Eighteen-Month Outcomes Among Pregnant and Nonpregnant Reproductive-Aged People Hospitalized for Coronavirus Disease 2019.

Autor: Bebell LM; Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA., Woolley AE; Department of Medicine, Division of Infectious Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., James KE; Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA., Kim A; Department of Medicine, Division of Infectious Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Joyc MR; Department of Medicine, Division of Infectious Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Gray KJ; Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington, USA., Radford C; Department of Medicine, Division of Infectious Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Bassett IV; Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA., Boatin AA; Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA., Ciaranello AL; Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA., Yawetz S; Department of Medicine, Division of Infectious Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Edlow AG; Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.; Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, Massachusetts, USA., Goldfarb IT; Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA., Diouf K; Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2024 Jul 08; Vol. 11 (7), pp. ofae278. Date of Electronic Publication: 2024 Jul 08 (Print Publication: 2024).
DOI: 10.1093/ofid/ofae278
Abstrakt: Background: Physiologic and immunologic adaptations in pregnancy may increase the risk of adverse outcomes from respiratory viral infections. However, data are limited on longer-term outcomes after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnancy prior to widespread vaccine availability.
Methods: Using electronic health record data, we retrospectively compared 6-, 12-, and 18-month outcomes including death and rehospitalization between pregnant and nonpregnant reproductive-aged individuals hospitalized for SARS-CoV-2 infection between 2020 and 2021 at 2 academic referral hospitals.
Results: There were 190 nonpregnant and 70 pregnant participants. Mean age was 31 years for pregnant and 34 years for nonpregnant participants. For pregnant patients, mean gestational age at coronavirus disease 2019 (COVID-19) diagnosis was 36 weeks, 54% delivered by cesarean, and 97% delivered a live birth. Compared to pregnant participants, nonpregnant participants had a higher prevalence of baseline comorbidities and a higher proportion received mechanical ventilation (84% vs 55%). Index hospitalization complications (31% vs 17%) and mortality (3% vs 0%) were more common in nonpregnant participants. Over 18 months following index hospitalization, 39 (21%) nonpregnant and 5 (7%) pregnant participants were readmitted, most for infection (28/44 [64%]). Most readmissions occurred within 6 months. There were no posthospitalization deaths in the pregnant group.
Conclusions: Pregnant people with severe COVID-19 disease had a low rate of severe adverse outcomes after index hospitalization. The low readmission rate is reassuring that pregnant individuals may not be at higher risk for long-term severe adverse health outcomes after COVID-19 compared to the nonpregnant reproductive-aged population, possibly because any increased risk conferred by pregnancy resolves soon after delivery.
Competing Interests: Potential conflicts of interest. K. J. G. reports consultation for BillionToOne, Aetion, Roche, and Janssen Global, outside the scope of the submitted work. All other authors report no potential conflicts.
(© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
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