NATIONAL HARBOR, Md. — One in 10 women pregnant during the index period for COVID-19 developed long-term COVID-19 infection, according to an analysis of pregnancy cohorts in the NIH’s RECOVER initiative. .
In the final cohort of 1,502 women, 9.3% met criteria for acute sequelae of SARS-CoV-2 infection (PASC), with a median time to study visit defining PASC of 10.3 months (interquartile (range 6.1-21.5). Tori Metz, MD, MSc, Chair of Maternal-Fetal Medicine at Utah Health University in Salt Lake City.
In general, 10-25% of adults will develop a new coronavirus infection long after infection, Professor Metz pointed out in a presentation at the Society for Maternal-Fetal Medicine annual meeting.
“This could provide insight into the pathophysiology of PASC, as well as the differences between pregnant and non-pregnant populations to determine whether there is something unique about pregnancy.” “We need further studies to investigate the “pregnancy cohort,” Metz said, adding that the team plans to compare the larger adult RECOVER population with the non-pregnant pregnancy cohort.
“We know that pregnant women are at higher risk of developing severe COVID-19, being admitted to the ICU, and dying. Therefore, pregnant people are disproportionately affected by COVID-19. ” Metz said.
said Amy Crockett, MD, MSc, PhD, a maternal-fetal medicine physician at Prisma Health in Greenville, South Carolina. today’s med page The new coronavirus is associated with many serious problems for pregnant women and infants, including an increased risk of stillbirth and more severe infection with the new coronavirus.
“The good news is that pregnant women are less likely to develop long-term symptoms of COVID-19 than non-pregnant patients,” Crockett said.
The most common symptoms in the study were post-exercise malaise, fatigue, gastrointestinal symptoms, dizziness, and brain fog, the researchers reported.
Among patients with PASC, 57% had difficulty meeting costs (adjusted OR 1.57, 95% CI 1.05-2.34), 38% were obese (aOR 1.65, 95% CI 1.12-2.43), and 59% were depressed. had an illness or anxiety disorder (aOR 2.64). , 95% CI 1.79-3.88), and 12% required oxygen for acute infections (aOR 1.86, 95% CI 1.00-3.44).
Pre-omicron infection, not fully vaccinated, higher discrimination index score, and comorbidities were associated with longer COVID-19 morbidity in unadjusted models, but not after adjustment was.
In total, 1,502 of the original group of 14,636 participants in the RECOVER pregnancy cohort were included. Individuals without a PASC symptom surveillance study visit more than 6 months after index infection were excluded. Participants were enrolled from December 2021 until September 2023. There were 26 in-person sites, and data from other locations were collected remotely through the University of California, San Francisco.
Metz and his team looked at sociodemographic factors such as insurance status and coverage, self-reported difficulty paying bills, and discrimination measured using the Everyday Discrimination Scale. We also assessed vaccination status and pre-existing clinical characteristics such as smoking, comorbidities such as obesity, hypertension, depression and anxiety disorders, and severity of SARS-CoV-2 infection, particularly the need for oxygen. The semester when the infection occurred and the date when the infection occurred as a substitute for the new coronavirus variant.
Every three months after initial COVID infection, participants completed a questionnaire regarding PASC symptoms and severity. RECOVER has developed the PASC scoring system, which is based on the presence and severity of symptoms on a scale of 0 to 34. If a participant’s score is 12 or higher, the participant is considered to have a long-term coronavirus infection.
Of these patients, 48% had their primary infection during the third trimester and 61% had their infection during the Omicron-predominant period. 51% had been fully vaccinated more than 2 weeks before their first infection. In addition, 24% reported obesity in the year before infection, and 29% had comorbidities.
Metz said the PASC algorithm may have missed some people with long-term COVID-19 infections, and some of the symptoms of long-term COVID-19 infections may overlap with pregnancy and postpartum symptoms. He pointed out that there is a gender. Additionally, nilmatrevir/ritonavir (Paxlovid) was not used frequently enough to analyze its effects.
disclosure
This research was funded by the NIH.
Metz is the principal investigator on two Pfizer studies on the coronavirus and pregnancy.
Co-authors received funding from Pfizer, Novartis, Janssen, and Gilead.
Crockett had no conflicts of interest.
Primary information
Society of Maternal and Child Medicine
Source reference: Metz T et al. “Development of SARS-CoV-2 (PASC) acute sequelae following infection during pregnancy: NIH RECOVER-Pregnancy Cohort” SMFM 2024; Abstract LB01.
