感染和未感染COVID-19的孕妇炎症和凝血生物标志物的探讨

M. P. Wardhana, D. Tumangger, H. J. Juwono, E. Ernawati, S. Rifdah, I. A. Wafa, K. Kuntaman, E. G. Dachlan
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摘要

目的:评估妊娠期炎症和凝血相关生物标志物及其与2019年冠状病毒病(COVID-19)的关系。方法:对2021年1月至6月在苏托莫综合学术医院产房就诊的正常妊娠晚期孕妇进行前瞻性病例对照研究。根据RT-PCR检测结果将患者分为两组。收集两组患者的人口学、临床及实验室结果资料进行比较。结果:血小板与淋巴细胞比值(PLR)是孕妇中唯一显著的生物标志物,与未感染COVID-19的孕妇相比,PLR高35.8% [212.25 (157.57-269.37)vs 156.29 (128.55-195.3), p=0.048]。各组间PLR的Logistic回归分析显示,PLR水平是感染新冠肺炎孕妇的独立影响因素(OR 4.483, 95%CI 1.262 ~ 15.926)。ROC分析显示孕妇的PLR截止值为171.335,敏感性和特异性均为66.7% (p=0.021)。结果显示,感染孕妇白细胞计数、绝对中性粒细胞-淋巴细胞计数和百分比、中性粒细胞/淋巴细胞比值(NLR)和d -二聚体水平与未感染孕妇无显著差异(p>0.05)。结论:有趣的是,无论是否感染COVID-19,妊娠晚期的生理适应在大多数炎症和凝血标志物上都没有差异。这项单中心研究的证据支持这样的观点,即PLR升高与独立的生物标志物有关,因此可能有助于检测COVID-19的孕妇。
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The explorat ion of inflammat ory and coagulation biomarkers between pregnantwomen with andwithout COVID-19
Objectives: to assess the effect-related inflammatory and coagulation biomarkers in pregnancy and their connection with the coronavirus disease of 2019 (COVID-19). Methods: A prospective case-control study was carried out among normal third-trimester pregnant women admitted to the labor room of Dr. Soetomo General Academic Hospital between January until June 2021. Two classified groups of patients were established in accordance with the result of the RT-PCR test. Demographic, clinical and laboratory results data of the two groups were collected and compared. Results: Platelet-to-lymphocyte ratio (PLR) was shown to be the only significant biomarkers found in the expectant with COVID-19, which was 35.8% higher compared to the ones free of COVID-19 [212.25 (157.57-269.37) vs 156.29 (128.55-195.3), p=0.048]. Logistic regression analysis of PLR between groups showed that the level of PLR was an independent factor in pregnant women with COVID-19 (OR 4.483, 95%CI 1.262-15.926). The ROC analysis showed that the PLR cut-off among the expectant was 171.335, with both sensitivity and specificity were 66.7% (p=0.021). The result shows no significant differences in leukocyte count, absolute neutrophils – lymphocyte count and percentage, neutrophil-to-lymphocyte ratio (NLR) and D-Dimer level between pregnant women infected with COVID-19 and free of the virus (p>0.05). Conclusion: Intriguingly, physiological adaptation during the course of the third trimester of pregnancy found no difference in most inflammation and coagulation markers, both in the condition of infected COVID-19 or not. The evidence from this single-centre study supports the viewpoint that elevated PLR was associated with independent biomarkers and thereby might be helpful to detect expectant with COVID-19.
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