Clinical Characteristics of Pregnant Women With Coronavirus Disease 2019 in Wuhan, China
Clinical Characteristics of Pregnant Women With Coronavirus Disease 2019 in Wuhan, China
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DOI：
10.1093/ofid/ofaa294
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发表时间：
2020-08-01
影响因子：
4.2
通讯作者：
Wang, Gaohua
中科院分区：
文献类型：
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作者：
Cheng, Biheng;Jiang, Tao;Wang, Gaohua
背景资料。冠状病毒病2019年(新冠肺炎)已成为大流行。尽管新冠肺炎感染患者的数量在不断增加，但有关孕妇临床特征的数据仍然有限。我们回顾了2020年1月15日至2月23日在武汉大学人民医院就诊的经实验室确诊的育龄女性新冠肺炎患者。回顾了人口学、临床、放射学、实验室和治疗数据。对妊娠与非妊娠患者的临床特点进行比较。纳入111例患有新冠肺炎的育龄妇女，其中16例(14.4%)患有严重或危重疾病。与非妊娠组(n=80)相比，妊娠组呼吸困难(16.1%比37.5%)、乏力(3.2%比33.8%)和3种症状(22.6%比45.0%)明显减少，中性粒细胞计数(5.2比2.5×10(9)/L)和CD_3~+细胞(76.7%比73.7%)和CD_8~+细胞(32.3%比28.4%)明显升高；淋巴细胞百分率(18.2%vs 31.8%)、CD_4~+/CD_8~+比值(1.2 vs 1.4)和免疫球蛋白G水平(9.8 vs 11.9 g/L)显著降低。值得注意的是，与非妊娠患者相比，妊娠患者严重疾病的比例显著降低(3.2%比18.8%)，炎症标志物水平显著升高，包括中性粒细胞/淋巴细胞比率(4.4vs1.9)和全身炎症指数(812.8 vs354.7)。记录了17例活产婴儿，均为出生后新冠肺炎检测阴性，阿普加评分正常。与非妊娠患者相比，妊娠新冠肺炎患者的严重程度较低，炎症反应和细胞免疫功能增强。
Background. Coronavirus disease 2019 (COVID-19) has become a pandemic. Despite the growing number of patients with COVID-19 infection, data on the clinical characteristics of pregnant patients are still limited.Methods. We retrospectively included childbearing-age female patients with laboratory-confirmed COVID-19 at Renmin Hospital of Wuhan University from January 15 to February 23, 2020. Demographic, clinical, radiological, laboratory, and treatment data were reviewed. Clinical characteristics of pregnant and nonpregnant patients were compared.Results. One hundred eleven childbearing-age women with COVID-19 were included, including 16 patients (14.4%) with severe or critical disease. Compared with nonpregnant patients (n = 80), pregnant patients (n = 31) were less likely to have dyspnea (16.1% vs 37.5%), asthenia (3.2% vs 33.8%), and >= 3 symptoms (22.6% vs 45.0%); had a significantly higher neutrophil count (5.2 vs 2.5 x10(9)/L) and a higher percentage of CD3+ cells (76.7% vs 73.7%) and CD8+ cells (32.3% vs 28.4%); and had a dramatically lower percentage of lymphocytes (18.2% vs 31.8%), a lower CD4+/CD8+ ratio (1.2 vs 1.4), and a lower level of IgG (9.8 vs 11.9 g/L). Of note, pregnant patients had a significantly lower percentage of severe disease (3.2% vs 18.8%) and a substantially higher level of inflammation markers including neutrophil-to-lymphocyte ratio (4.4 vs 1.9) and systematic inflammatory index (812.8 vs 354.7) than nonpregnant patients. Seventeen live births were recorded, and all of these showed negative results of postnatal COVID-19 detection together with a normal Apgar score.Conclusions. Pregnant patients with COVID-19 had a lower level of severity and an enhanced inflammatory response and cell immunity when compared with nonpregnant patients.