Predictive Value of Hematological Parameters in Pregnant Women with Severe COVID-19 Associated with the Delta Variant of SARS-CoV-2

Abstract

Introduction: There are many uncertainties regarding the prognosis of COVID-19 in pregnant women. The present study aimed to investigate the relationship between severe COVID-19 during pregnancy associated with the delta variant of SARS-CoV-2 and hematological parameters, including white blood cell (WBC), platelet (PLT), neutrophil (N), lymphocyte (L), monocyte (M), mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), derived neutrophil-to-lymphocyte ratio (dNLR), red cell distribution width (RDW), plateletcrit (PCT), and platelet distribution width (PDW). Materials and Methods: Data obtained from 54 pregnant women who required hospitalization due to COVID-19 associated with the delta variant of SARS-CoV-2 were retrospectively reviewed. The pregnant women were divided into two disease groups as severe (n= 16) and non-severe (n= 38). Intergroup analyses were conducted based on WBC, PLT, N, L, M, MPV, NLR, PLR, LMR, dNLR, RDW, PCT, and PDW parameters obtained from the hematological test done at the time of first admission. Results: WBC, PLT, MPV, N, PCT, NLR, PLR, and dNLR levels were statistically significantly higher and the L and LMR levels were significantly lower in pregnant women with severe COVID-19. The odds ratio (OR) and area under the curve (AUC) values for all parameters were 1.764, 1.014, 1.620, 2.161, 350.81, 2.736, 1.016, 1.722, 0.0004, 0.412 and 0.903, 0.815, 0.818, 0.929, 0.910, 0.728, 0.985, 0.944, 0.828, 0.826 respectively. All parameters had a significant predictive value (AUC< 0.50) for the diagnosis of severe disease. PCT parameter had the greatest increase in the risk of severe disease (approximately 350 times higher), and the NLR variable (AUC= 0.985) had the best diagnostic performance. Conclusion: It was concluded that WBC, PLT, MPV, N, L, PCT, NLR, PLR, LMR, and dNLR parameters could be used in the assessment of the risk of severe disease or in the diagnosis of severe COVID-19 in pregnant women positive for the delta variant. We believe that the cut-off values calculated for the parameters, which had a significant predictive value based on receiver operating characteristic analysis, would help our colleagues in order to predict the clinical course in symptomatic pregnant women.

Keywords

• covid-19
• delta variant of sars-cov-2
• pregnancy