7 Detailed information on treating COVID-19 in pregnant patients can be found in Special Considerations in Pregnancy and in the pregnancy considerations subsection of each section of the Guidelines. 6 D-dimer and CRP levels also increase during pregnancy and are often higher in pregnant patients than nonpregnant patients. This increase is mainly due to neutrophilia. In general, leukocyte cell count increases throughout gestation and delivery and peaks during the immediate postpartum period. 5 If laboratory parameters are used for monitoring pregnant patients and making decisions about interventions, clinicians should be aware that normal physiologic changes during pregnancy can alter several laboratory values. For example, oxygen supplementation is recommended for pregnant patients when SpO 2 falls below 95% on room air at sea level to accommodate physiologic changes in oxygen demand during pregnancy and to ensure adequate oxygen delivery to the fetus. However, the threshold for certain interventions may be different for pregnant patients and nonpregnant patients. The definitions for the severity of illness categories listed above also apply to pregnant patients. Although inflammatory markers such as C-reactive protein (CRP), D-dimer, and ferritin are not routinely measured as part of standard care, results from such measurements may have prognostic value. Laboratory testing includes a complete blood count with differential and a metabolic profile, including liver and renal function tests. An electrocardiogram should be performed if indicated. Initial evaluation for these patients may include a chest X-ray, ultrasound screening, or, if indicated, a computed tomography scan. The optimal pulmonary imaging technique has not yet been defined for people with symptomatic SARS-CoV-2 infection. 1 Health care providers should monitor such patients closely until clinical recovery is achieved.
These comorbidities include being aged ≥65 years having cardiovascular disease, chronic lung disease, sickle cell disease, diabetes, cancer, obesity, or chronic kidney disease being pregnant being a cigarette smoker being a transplant recipient and receiving immunosuppressive therapy. Patients with certain underlying comorbidities are at a higher risk of progressing to severe COVID-19.
Critical Illness: Individuals who have respiratory failure, septic shock, and/or multiple organ dysfunction.
Severe Illness: Individuals who have SpO 2 30 breaths/min, or lung infiltrates >50%.Moderate Illness: Individuals who show evidence of lower respiratory disease during clinical assessment or imaging and who have an oxygen saturation (SpO 2) ≥94% on room air at sea level.
Mild Illness: Individuals who have any of the various signs and symptoms of COVID-19 (e.g., fever, cough, sore throat, malaise, headache, muscle pain, nausea, vomiting, diarrhea, loss of taste and smell) but who do not have shortness of breath, dyspnea, or abnormal chest imaging.Asymptomatic or Presymptomatic Infection: Individuals who test positive for SARS-CoV-2 using a virologic test (i.e., a nucleic acid amplification test or an antigen test) but who have no symptoms that are consistent with COVID-19.In general, adults with SARS-CoV-2 infection can be grouped into the following severity of illness categories however, the criteria for each category may overlap or vary across clinical guidelines and clinical trials, and a patient’s clinical status may change over time. Patients with SARS-CoV-2 infection can experience a range of clinical manifestations, from no symptoms to critical illness.