conditions is significantly associated with disease severity of COVID-19.…”