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.
【저자키워드】 COVID-19, Biomarkers, Pregnancy, perinatal health, 【초록키워드】 immune response, Prognosis, neutrophil, Intervention, outcome, Laboratory, monocyte, outcomes, Neonate, COVID-19 infection, response, Patient, Complication, complications, WBC, Admission, Intensive, predict, mother, association, Hypothesis, pregnant, Haematology, distress, COVID-19 patient, Neonatal, APGAR score, clinician, subject, help, pregnant patients, significantly lower, non-pregnant females, populations, prevalent, pregnant population, PROTECT, pregnant females, Result, defined, tested, collected, significantly, facilitate, exhibited, appear, correlated, reduce, impacted, accompanied, haematological parameter, hypothesised, pregnant female, pregnant patient, 【제목키워드】 Immunity, Prognostic marker, Neonatal, APGAR score, pregnant population,