Clinical Radiological and Biochemical Profile of Moderate to Severe Covid-19 Pregnant Females and its Correlation with Clinical Outcome.

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Since December 2019, severe acute respiratory syndrome corona virus 2 has been recognized as the causal factor in a series of severe cases of pneumonia originating in Wuhan, China which has been named Corona virus disease 2019 (COVID-19) by WHO. The physiological and mechanical changes associated with pregnancy increase maternal susceptibility to infections in general and is a state of relative immunosuppression. MATERIAL: 49 pregnant COVID-19 moderate to severe Pneumonia patients classified as per MHFW, GOI were taken into the study for a period of 3 months at Bowring & Lady Curzon Hospital. Clinical history, duration of illness, co-morbidities, q-sofa score, basic blood panel and inflammatory markers, were done at the time of admission and co-related with the pregnancy and Covid -19 outcomes. OBSERVATION: Among 49 patients, 13 were in the age group of 20-25 years, 24 in 26-30 years and 12 in 31-41 years. 27 patients (55.1%) recovered whereas 22 patients (44.9%) died. 69.4% had cough and breathlessness as presenting complaint followed by fever in 59.2 %, fatigue in 30.6%, headache in 26.5% and diarrhoea in 28.6%. 4 patient had gestational diabetes, 2 had hypothyroidism, 2 had pre eclampsia. Comparison between biochemical parameters and clinical out come showed statistically significant result with total leucocyte count, D-dimer, LDH, CRP and pro calcitonin. All 13 subjects with moderate disease recovered and out of 36 severe disease 22 died and 14 recovered. 24 Patients were primigravida of which 16 recovered and 8 died, 25 patients were multigravida of which 11 recovered and 14 died. Correlation between chest radiograph score and q sofa score with clinical outcome showed statistically significant result. CONCLUSION: Compared to first wave of COVID-19 infection second wave showed significant mortality and morbidity among COVID-19 positive pregnant women. Pregnancy is a state of relative immunosuppression and hence close monitoring and early intervention and multidisciplinary care is of importance in order to prevent severe COVID-19 infection and mortality.

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