Association of Covid-19 Infection with Liver Tests and Pregnancy Outcomes: A Prospective Cohort Study

Background & aim: With the spread of the newly emerging virus, Covid-19, there were many concerns about the effects and complications of pregnant women contracting this virus.Since pregnant women are in a vulnerable group due to the physiological changes associated with pregnancy, the purpose of the present study was to determine and relate the infection of covid-19 with liver tests and pregnancy outcomes. Methods:The present prospective cohort study was conducted from October 2019 to September 2021 at Shahid Akbarabadi and Firouzgar educational centers of Tehran, Iran.In this study, 191 female patients were included in the study and divided into two groups: 1-pregnant women infected with covid-19 (case group), 2-pregnant women not infected with covid-19 (control group).Eligible people were initially included in the study by available method and then by simple random allocation.Data collection was done by demographic and fertility questionnaires, pain (VAS) and relevant checklists.Collected data were analyzed using t-test, Mann-Whitney, chi-square, Fisher's exact test, Spearman, Pearson and logistic regression. Results:The level of liver tests (International Normalized Ratio(INR), aspartate aminotransferase (AST), alanine aminotransferase (ALT, ALP, alkaline phosphatase) increased between the two groups.The increase between the two groups indicated a statistically significant difference (p<0.001),but the mean platelet, indirect bilirubin and relative thromboplastin time in the case group were significantly lower than the control group respectively (p<0.002, p<0.001, 041.Moreover, there was a significant difference in premature delivery and the intensity of contractions in the case and control groups (p<0.001).Phosphatase increased ALP by 15% and indirect bilirubin risk by 58%, which was reported to be statistically significant, but it had no effect on platelets and INR. Conclusion:Based on the results of the present study, the infection of covid-19 caused liver test disorders.Disruption of liver tests due to covid-19 infection can overlap the changes made during preeclampsia syndrome or HELLP syndrome (hemolysis, increase of liver enzymes, decrease of platelets).Furthermore, the covid-19 infection increased the intensity of contractions and premature delivery.