Clinical features and risk factors associated with acute respiratory distress syndrome in pregnant women diagnosed with COVID-19: a multi-center case-control study
Creators: name: Aski, Soudabeh Kazemi
name: Norooznezhad, Amir Hossein
name: Shamshirsaz, Amir A.
name: Mostafaei, Shayan
name: Aleyasin, Ashraf
name: Nabavian, Seyedeh Maedeh
name: Alimohammadi, Shohreh
name: Ahangari, Roghaye
name: Ariana, Shideh
name: Ghotbizadeh, Fahimeh
name: Tara, Fatemeh
name: Pooransari, Parichehr
name: Laki, Mahboobeh Gharib
name: Zarean, Elaheh
name: Soleimani, Zahra
name: Saliminia, Alireza
name: Havaei, Arash
name: Akbari, Razieh
name: Ramezani, Masoud
name: Soleimani, Azam
name: Naemi, Mahsa
name: Shamshirsaz, Alireza A.
name: Hantoushzadeh, Sedigheh
Publisher: name: Taylor & Francis
Year: 2021
Subjects: subject: Medicine
subject: Cell Biology
subject: Physiology
subject: FOS: Biological sciences
subject: Biotechnology
subject: Immunology
subject: FOS: Clinical medicine
subject: Biological Sciences not elsewhere classified
subject: Mathematical Sciences not elsewhere classified
subject: Cancer
subject: Science Policy
subject: Mental Health
subject: Infectious Diseases
subject: FOS: Health sciences

description: The aim of this study was to evaluate differences in clinical features and laboratory parameters in critically ill pregnant women with acute respiratory distress syndrome (ARDS) compared to moderate and severe pregnant women with coronavirus disease-2019 (COVID-19) but without ARDS. This was a retrospective multicenter study of all pregnant women with COVID-19 diagnosed with ARDS between February 15, and May 1, 2020 in nine level III maternity centers in Iran (ARDS group). The control COVID-19 pregnant women were selected from 3 of 9 level III maternity centers between March 15 and April 20, 2020. Univariate statistics were used to look at differences between groups. Cluster dendrograms were used to look at the correlations between clinical and laboratory findings in the groups. A value of <i>p</i> &lt;.05 was considered statistically significant. Fifteen COVID-19 infected women with ARDS were compared to 29 COVID-19 positive and ARDS negative control (moderate: (<i>n</i> = 26) 89.7% and severe: (<i>n</i> = 3)10.3%). The mean maternal age (35.6 vs. 29.4 years; <i>p</i> = .002) and diagnosis of chronic hypertension (20.0% vs. 0%, <i>p</i> = .034) were significantly higher in the ARDS group. There was no significant difference between the two groups in their presenting symptoms. The ARDS group had a significantly higher prevalence of tachypnea (66.6% vs. 10.3%, <i>p</i> = .042) and blood oxygen saturation (SpO<sub>2</sub>) &lt;93% (66.6% vs. 10.3%, <i>p</i> = .004) at presentation. Relative lymphopenia (lymphocyte ratio &lt; 10.5%, 66.6% vs. 17.2%, <i>p</i> = .002), lymphocytes to leukocytes ratio (11.3% vs. 17.7%, <i>p</i> = .010), and neutrophils to lymphocytes ratio (NLR) &gt;7.5 were significantly different between the two groups (all <i>p</i> &lt; .05). Our data demonstrate that symptom-based strategies for identifying the critically ill pregnant women with SARS-CoV-2 are insufficient; however, vital signs and laboratory data might be helpful to predict ARDS in critically ill COVID-19 pregnant patients.