Inflammatory biomarkers in pregnant women with COVID-19: a retrospective cohort study

  1. Andrea Lombardi
  2. Silvia Duiella
  3. Letizia Li Piani
  4. Agnese Comelli
  5. Ferruccio Ceriotti
  6. Massimo Oggioni
  7. Antonio Muscatello
  8. Alessandra Bandera
  9. Andrea Gori
  10. Enrico Ferrazzi

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Abstract

Coronavirus disease 2019 (COVID-19) is a pandemic viral disease affecting also obstetric patients and uncertainties exist about the prognostic role of inflammatory biomarkers and hemocytometry values in patients with this infection. To clarify that, we have assessed the values of several inflammatory biomarkers and hemocytometry variables in a cohort of obstetric patients hospitalized with COVID-19 and we have correlated the values at admission with the need of oxygen supplementation during the hospitalization. Overall, among 62 (27.3%) pregnant women and 165 (72.7%) postpartum women, 21 (9.2%) patients received oxygen supplementation and 2 (0.9%) required admission to intensive care unit but none died. During hospitalization leukocytes (p < 0.001), neutrophils (p < 0.001), neutrophils to lymphocytes ratio (p < 0.001) and C reactive protein (p < 0.001) decreased significantly, whereas lymphocytes (p < 0.001), platelets (p < 0.001) and ferritin (p = 0.001) increased. Lymphocyte values at admission were correlated with oxygen need, with a 26% higher risk of oxygen supplementation for each 1000 cells decreases. Overall, in obstetric patients hospitalized with COVID-19, C reactive protein is the inflammatory biomarker that better mirrors the course of the disease whereas D-dimer or ferritin are not reliable predictors of poor outcome. Care to the need of oxygen supplementation should be reserved to patients with reduced lymphocyte values at admission.

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  1. Version published to 10.1038/s41598-021-92885-7
  2. ScreenIT

    SciScore for 10.1101/2020.08.27.20183624: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study was approved by the Institutional Review Board (#339_2020) and conducted according to the Declaration of Helsinki.
    Consent: An informed consent was obtained from all the patients enrolled.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableStudy population: We enrolled a cohort of pregnant women consecutively admitted at the COVID-19 Maternity Hub at the Foundation IRCCS

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    , RNA extraction with STARMag Universal Universal Cartridge kit on Nimbus instrument (Hamilton, Agrate Brianza, Italy) and amplification with Allplex® 2019-nCoV assay, while the second employed a GeneFinder® COVID-19 Plus RealAmp Kit (OSANG Healthcare, Anyangcheondong-ro, Dongan-gu, Anyang- si, Gyeonggi-do, Korea) on ELITech InGenius® instrument (Torino, Italy).
    OSANG Healthcare
    suggested: None
    All the analysis was performed with SPSS Statistics 23
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.08.27.20183624 on medRxiv