Abstract
Our aim was to investigate whether SARS-CoV-2 infection raised high risks of late pregnancy complications, and posed health problems in fetuses and neonates. We analyzed the data of COVID-19 pregnant women with COVID-19 during late pregnancy and their neonates. Eleven out of 16 (69%) pregnant women with COVID-19 had ++ or +++ of ketone body in urine. The blood uric acid of pregnant patients was 334 μmol/L (IQR, 269-452). D-dimer and FDP in pregnant patients were 3.32 mg/L (IQR, 2.18-4.21) and 9.6 mg/L (IQR, 5.9-12.4). Results of blood samples collected at birth showed that 16 neonates had leukocytes (15.7 × 10 9 /L (IQR, 13.7-17.2)), neutrophils (11.1 × 10 9 /L (IQR, 9.2-13.2)), CK (401 U/L (IQR, 382-647)), and LDH (445 U/L (IQR, 417-559)). Twenty-four hours after birth, a neonate from COVID-19 woman had fever and positive of SARS-CoV-2 gene. Another woman had strongly positive for SARS-CoV-2 gene (+++) for 4 weeks, and delivered one neonate who had SARS-CoV-2 IgM (46 AU/mL) and IgG (140 AU/mL) on day 1 after birth. In the third trimester, COVID-19 infection in pregnant patients raised high risks of ketonuria, hypercoagulable state, and hyperfibrinolysis, which may lead to severe complications. COVID-19 increased the inflammatory responses of placenta, and fetuses and neonates had potential organ dysregulation and coagulation disorders. There was a potential intrauterine transmission while pregnant women had high titer of SARS-CoV-2, but it is necessary to detect SARS-CoV-2 in the blood cord, placenta, and amniotic fluid to further confirm intrauterine infection of fetuses.
Keywords: COVID-19; Immune responses; Intrauterine transmission; Neonates; Pregnancy metabolic complications; SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2., Neonates, immune responses, Intrauterine transmission, Pregnancy metabolic complications, 【초록키워드】 Neutrophils, SARS-CoV-2, IgG, Inflammatory responses, Placenta, SARS-COV-2 infection, neutrophil, LDH, D-dimer, Transmission, pregnant women, Pregnancy, Neonate, Neonates, Health, COVID-19 infection, immune responses, Fever, Amniotic fluid, Birth, Urine, complications, pregnancy complications, Blood, SARS-CoV-2 IgM, Hypercoagulable state, leukocytes, intrauterine infection, Inflammatory response, high risk, hypercoagulable, lead, dysregulation, health problems, leukocyte, in urine, uric acid, coagulation disorders, ketone body, Blood samples, blood sample, ketone, problem, severe complications, positive, pregnant patients, organ, hyperfibrinolysis, ketonuria, Result, analyzed, detect, collected, raised, amniotic, IQR, pregnant patient, with COVID-19, 【제목키워드】 immunological characteristics, with COVID-19,