COVID-19 related maternal mortality cases in associated with Delta and Omicron waves and the role of lung ultrasound/COVID-19'a bagli anne ölümü olgularinin Delta ve Omikron dalgalari ile iliskisi ve akciger ultrasonunun rolÃ

• Published in: Turkish journal of obstetrics and gynecology Vol. 19; no. 2; p. 88
• Main Authors: Tekin, Arzu Bilge, Yassa, Murat, Ilter, Pinar Birol, Yavuz, Emre, Önden, Betül, Usta, Canberk, Budak, Dogus, Günkaya, Osman Samet, Çavusoglu, Gül, Taymur, Bilge Dogan, Tug, Niyazi
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01.06.2022
• Subjects: Diagnosis, Ultrasonic; Mothers; Patient outcomes; Perinatal infection; Prognosis; Turkey
• ISSN: 2149-9322
• DOI: 10.4274/tjod.galenos.2022.36937

Objective: To present coronavirus disease-2019 (COVID-19) related maternal mortality in relation to Delta and Omicron waves and to investigate the role of lung ultrasound (LUS) in estimating mortality. Materials and Methods: This retrospective cohort study was conducted in the obstetrics and gynecology clinic of a tertiary pandemic hospital between March 2020 and January 2022. The hospitalized pregnant women with COVID-19 diagnosis and maternal deaths were studied in relation with Delta and Omicron waves. The relationship between LUS scores of hospitalized patients and maternal mortality was explored. Results: Thousand and sixty-five pregnant women were hospitalized because of COVID-19 infection. Fifty-one (4.79%) of these patients had critical sickness, 96 (9.01%) of them had severe illness, 62 (5.82%) of them were admitted to the intensive care unit and 28 (2.63%) of all hospitalized pregnant women had died. Of the 1.065 patients, 783 (73.5%) were hospitalized before the Delta wave and the maternal mortality rate was 1.28% (10/783), 243 (22.8%) were hospitalized during the Delta wave and the maternal mortality rate was 7% (17/243) [relative risk (RR)=5.478, 95% confidence interval (CI) (2.54-11.8), z=4.342, p<0.001]. During the Omicron wave 39 (3.66%) patients were hospitalized and the maternal mortality rate was 2.56% (1/39). Maternal mortality rates, according to LUS scores, were 0.37% (1/273) for LUS 0, 0.72% (2/277) for LUS 1, 2.58% (10/387) for LUS 2 and 11.72% (15/128) for LUS 3 respectively (LUS 3 vs. others; maternal mortality: RR=8.447, 95% CI (4.11-17.34), z=5.814, p<0.0001). There were no vaccinated patients in the study cohort. Conclusion: The maternal mortality rate was relatively high, particularly during the Delta wave at our referral center. The Delta wave, delayed vaccination and vaccine hesitancy of pregnant women might have important roles in maternal mortality. Higher LUS scores should warn clinicians of an increased risk of maternal death. Keywords: COVID-19, Delta, lung ultrasound, maternal mortality, Omicron Amaç: Delta ve Omikron dalgalari ile iliskili olarak koronavirüs hastaligi-2019 (COVID-19) ile iliskili anne ölümlerini sunmak ve akciger ultrasonunun (AUS) hastalik siddeti-mortalite tahminindeki rolünü arastirmaktir. Gereç ve Yöntemler: Bu retrospektif kohort çalismasi, üçüncü basamak bir pandemi hastanesinin kadin hastaliklari ve dogum kliniginde Mart 2020 ile Ocak 2022 tarihleri arasinda yapilmistir. Hastanede yatan COVID-19 tanili gebeler ve anne ölümü olgulari Delta ve Omikron dalgalari ile iliskili olarak incelenmistir. Hastanede yatan hastalarin AUS skorlari ile anne ölümleri arasindaki iliski arastirilmistir. Bulgular: Bin altmis bes hamile kadin COVID-19 enfeksiyonu nedeniyle hastaneye yatirildi. Bu hastalarin 51'inde (%4,79) kritik hastaliga, 96'sinda (%9,01) agir bir hastalik mevcuttu, 62'si (%5,82) yogun bakima yatirildi ve hastanede yatan tüm gebe hastalarin 28'inde (%2,63) ölüm gerçeklesti. Delta dalgasi öncesinde 783 (%73,5) hasta hastaneye yatirildi, anne ölüm orani %1,28 (10/783), Delta dalgasi sirasinda 243 (%22,8) COVID-19 hasta hastaneye yatirildi ve anne ölüm orani %7'di (17/243) [göreceli risk (RR)=5,478, %95 güven araligi (GA) (2,54-11,8), z=4,342, p<0,001]. Omikron dalgasi sirasinda 39 (%3,66) hasta hastaneye yatirildi ve anne ölüm orani %2,56 (1/39) idi. AUS skorlarina göre anne ölüm oranlari, AUS 0 için %0,37 (1/273), AUS 1 için %0,72 (2/277), AUS 2 için %2,58 (10/387) ve AUS için %11,72 (15/128) idi (AUS 3 ve digerleri; anne ölüm orani: RR=8,447, %95 GA (4,11-17,34), z=5,814, p<0,0001). Çalisma grubunda asili hasta bulunmamaktaydi. Sonuç: Anne ölüm orani, özellikle sevk merkezimizde Delta dalgasi sirasinda nispeten yüksekti. Gebelerin Delta dalgasi, asi gecikmesi ve asi tereddütlerinin anne ölümlerinde önemli rolleri olabilir. Daha yüksek akciger ultrason skorlari, klinisyenleri artan anne ölümü riski konusunda uyarmalidir. Anahtar Kelimeler: COVID-19, Delta, akciger ultrasonu, anne ölümü, Omikron