Do Ectopic Pregnancy Treatment Choices Affect the Risk of COVID-19 Transmission?

Abstract

BACKGROUND/AIMS: To investigate the effects of treatment choices in ectopic pregnancy (EP), either surgery or single-dose methotrexate approaches, to see whether it leads to the incidence of coronavirus disease-19 (COVID-19) disease after discharge, as well as to determine any correlations in changes in cell blood counts (CBC) with the progress of COVID-19 infections.MATERIALS AND METHODS: This study was conducted with 95 patients who were diagnosed as having EP at University of Health Sciences Turkiye, Etlik Zubeyde Hanim Gynaecology Training and Research Hospital. COVID-19 swabs were taken from the patients with EP before hospitalization. Demographic parameters, CBCs, post-discharge COVID-19 disease occurrence rates, and infection progress were evaluated.RESULTS: Ninety-five patients with tubal EP were separated into two groups;20 patients who underwent surgical intervention (Group 1), and 75 patients who underwent single-dose methotrexate treatment (Group 2). There was no difference between the groups in terms of their demographic characteristics (p>0.05). The mass size was measured using transvaginal ultrasound and the mean mass diameter in Group 2 was significantly smaller than in Group 1 (Z=4.123;p<0.001). The hospital stay of Group 2 was longer than in group 1 (Z=4.451;p<0.001). No patients were infected with COVID-19 before the hospitalization period;however, three (3.1%) patients were COVID-19-positive in the 90-day post-treatment period, two of whom had surgical treatment, and the other who received medical treatment. The patient who had medical treatment went into self-isolation and used favipiravir medication at home and completely recovered. By contrast, the patients who had surgical treatment needed hospital care. The mean neutrophil-lymphocyte ratio (NLR) values were significantly higher for those patients with EP in Group 1 compared with Group 2, both pre-treatment and post-treatment (Z=4.108, p<0.001;Z=4.783;p<0.001). Also, significant differences were detected between the groups regarding their haemoglobin levels, and white blood cell, platelet, and neutrophil counts (p=0.005 p=0.001, p=0.008, and p=0.001 respectively).CONCLUSION: Variances in EP treatment modalities and durations of hospitalization days did not increase the transmission of disease or mortality scores. It was concluded that methotrexate treatment could be chosen as the first-line treatment for ectopic pregnancy during the COVID-19 pandemic for patients. However, healthcare professionals must be aware that medical or surgical treatment approaches for patients with EP may change the NLR, which is an independent prognostic factor in COVID-19.