Abstract
Background: During viral outbreaks, pregnancy poses an increased risk of infection for women. Methods: In a prospective study, all patients admitted for delivery at term to Elena Doamna Obstetrics and Gynecology University Hospital in Iasi, Romania, between 1 April 2020 and 31 December 2020 were included. There were 457 patients, divided into two groups: group 1, SARS-CoV-2-positive patients (n = 46) and group 2, SARS-CoV-2-negative patients (n = 411). Among other tests, complete blood count was determined upon admittance, and the following values were studied: white blood cell count, lymphocytes, neutrophils, red blood cell count, hemoglobin, mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, mean corpuscular volume, red blood cell distribution width, hematocrit, platelet count, mean platelet volume, platelet distribution width, plateletcrit, and platelet large cell ratio. Results: in pregnant SARS-CoV-2-infected patients at term, there was a significant decrease in white blood cell, neutrophil, and lymphocyte count, and an increase in mean corpuscular hemoglobin concentration, compared to healthy pregnant women at term, although all still within normal limits. None of the other components of the complete blood count or fetal outcomes studied was significantly influenced by SARS-CoV-2 infection in pregnant patients at term.
Highlights
During viral outbreaks, pregnancy poses an increased risk for women due to changes to immune function together with adaptive physiological alterations, such as increased oxygen consumption and edema of the respiratory tract [1,2]
We found no significant difference in pregnant SARS-CoV-2-positive patients compared to negative ones, as regards RBC, HGB, MCH, MCV, RDW-CV, RDW-SD, and HCT; we found a significant increase in MCHC (p = 0.022), it was still within normal limits
Some studies [30,31,32] showed that lymphopenia was the leading laboratory change in pregnant women confirmed with Sars-CoV-2 infection. This was not true in our study: we only found one pregnant patient at term with lymphopenia, which belonged to the pregnant SARS-CoV-2-negative patients, while no pregnant SARS-CoV-2-positive patient at term in our study group had lymphopenia
Summary
Pregnancy poses an increased risk for women due to changes to immune function together with adaptive physiological alterations, such as increased oxygen consumption and edema of the respiratory tract [1,2]. Yang [11] found no difference between pregnant SARS-Cov-2-positive and negative patients during the prenatal and postpartum period, as regards the count of white blood cells, neutrophils, and lymphocytes, the ratio of neutrophils to lymphocytes, and the level of C-reactive protein between the confirmed COVID-19 group and the control group, during the prenatal and postpartum period. According to Wu [5], white blood cell counts were normal or slightly higher than normal, while the lymphocyte counts were normal or slightly lower than normal, before delivery in patients with SARS-Cov-2 infection, while, according to Sun [12], pregnant COVID-19 patients showed significantly lower numbers of blood lymphocytes and higher numbers of neutrophils compared to healthy pregnant patients. Results: in pregnant SARS-CoV-2-infected patients at term, there was a significant decrease in white blood cell, neutrophil, and lymphocyte count, and an increase in mean corpuscular hemoglobin concentration, compared to healthy pregnant women at term, all still within normal limits. None of the other components of the complete blood count or fetal outcomes studied was significantly influenced by SARS-CoV-2 infection in pregnant patients at term
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