E-ISSN: 2619-9467

Contents    Cover    Publication Date: 03 Nov 2021
Year 2021 - Volume 31 - Issue 3

Open Access

Peer Reviewed

ORIGINAL RESEARCH
163 Viewed120 Downloaded

Comparison of Serum D-dimer, Fibrinogen and Platelet Levels in Pregnant Women with COVID-19 Symptoms According to PCR Positivity or PCR Negativity: A Case-Control Study

Full Text PDF  
JCOG. 2021;31(3):84-8
DOI: 10.5336/jcog.2021-85851
Article Language: EN
Copyright Ⓒ 2020 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: The diagnosis and treatment of coronavirus disease-2019 (COVID-19) infection may be delayed in pregnant women because of the non-specific symptoms and limited application of the necessary radiological tests. The aim of this study was to compare the serum D-dimer, fibrinogen, and platelet levels in pregnant patients with COVID-19 symptoms and polymerase chain reaction (PCR) positivity or PCR negativity. Material and Methods: The study included 100 pregnant women who presented at the Gynaecology and Obstetrics Clinic of Tokat State Hospital between April 2020 and December 2020 with symptoms of COVID-19 infection (fever, cough, shortness of breath). Half of the patients were COVID-19 PCR positive and half were negative. The groups were compared in respect of age, gravida, gestational week, COVID-19 symptoms (fever, cough, shortness of breath), serum D-dimer, fibrinogen, and platelet values. Results: The serum D-dimer and fibrinogen levels were determined to be significantly higher in the PCR positive group than in the PCR negative group (1.78±1.04 mg/L vs. 0.97±0.48 mg/L, p=0.001 and 348.02±84.69 g/mL vs. 265.84±92.10 g/mL, p=0.001, respectively). The complaints of cough and shortness of breath were determined to be significantly higher in the PCR positive group than in the PCR negative group (p=0.001, p=0.008). Conclusion: Routine measurements of serum D-dimer and fibrinogen levels in pregnant patients presenting with COVID-19 symptoms may be useful in early diagnosis and therefore an earlier start to treatment, without performing a COVID-19 PCR test. The presence of cough and shortness of breath in pregnant patients is more important than fever in the management of COVID-19 infection.
REFERENCES:
  1. World Health Organization. Coronavirus disease (COVID-19) technical guidance: Surveillance and case definitions. Geneva: World Health Organization. 2020. Date of access:2 April 2020. [Link] 
  2. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. Erratum in: Lancet. 2020. [Crossref]  [PubMed]  [PMC] 
  3. Tetikkurt C. Gebelikte solunum fizyolojisi [Respiratory physiology in pregnancy]. Cerrahpaşa J Med. 2000;31(2):118-22. [Link] 
  4. Gottfredsson M. Spaenska veikin á Islandi 1918. Laerdómur í laeknisfraedi og sögu [The Spanish flu in Iceland 1918. Lessons in medicine and history]. Laeknabladid. 2008;94(11):737-45. Icelandic. [PubMed] 
  5. Qiao J. What are the risks of COVID-19 infection in pregnant women? Lancet. 2020;395(10226):760-2. [Crossref]  [PubMed]  [PMC] 
  6. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395(10226):809-15. Erratum in: Lancet. 2020;395(10229):1038. Erratum in: Lancet. 2020;395(10229):1038. [Crossref]  [PubMed]  [PMC] 
  7. Özcan H, Elkoca A, Yalçın Ö. COVID-19 Enfeksiyonu ve Gebelik Üzerindeki Etkileri. Anadolu Klin. 2020;25(Special Issue on COVID 19):43-50. [Crossref] 
  8. Dashraath P, Wong JLJ, Lim MXK, Lim LM, Li S, Biswas A, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020;222(6):521-31. [Crossref]  [PubMed]  [PMC] 
  9. Benedetti TJ, Valle R, Ledger WJ. Antepartum pneumonia in pregnancy. Am J Obstet Gynecol. 1982;144(4):413-7. [Crossref]  [PubMed] 
  10. Boldog P, Tekeli T, Vizi Z, Dénes A, Bartha FA, Röst G. Risk assessment of novel coronavirus COVID-19 outbreaks outside China. J Clin Med. 2020;9(2):571. [Crossref]  [PubMed]  [PMC] 
  11. Dhama K, Khan S, Tiwari R, Sircar S, Bhat S, Malik YS, et al. Coronavirus disease 2019-COVID-19. Clin Microbiol Rev. 2020;33(4):e00028-20. [Crossref]  [PubMed]  [PMC] 
  12. Uzel K, Lakhno I. PCR positivity and D-dimer levels in pregnant women with COVID-19. Clinical and Experimental Obstetrics & Gynecology. 2020;47(5):638-44. [Crossref] 
  13. Abbassi-Ghanavati M, Greer LG, Cunningham FG. Pregnancy and laboratory studies: a reference table for clinicians. Obstet Gynecol. 2009;114(6):1326-31. Erratum in: Obstet Gynecol. 2010;115(2 Pt 1):387. [Crossref]  [PubMed] 
  14. Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID-19: A systematic review of 108 pregnancies. Acta Obstet Gynecol Scand. 2020;99(7):823-9. [Crossref]  [PubMed]  [PMC] 
  15. Ruggiero M, Somigliana E, Tassis B, Piani LL, Renteria SU, Barbara G, et al. COVID-19 in the second half of pregnancy: prevalence and clinical relevance. Research Square. 2020. [Crossref] 
  16. Eljilany I, Elzouki AN. D-dimer, fibrinogen, and IL-6 in COVID-19 patients with suspected venous thromboembolism: a narrative review. Vasc Health Risk Manag. 2020;16:455-62. [Crossref]  [PubMed]  [PMC] 
  17. Thachil J, Tang N, Gando S, Falanga A, Cattaneo M, Levi M, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 2020;18(5):1023-6. [Crossref]  [PubMed] 
  18. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al; China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8): 727-33. [Crossref]  [PubMed]  [PMC] 
  19. Hellewell J, Abbott S, Gimma A, Bosse NI, Jarvis CI, Russell TW, et al. Feasibility of controlling COVID-19 outbreaks by isolation of cases and contacts. Lancet Glob Health. 2020;8(4):e488-96. Erratum in: Lancet Glob Health. 2020. [Crossref]  [PubMed]  [PMC] 
  20. Vlachodimitropoulou Koumoutsea E, Vivanti AJ, Shehata N, Benachi A, Le Gouez A, Desconclois C, et al. COVID-19 and acute coagulopathy in pregnancy. J Thromb Hae most. 2020;18(7):1648-52. [Crossref]  [PubMed]