1. Severity of COVID-19 Respiratory Complications during Pregnancy are Associated with Degree of Lymphopenia and Neutrophil to Lymphocyte Ratio on Presentation: A Multicenter Cohort Study
- Author
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Robert M. Moore, Yogangi Malhotra, Daniel M. Lasser, Tianying Li, Clementine Knight, Judith Chervenak, and Hugo O. Teo
- Subjects
Adult ,medicine.medical_specialty ,Neutrophils ,Disease ,Sensitivity and Specificity ,Severity of Illness Index ,Hypoxemia ,Cohort Studies ,Pregnancy ,Lymphopenia ,Internal medicine ,Severity of illness ,medicine ,Humans ,Lymphocyte Count ,Pregnancy Complications, Infectious ,Neutrophil to lymphocyte ratio ,Retrospective Studies ,business.industry ,COVID-19 ,Obstetrics and Gynecology ,Retrospective cohort study ,medicine.disease ,Triage ,Pediatrics, Perinatology and Child Health ,Disease Progression ,Female ,medicine.symptom ,business ,Cohort study - Abstract
Objective This study aimed to determine if laboratory inflammatory markers can predict critical disease in symptomatic COVID-19 pregnant women. Study Design Multicenter, retrospective cohort study of all pregnant women presenting to New York City Health + Hospitals emergency departments from March 1 to May 30, 2020. We assessed all symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive pregnant women with room air oxygen saturation Results A total of 498 of 5,002 pregnant women were SARS-CoV-2 RT-PCR positive of which 77 presented with hypoxemia. The absolute lymphocyte count (ALC) and neutrophil to lymphocyte ratio (NLR) were highly sensitive for progression to severe illness. ROC curve analysis identified predictive cutoffs: ALC 8.1 (100% sensitivity, 70% specificity, AUC = 0.86 (95% CI: [0.76–0.96]). Conclusion ALC and NLR on presentation are sensitive markers of progression to critical COVID-19 disease in symptomatic pregnant women. This finding provides a practical, rapid method for assessment and can assist clinicians with decision-making regarding triage, level of care, and patient management. Key Points
- Published
- 2021
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