Coronavirus disease 2019 in pregnant and non-pregnant women: a retrospective study

Abstract

[2] Clinical manifestations and treatment monitoring of pregnant women with COVID-19 have been reported in previous studies,[3] which mainly focus on maternal and neonatal outcomes by analyzing small sample size data, but studies regarding the influence of pregnancy on the progression and prognosis of COVID-19 remain relatively rare. According to the New Coronavirus Pneumonia Prevention and Control Program (5th edition),[4] we included both laboratories diagnosed cases and clinically diagnosed cases to present the complete spectrum of COVID-19 and defined the severity of COVID-19 and hospital discharge standards. The pregnancy group had a higher leukocyte count (8.72 [5.96, 10.12] × 109/L vs. 5.36 [4.02, 6.97] × 109/L, Z = −5.106, P < 0.001), a higher neutrophil percentage (77.55 [70.63, 83.23]% vs. 58.90 [51.85, 68.20]%, Z = −6.328, P < 0.001), and lower percentages of lymphocytes (15.50 [12.50, 21.90]% vs. 29.60 [22.05, 36.50]%, Z = −5.820, P < 0001) and monocytes (6.15 [4.65, 7.33]% vs. 8.10 [6.60, 9.80]%, Z = −4.258, P < 0.001) compared with the non-pregnancy group. [...]the pregnancy group also presented with higher levels of D-dimer (1.31 [0.65, 1.95] μg/mL vs. 0.32 [0.22, 0.59] μg/mL, Z = −5.132, P < 0.001), high-sensitivity C-reactive protein (16.65 [1.68, 41.03] mg/L vs. 2.50 [0.53, 16.38] mg/L, Z = −2.932, P = 0.003), erythrocyte sedimentation rate (29.00 [21.00, 43.00] mm/1 h vs. 16.00 [8.00, 36.25] mm/1 h, Z = −2.689, P = 0.007) and interleukin-6 (14.50 [3.56, 39.75] pg/mL vs. 4.46 [2.34, 12.98] pg/mL, Z = −2.396, P = 0.017] than the non-pregnancy group [Supplementary Table 2, http://links.lww.com/CM9/A469]. Items Pregnancy group (n = 30) Non-pregnancy group (n = 255) Statistics P Complications  Abnormal liver function 4 (13.3) 16 (6.3) – 0.245  Abnormal renal function 0 (0) 10 (3.9) – 0.607  Heart function injury 1 (3.3) 27 (10.6) – 0.332  Digestive system injury 6 (20.0) 40 (15.7) 0.369∗ 0.544  Respiratory system injury 23 (76.7) 236 (92.5) 8.167∗ 0.004  Nervous system injury 0 (0) 5 (2.0) – 1.000 Treatments  Oxygen support 26 (86.7) 171 (67.1) 4.835∗ 0.028  Tracheal intubation 0 (0) 5 (2.0) – 1.000  On a ventilator 0 (0) 14 (5.5) – 0.375  Antiviral therapy 21 (70.0) 221 (86.7) 5.820∗ 0.016  Antibiotic therapy 25 (83.3) 169 (66.3) 3.594∗ 0.058  Use of glucocorticoids 7 (23.3) 74 (29.0) 0.427∗ 0.514  Intravenous immunoglobulin therapy 4 (13.3) 41 (16.1) – 1.000  Admission to intensive care unit 0 (0) 24 (9.4) – 0.089 Terminate pregnancy 22 (73.3) – – – Continue pregnancy 8 (26.7) – – – Prognosis – 0.022  Hospital discharge 27 (90.0) 245 (96.1)  Still under treatment 3 (10.0) 3 (1.2)  Death 0 (0) 7 (2.7) Symptom-to-discharge duration (days) 24 (18, 38) 31 (23, 42) −2.143† 0.032 Data were shown as median (Q1, Q3) or n (%).