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- Title
SARS-2 COVID-19-induced immunity response, a new prognostic marker for the pregnant population correlates inversely with neonatal Apgar score.
- Authors
Marwah, M.; Shokr, H.; Demitry, A.; Wang, K.; Ahmad, S.; Marwah, S.; Wandroo, F.
- Abstract
Background: The COVID-19 infection has impacted pregnancy outcomes; however, few studies have assessed the association between haematological parameters and virus-related pregnancy and neonatal outcomes. We hypothesised differences in routine haematology indices in pregnant and non-pregnant COVID-19 patients as well as COVID-19-negative pregnant subjects and observed neonatal outcomes in all pregnant populations. Further, we tested if pattern identification in the COVID-19 pregnant population would facilitate prediction of neonates with a poor Apgar score. Methods: We tested our hypothesis in 327 patients (111 COVID-19-positive pregnant females, 169 COVID-19-negative pregnant females and 47 COVID-19-positive non-pregnant females) in whom standard routine laboratory indices were collected on admission. Results: Pregnant COVID-19-positive patients exhibited higher WBC, neutrophil, monocyte counts as well as neutrophil/lymphocyte and neutrophil/eosinophil ratio compared to non-pregnant COVID-19-positive patients (p = 0.00001, p = 0.0023, p = 0.00002, p = 0.0402, p = 0.0161, p = 0.0352, respectively). Preterm delivery was more prevalent in COVID-19-positive pregnant patients accompanied with a significantly lower birth weight (2894.37 (± 67.50) g compared with 3194.16 (± 50.61) g, p = 0.02) in COVID-19-negative pregnant patients. The COVID-19-Induced Immunity Response (CIIR) was defined as (WBC × neutrophil) / eosinophil; Apgar scores were significantly and inversely correlated with the CIIR index (r =—0.162). Interpretation: Pregnancy appears to give rise to an increased immune response to COVID-19 which appears to protect the mother, however may give rise to complications during labour as well as neonatal concerns. CIIR is a simple metric that predicts neonatal distress to aid clinicians in determining the prognosis of COVID-19 and help provide early intensive intervention to reduce complications.
- Subjects
BIOMARKERS; EOSINOPHILS; COVID-19; PREMATURE infants; LEUCOCYTES; WOMEN; PREGNANCY outcomes; NEUTROPHILS; NEUTROPHIL lymphocyte ratio; DESCRIPTIVE statistics; BIRTH weight; ERYTHROCYTES; APGAR score; ROUTINE diagnostic tests; MONOCYTES; PREGNANCY
- Publication
Infection, 2022, Vol 50, Issue 5, p1121
- ISSN
0300-8126
- Publication type
Article
- DOI
10.1007/s15010-022-01773-3