Abstract
Background: Critical COVID-19 patients account for 1.7 to 13% of all pregnant COVID-19 patients. Methods: Patients admitted to the COVID-19 intensive care unit of Elena Doamna Obstetrics and Gynecology University Hospital in Iasi between 1 January and 1 December 2021, with critical forms of the disease, were included and retrospectively studied. The patients’ age range was 25–44 years in the Alpha group (n = 12) and 27–52 years in the Delta group (n = 9). Results: Most critically ill pregnant COVID-19 patients in the Alpha group delivered when admitted to the intensive care unit, while less than half of those in the Delta group delivered when admitted; the rest were released home and continued their pregnancy normally. There was a significant difference regarding the number of patients released to home care and the number of days after admission when delivery occurred (p = 0.02 and 0.022, respectively). Conclusions: There was no significant difference in maternal and fetal outcomes between the two groups, except for the number of patients released to home care and the number of days after admission when delivery occurred. There was no correlation between any Brixia scores (H, L, A, E) and any maternal or fetal outcomes in both groups.
Highlights
Patients admitted to the COVID-19 intensive care unit (ICU) of Elena Doamna Obstetrics and Gynecology University Hospital in Iasi between 1 January and 1 December 2021, who had a critical form of the disease and underwent conventional chest X-rays, were included and retrospectively studied
We studied the highest score (H-score), corresponding to the only score for patients who had only one chest X-ray and the highest score for those with multiple X-rays, and the lowest score (L-score), the score assigned at admission (A-score), and the last score obtained before hospitalization ended (E-score) or the patient died [15]
Maroldi [17] found that H-score was significantly higher in deceased patients compared to discharged patients, and in patients with more than two conventional chest X-rays, A, L, and E-scores correlated significantly with outcome. This was not true in our case, as we found no significant difference between H-scores in the two groups; still, there was a significant difference between outcomes, as all patients in group 2 were discharged to home care due to progress in COVID-19 medical care
Summary
Results: Most critically ill pregnant COVID-19 patients in the Alpha group delivered when admitted to the intensive care unit, while less than half of those in the Delta group delivered when admitted; the rest were released home and continued their pregnancy normally. There was a significant difference regarding the number of patients released to home care and the number of days after admission when delivery occurred (p = 0.02 and 0.022, respectively). Conclusions: There was no significant difference in maternal and fetal outcomes between the two groups, except for the number of patients released to home care and the number of days after admission when delivery occurred. Pregnant patients admitted to the intensive care unit (ICU) constitute a relatively unique population in that both the maternal and fetal status must be taken into account simultaneously [4].
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