xfg3iczd

Property	Value
?:abstract	Background There are specific physiologic features regarding the immunity and coagulation among pregnant women, which may play important roles in the illness development of COVID-19. Objective To determine the key factors associated with the deterioration of patients with COVID-19 and the differentiating clinical characteristics of pregnant women with COVID-19, to interfere with the progression of COVID-19. Study Design A retrospective study of 539 Chinese Han adult patients with COVID-19 was conducted, of which 36 cases were pregnant women. 36 pregnant women without COVID-19 were recruited as the control. The characteristics of severe and critical illness which were differentiated from mild and moderate illness in patients with COVID-19 were analyzed using a machine learning algorithm. Additionally, major differences between pregnant women with COVID-19 and age-matched non-pregnant women with severe/critical COVID-19, paired with pregnant women without COVID-19, were explored to identify specific physiological features of pregnant women with COVID-19. Results For the total patient population, the lymphocyte, CD3+, CD4+, CD8+, CD19+ and CD16+56+ cell counts were significantly lower, and white blood cell (WBC), neutrophil and neutrophil-to-lymphocyte ratio (NLR) were higher in those with severe/critical illness than those with mild/moderate illness (P<0.001). The plasma levels of IL-6, IL-10 and IL-6 to IL-10 ratio (IL-6/10) were significantly increased in critical patients, compared to mild, moderate and severe patients (P<0.001). The above immunological co-clusters achieved an AUC of 0.801 (95% CI: 0.764-0.838); and its combined model with the coagulation and fibrinolysis index (prothrombin time, d-dimer) achieved an AUC of 0.815 (95% CI: 0.779-0.851) using the random Forest regression model to predict severe or critical illness. For the pregnant women with COVID-19, none had pre-existing diseases. They displayed increased WBC, neutrophil count, NLR, and levels of D-dimer and fibrinogen, along with decreased lymphocyte and IL-4 level (P<0.05), compared with non-pregnant women with mild/moderate COVID-19. Although they presented similar changes of immunological markers of lymphocyte, WBC, NLR, CD3+, CD4+, CD8+, CD16+56+ cell count and IL-6/10 compared with non-pregnant women with severe/critical COVID-19, none of the pregnant women with COVID-19 deteriorated into severe or critical illness. There were no significant differences in comparison to WBC, lymphocyte, neutrophil, NLR, immunological markers or coagulation fibrinolysis markers between pregnant women with COVID-19 and pregnant women without COVID-19. As for the discrepancy of pathophysiological features between pregnant women with COVID-19 and non-pregnant women with severe/critical COVID-19, the immunological markers achieved an AUC of 0.875 (95% CI: 0.773-0.977); and its combined model with coagulation and fibrinolysis index achieved an AUC of 0.931 (95% CI: 0.850-1.000). Conclusions Immune dysregulation was identified as a crucial feature of COVID-19 patients which developed severe or critical illness, and pregnant women with COVID-19 presented with similar immune responses but rarer incidences of severe or critical illness. Immune dysregulation is related to the risks of deterioration into severe or critical illness. The specific coagulation/fibrinolysis system of pregnancy may reduce pregnant women with COVID-19 without pre-existing disease from the development of severe illness.
is ?:annotates of	<https://research.tib.eu/covid-19/entity/xfg3iczd_hasAnnotation_C1704691> <https://research.tib.eu/covid-19/entity/xfg3iczd_hasAnnotation_C3540595>
?:creator	<https://research.tib.eu/covid-19/entity/Zhong%2C_Yajuan%3B_Cao%2C_Yacong%3B_Zhong%2C_Xiaozhu%3B_Peng%2C_Zhihang%3B_Jiang%2C_Sushi%3B_Tang%2C_Tiantian%3B_Chen%2C_Hai%3B_Li%2C_Xiaojia%3B_Xia%2C_Yankai%3B_Cheng%2C_Yanxiang%3B_Zhao%2C_Xiaomiao>
?:doi	10.1016/j.ajog.2020.10.032
?:doi	<https://research.tib.eu/covid-19/entity/10.1016/j.ajog.2020.10.032>
?:journal	Am_J_Obstet_Gynecol
?:license	els-covid
?:pdf_json_files	document_parses/pdf_json/f05cf922797e40b72f8da6e18de97ed53044da23.json
?:pmcid	<https://research.tib.eu/covid-19/entity/PMC7578241>
?:pmid	<https://research.tib.eu/covid-19/entity/33098813.0>
?:pmid	33098813.0
?:publication_isRelatedTo_Disease	<https://research.tib.eu/covid-19/entity/COVID-19>
?:sha_id	<https://research.tib.eu/covid-19/entity/f05cf922797e40b72f8da6e18de97ed53044da23>
?:source	Elsevier; Medline; PMC
?:title	Immunity and Coagulation/Fibrinolytic Processes may Reduce the Risk of Severe Illness in Pregnant Women with COVID-19
?:type	<https://research.tib.eu/covid-19/vocab/Publication>
?:year	2020-10-22

Property

Value

?:abstract

Background There are specific physiologic features regarding the immunity and coagulation among pregnant women, which may play important roles in the illness development of COVID-19. Objective To determine the key factors associated with the deterioration of patients with COVID-19 and the differentiating clinical characteristics of pregnant women with COVID-19, to interfere with the progression of COVID-19. Study Design A retrospective study of 539 Chinese Han adult patients with COVID-19 was conducted, of which 36 cases were pregnant women. 36 pregnant women without COVID-19 were recruited as the control. The characteristics of severe and critical illness which were differentiated from mild and moderate illness in patients with COVID-19 were analyzed using a machine learning algorithm. Additionally, major differences between pregnant women with COVID-19 and age-matched non-pregnant women with severe/critical COVID-19, paired with pregnant women without COVID-19, were explored to identify specific physiological features of pregnant women with COVID-19. Results For the total patient population, the lymphocyte, CD3+, CD4+, CD8+, CD19+ and CD16+56+ cell counts were significantly lower, and white blood cell (WBC), neutrophil and neutrophil-to-lymphocyte ratio (NLR) were higher in those with severe/critical illness than those with mild/moderate illness (P<0.001). The plasma levels of IL-6, IL-10 and IL-6 to IL-10 ratio (IL-6/10) were significantly increased in critical patients, compared to mild, moderate and severe patients (P<0.001). The above immunological co-clusters achieved an AUC of 0.801 (95% CI: 0.764-0.838); and its combined model with the coagulation and fibrinolysis index (prothrombin time, d-dimer) achieved an AUC of 0.815 (95% CI: 0.779-0.851) using the random Forest regression model to predict severe or critical illness. For the pregnant women with COVID-19, none had pre-existing diseases. They displayed increased WBC, neutrophil count, NLR, and levels of D-dimer and fibrinogen, along with decreased lymphocyte and IL-4 level (P<0.05), compared with non-pregnant women with mild/moderate COVID-19. Although they presented similar changes of immunological markers of lymphocyte, WBC, NLR, CD3+, CD4+, CD8+, CD16+56+ cell count and IL-6/10 compared with non-pregnant women with severe/critical COVID-19, none of the pregnant women with COVID-19 deteriorated into severe or critical illness. There were no significant differences in comparison to WBC, lymphocyte, neutrophil, NLR, immunological markers or coagulation fibrinolysis markers between pregnant women with COVID-19 and pregnant women without COVID-19. As for the discrepancy of pathophysiological features between pregnant women with COVID-19 and non-pregnant women with severe/critical COVID-19, the immunological markers achieved an AUC of 0.875 (95% CI: 0.773-0.977); and its combined model with coagulation and fibrinolysis index achieved an AUC of 0.931 (95% CI: 0.850-1.000). Conclusions Immune dysregulation was identified as a crucial feature of COVID-19 patients which developed severe or critical illness, and pregnant women with COVID-19 presented with similar immune responses but rarer incidences of severe or critical illness. Immune dysregulation is related to the risks of deterioration into severe or critical illness. The specific coagulation/fibrinolysis system of pregnancy may reduce pregnant women with COVID-19 without pre-existing disease from the development of severe illness.

is ?:annotates of