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

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.