Clinical evolution and alterations in the liver profile in pregnant women with COVID-19

Abstract

Introduction: Liver involvement in pregnant women with COVID-19 is multifactorial and it is unknown if this disorder is a cause or consequence of a worse evolution of the disease.

Objective: To describe the clinical evolution and alterations in the liver profile in pregnant women with COVID-19.

Methods: A retrospective descriptive study was carried out. 507 pregnant women with COVID-19 were included, who were admitted to the “Dr. Luis Díaz Soto”, from January to December 2021. Two groups were formed according to the alteration of the liver profile (reference range of the center laboratory: aspartateamino transferase (AST) > 32 U/L, alanineamino transferase (ALT) > 32 U/L and total bilirubin > 21 umol/l). Demographic, clinical and humoral variables, extracted from the medical records, were used to compare both groups.

Results: 129 pregnant women (25.4%) presented an altered liver profile. This group was associated, when compared with the group with a normal liver profile, with greater severity, admission to the Intensive Care Unit with 54 cases (42%) vs. 79 (21%), the need for invasive mechanical ventilation in 20 cases (16%) vs. 18 (5%), as well as maternal death in 8 patients (6.2%) vs. 6 (1.6%). In addition, they had older maternal age, comorbidities such as obesity and gestational diabetes, and alterations in inflammation biomarkers such as: neutrophil/lymphocyte ratio >3 in 66 cases (51%) and lactate dehydrogenase in 55 patients (43%).

Conclusions: Pregnant women with COVID-19 and altered liver profile have greater inflammation, severity, and mortality.

Keywords: Pregnancy, COVID-19, liver dysfunction, liver enzymes