CHANGES IN HEMOSTASIOLOGICAL PARAMETERS IN PREGNANT WOMEN WITH ASYMPTOMATIC AND MILD FORM OF COVID-19
Journal: Journal of the Grodno State Medical University (Vol.21, No. 6)Publication Date: 2024-01-11
Authors : T. N. Grinevich M. O. Kot M. S. Bakh K. A. Ostrovskaya;
Page : 556-562
Keywords : pregnant women; COVID-19; coagulopathy; D-dimer;
Abstract
Background. Coronavirus infection (COVID-19) is characterized by various abnormalities including pulmonary inflammation and activation of the hemostatic system, termed COVID-19-associated coagulopathy. Objective. To study the nature and direction of changes in the hemostatic system in pregnant women with COVID-19. Material and methods. A total of 132 pregnant women in the third trimester of gestation were examined: 91 patients diagnosed with SARS-CoV-2 virus infection constituted the main group and 41 pregnant women without coronavirus infection constituted the control group. Haemostasiological, biochemical and haematological investigations were performed. Results. An asymptomatic course of COVID-19 infection was registered in 84.6% of pregnant women in the experimental group. In pregnant women with signs of viral infection, the disease course was mild. There were no statistically significant differences in D-dimer between the experimental and control groups, but there was an increase in its level in 29.1% of pregnant women with coronavirus infection (815-8307 ng/ml) and in 27.3% of pregnant women in the control group (703-1175 ng/ml). In pregnant women with a confirmed diagnosis of COVID-19, as compared to controls, a shortening of the aPTT was significantly more likely to be observed (p=0.032), and these changes, along with a decrease in R-aPTT, were more common in those with clinical manifestations of coronavirus infection (p=0.0025). Pregnant women with elevated D-dimers had a higher level of CRP (p=0.043), a lower prothrombin level (p=0.05) and a higher INR (p=0.003); there was also a decrease in erythrocyte count (p=0.031), higher monocyte count (p=0.0067) and a lower proportion of segmented neutrophils (p=0.0024). Conclusions. The revealed abnormalities may indicate the presence of disturbances in the blood coagulation system in pregnant women with asymptomatic or mild course of COVID-19 directed towards hypercoagulable processes, and these changes are statistically significantly more common in individuals with clinical manifestations of coronavirus infection.
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