A robust tool to identify COVID-19 status among pregnant women: Proxy indicator during emergencies

Abstract

Introduction: The WHO has now declared COVID-19 as endemic and it may be prudent to identify high-risk patients requiring reverse transcriptase-polymerase chain reaction (RT-PCR). During the pandemic, RT-PCR testing and reporting were running around-the-clock. We attempted to validate this scoring system and predict high probable in the obstetric subpopulation based on a modified early warning scoring system (EWSS) score. Materials and Methods: Data were collected from case sheets of pregnant women who were admitted to the obstetrics and gynecology department, according to the EWSS protocol. All the criteria mentioned in the EWSS score were tabulated in an Excel sheet. A modified list of signs, symptoms, and investigations was correlated with RT-PCR. This model obtained was validated with appropriate statistical tests. Patients who had undergone lower-segment cesarean section had hypertension (HTN), and diabetes as comorbidities and were included in the scoring system. Results: The odds ratio of the patient being positive was 3.56 with diabetes mellitus and 0.93 with HTN, most presented with minor symptoms such as expectoration, sore throat, dyspnea, and anosmia and these had odds ratio of 7.03, 12.68, 4.24, and 2.45, respectively, but the confidence interval was very wide. In laboratory investigations, C-reactive protein (CRP) and lactate dehydrogenase (LDH) elevations were found commonly and the odds ratio was 16.09 and 8.78, respectively. Conclusion: We concluded that if a pregnant woman presents with a sore throat, expectoration, dyspnea, or anosmia and presents with raised CRP and LDH with diabetes as a comorbidity there is a very high probability that the patient may have COVID-19 and needs to be tested or isolated.

Keywords

• cesarean section
• covid-19
• early warning score
• isolation
• obstetric
• triage