Coagulopathy parameters in symptomatic and asymptomatic Pregnant Women with COVID-19
Article Sidebar
Main Article Content
Abstract
Abstract:
Purpose: The purpose of the study was to determine if the physiological hypercoagulability during pregnancy is compounded by SARS-CoV-2 infection-induced coagulability.
Patients and methods: We retrospectively analysed (October 2020 and August 2021) modifications of the coagulation parameters recommended by the ISTH (International Society on Thrombosis and Haemostasis) (fibrinogen, APTT, PT, INR, D-dimers complete blood count) in 96 pregnant women infected with SARS-CoV-2.
Results: Our results indicated that none patients had severe evolution of the SARS-CoV-2 infection and did not require transfer to the ICU. We also monitored the variation of such parameters, depending on subsequent SARS-CoV-2 PCR screening tests. We established that the laboratory parameters used to assess the coagulability are directly correlated with positive SARS-CoV-2 tests, and pregnancy represents a condition that is likely to increase the risk of embolisms in pregnant patients infected with SARS-CoV-2, compared with the general population. No cases of confirmed SARS-CoV-2 infection were observed in the neonates.
Conclusion: Knowledge of laboratory modifications with prognostic utility in relation to coagulation may be extremely valuable in the management of pregnant women with COVID-19. A better understanding of coagulopathy caused by COVID-19 would also be helpful to guide treatment recommendations for pregnant women. Pregnancy may also be an additional risk factor for coagulopathy in women infected with SARS-CoV-2 in both symptomatic and asymptomatic positive pregnant women.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Verma S, Carter EB, Mysorekar IU. SARS-CoV-2 and pregnancy: An invisible enemy? (published online ahead of print, 17 Jul. 2020). Am. J. Reprod. Immunol 2020; e13308. Available online: https://doi:10.1111/aji.13308 .
Zaigham M and Andersson O: Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta. Obstet. Gynecol. Scand; 99(7): 823–829. Available online: https://doi:10.1111/aogs.13867, 2020.
Rasmussen SA, Jamieson DJ, Uyeki TM. Effects of influenza on pregnant women and infants. Am. J. Obstet. Gynecol; 207(3 Suppl.): S3–S8, 2012. Available online: https://doi:10.1016/j.ajog.2012.06.068 . Available from: 406 https://www.ajog.org/article/S0002-9378(12)00722-3/pdf .
Abbassi-Ghanavati M, Greer LG, Cunningham FG. Pregnancy and laboratory studies: a reference table for clinicians. Obstet. Gynecol; 114: 1326–31, 2009. 10.1097/AOG.0b013e3181c2bde8.
Thachil J, Tang N, Gando S et al: ISTH interim guidance on recognition and management of coagulopathy in COVID‐19. J. Thromb. Haemost 2020. (ePub ahead of print). Wiley Online Library, Web of Science®, Google Scholar.
Iba T, Levy JH, Warkentin TE, Thachil J, van der Poll T, Levi M. The Scientific and Standardization Committee on DIC atSaSCoPaCCotISoTaH. Diagnosis and management of sepsis‐induced coagulopathy and disseminated intravascular coagulation. J. Thromb. Haemost; 17: 1989–1994, 2019. Wiley Online Library, CAS PubMed, Web of Science®, Google Scholar.
Tan L, Wang Q, Zhang D et al: Lymphopenia predicts disease severity of COVID‐19: a descriptive and predictive study. Signal Transduction and Targeted Therapy 2020; 5: 33. Crossref CAS PubMed, Web of Science®, Google Scholar.
Vlachodimitropoulou Koumoutsea E, Vivanti AJ, Shehata N et al: COVID-19 and acute coagulopathy in pregnancy. J. Thromb. Haemost 2020.
Kobayashi T. Obstetrical disseminated intravascular coagulation score. J. Obstet. Gynaecol. Res.; 40: 1500–6, 2014.
Erez O, Novack L, Beer-Weisel R et al: DIC score in pregnant women--a population-based modification of the International Society on Thrombosis and Hemostasis score. PLoS One; 9: e93240, 2014.
Koumoutsea, EV, Vivanti, AJ, Shehata, N et al: COVID‐19 and acute coagulopathy in pregnancy. J. Thromb. Haemost. ; 18: 1648–1652, 2020. Available online: https://doi.org/10.1111/jth.14856 .
Tatu AL, Nadasdy T, Nwabudike LC. Observations about sexual and other routes of SARS-CoV-2 transmission and its prevention.Clin Exp Dermatol; 45(6): 761-762, 2020.
Ionescu MA. COVID-19 skin lesions are rarely positive at RT-PCR test: the macrophage activation with vascular impact and SARS-CoV-2-induced cytokine storm. Int J Dermatol. 2021 Jul 2:10.1111/ijd.15749. doi: 10.1111/ijd.15749. Epub ahead of print
Tatu AL, Nadasdy T, Bujoreanu FC. Familial clustering of COVID-19 skin manifestations. Dermatol Ther.;33(6):e14181, 2020.
Tatu AL, Ionescu MA. Multiple autoimmune syndrome type 3- thyroiditis, vitiligo and alopecia areata. Acta Endocrinol (Buchar); 13(1):124-125, 2017. Available online: https://doi:10.4183/aeb.2017.124 .
Tatu AL - Umbilicated blue black lesion on the lateral thorax J. Cutan. Med. Surg. 21(3); 252, 2017.
Narang K, Ibirogba ER., Elrefaei A et al: SARS-CoV-2 in Pregnancy: A Comprehensive Summary of Current Guidelines. J. Clin. Med.; 9(5): 1521, 2020. Available online: https://doi:10.3390/jcm9051521 . Published 18 May 2020.
Tatu AL, Nwabudike LC. The Treatment Options of Male Genital Lichen Sclerosus et Atrophicus Short Title for a Running Head: Treatments of Genital Lichen Sclerosus. Conference: 14th National Congress of Urogynecology (Urogyn), Location: Eforie, Romania, Date: SEP 07-09, 2017. Proceedings of the 14th national congress of Urogynecology and the national conference of the Romanian association for the study of pain, Pages: 262-264, Published: 2017.
Tatu AL, Merezeanu N, Pântea O, Gheorghe I, Popa M, Banu O, Cristea VC, Chifiriuc MC, Lazăr V, Marutescu L. Resistance features of Pseudomonas aeruginosa strains isolated from patients with infectious complications of cardiovascular surgery. Biointerface Res. Appl. Chem.; 7(2):2004-2008, 2017.
Pricop R, Cristea VC, Gheorghe I, Tatu AL, Mihaescu G, Chifiriuc MC. Matrix-assisted laser desorption/ionization time-of-flight mas spectrometry (MALDI-TOF MS) reveals the anaerobic Slakia exigua as unique etiology of a dental abscess. Biointerface Res. Appl. Chem.; 7(2):1995-1997, 2017.
Pelin AM, Silvia Matasaru, Metabolic Syndromein obese children and adolescents, The Medical-Surgical Journal, Vol 116 No 4: 957-961(2012)
Pelin AM, Gavat CC, Balan G, Popescu E, Georgescu CV. Particularities of Statin Therapy in Diabetic Patients. Rev. Chim. Apr;68(4):720-725. 2017
Meca AD, Mititelu-Tarțău L, Bogdan M, Dijmarescu LA, Pelin AM, Foia LG. Mycobacterium tuberculosis and Pulmonary Rehabilitation: From Novel Pharmacotherapeutic Approaches to Management of Post-Tuberculosis Sequelae. J Pers Med. 2022 Apr 2;12(4):569. doi: 10.3390/jpm12040569. PMID: 35455684; PMCID: PMC9027178.
Balan G, Pelin AM, Macovei LA, Condratovici AP, Condratovici CP, Busil C. Budd-Chiari Syndrome:Rare Cause, But Important of Portal Hypertension. Rev. Chim.[internet]. 2017 Mar;68(3):608-611. Available from: https://doi.org/10.37358/RC.17.3.5512
Maftei, N.-M.; Iancu, A.-V.; Goroftei Bogdan, R.E.; Gurau, T.V.; Ramos-Villarroel, A.; Pelin, A.-M. A Novel Symbiotic Beverage Based on Sea Buckthorn, Soy Milk and Inulin: Production, Characterization, Probiotic Viability, and Sensory Acceptance. Microorganisms 2023, 11, 736. https://doi.org/10.3390/microorganisms11030736