Prospective Evaluation of Hematological Indices in Prognostication of COVID-19 Infection in Pregnant Population
Isha Wadhawan, Bhawana Garg
Keywords :
COVID-19 in pregnancy, Hematologic indices, Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio, Prognosis, Severe COVID-19
Citation Information :
Wadhawan I, Garg B. Prospective Evaluation of Hematological Indices in Prognostication of COVID-19 Infection in Pregnant Population. J South Asian Feder Obs Gynae 2022; 14 (4):356-360.
Background: Neutrophil-to-lymphocyte ratio (NLR) is a well-established inflammatory marker that has been studied in COVID-19 inflicted patients. Pregnancy per se is associated with its own physiological changes in hematological parameters. No study has specifically been done on the pregnant population to evaluate the role of various hematological markers for prognosticating the severity of COVID-19 infection. Aim: The aim of this study was to prospectively evaluate changes in NLR and other indices in a cohort of pregnant women with severe and non-severe COVID-19. Materials and methods: Prospective cohort study at a COVID dedicated tertiary care center of a low-middle income country for a period of 6 months involving hospitalized COVID-19 positive pregnant women. Results: In total, 8/8 (100%) and 6/8 (75%) of the pregnant women with severe COVID-19, had a raised NLR and platelet-to-lymphocyte ratio (PLR), respectively, compared to only 3/47 (6.4%) and 1/47 (2.13%) with non-severe COVID-19 (p <0.0001, p <0.0001). These ratios were noted to normalize at 2 and 4 weeks follow-up in the survivors of severe COVID-19. Conclusion: This is the first prospective study demonstrating an association between COVID-19 disease severity in pregnant women and NLR and PLR on admission. These indices may be utilized for prognostication and better preparations for the care of pregnant women hospitalized with COVID-19 infections.
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