COVID-19 infection in pregnancy: a single center experience with 75 cases.

OBJECTIVES: This study aimed to summarize the clinical features, maternal, fetal, and perinatal outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) proven infections of pregnancies. MATERIAL AND METHODS: This retrospective single center study was conducted on 75 pregnant patients diagnosed of coronavirus disease 2019 (COVID-19). Demographic characteristics, clinical courses, laboratory and radiological findings, and maternal and perinatal outcomes were analyzed using medical records. RESULTS: Of the 75 pregnant women infected with COVID-19, 49 had mild infections. The most common initial symptoms were myalgia (61.4%), cough (57.9%), headache (50.9%), and dyspnea (49.1%). More than half of the patients (57.3%) on admission were in their third trimester. Three patients had pre-existing chronic illnesses (hypothyroidism, asthma and rheumatoid arthritis) and three patients had gestational diabetes. There were two cases admitted to intensive care unit, one of whom was due to COVID-19 infection. No maternal mortality was recorded. The mode of delivery was a cesarean section in 20 cases among the 35 labors. Six gestations ended in a miscarriage and 11 women gave birth prematurely. One stillbirth occurred at the 38th week of gestation. Among 37 neonates, 14 necessitated admission to neonatal intensive care unit. Neonatal mortality, congenital malformation, and mother to child transmission were not seen in the newborns. CONCLUSIONS: The results of our study suggest that the clinical course of COVID-19 infection in pregnant women was mostly asymptomatic/mild. There was also no evidence of vertical transmission of COVID-19 infection.

The value of C-reactive protein/albumin, fibrinogen/albumin, and neutrophil/lymphocyte ratios in predicting the severity of CoVID-19.

OBJECTIVE: This retrospective study aimed to determine the predictive values of the C-reactive protein (CRP)/albumin ratio (CAR), fibrinogen/albumin ratio (FAR), and neutrophil/lymphocyte ratio (NLR) parameters, which reflect the systemic inflammatory status, for the severity of COVID-19. METHODS: A total of 188 patients diagnosed with COVID-19 were enrolled in this study. Among them, 118 were in the severe group, and 70 were in the non-severe group. Levels of albumin, CRP, D-dimer, procalcitonin, fibrinogen, and hemoglobin; leukocyte, neutrophil, lymphocyte, and monocyte counts; and the FAR, CAR, and NLR were compared between the two groups. RESULTS: The CAR, FAR, and NLR values were significantly higher in the severe group compared to the non-severe group. CAR, FAR, and NLR were positively correlated with leukocyte and neutrophil counts and CRP, procalcitonin, and fibrinogen levels. On the other hand, they were inversely correlated with monocyte (except for NLR) and lymphocyte counts. Receiver operator characteristic analysis showed that the area under the curve (AUC) for CAR, FAR, and NLR was 0.841, 0.737, and 0.802, respectively. CONCLUSIONS: Our investigation revealed that the CAR, FAR, and NLR indices can be used to predict the severity of COVID-19, among which CAR was the best predictor of severe COVID-19.

Role of NLR, PLR, ELR and CLR in differentiating COVID-19 patients with and without pneumonia.

OBJECTIVES: Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), eosinophil/lymphocyte ratio (ELR), and C-reactive protein (CRP)/lymphocyte ratio (CLR) are well-established inflammatory indices. This study aimed to examine whether NLR, PLR, MLR, ELR and CLR could differentiate coronavirus disease 2019 (COVID-19) patients with pneumonia from those of without. METHODS: We retrospectively examined the laboratory parameters including CRP, D-dimer, procalcitonin and complete blood count of 306 COVID-19 patients (pneumonic = 152 and non-pneumonic = 154). NLR, PLR, MLR, ELR and CLR values of each patient were calculated. The ability of these indices to distinguish COVID-19 patients with and without pneumonia was determined by receiver operating characteristic (ROC) analysis. RESULTS: NLR, PLR and CLR values were higher while ELR value was lower in pneumonic COVID-19 patients compared with patients with non-pneumonic COVID-19 infection. MLR value was similar in the two groups. NLR, PLR and CLR were positively correlated with CRP and procalcitonin. ELR was negatively correlated with CRP. The ROC analysis revealed that the optimal cut-off value of CLR for discriminating COVID-19 patients with pneumonia from those without pneumonia was 1.14 and the area under curve (AUC) for CLR was 0.731 (sensitivity = 81.5% and specificity = 55.6%), which was markedly higher than the AUCs of NLR (0.622), PLR (0.585) and ELR (0.613). However, no statistical differences were observed between AUC values of NLR, PLR and ELR (P > .05). CONCLUSION: Our findings showed that NLR, PLR, ELR and CLR indices can be used in differentiating COVID-19 patients with or without pneumonia. Among them, the CLR index was the best predictor of pneumonia in COVID-19 patients.