Higher severe acute respiratory syndrome coronavirus 2 infection rate in pregnant patients

Abstract

Background During the early months of the coronavirus disease of 2019 (COVID-19) pandemic, risks to pregnant women of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were uncertain. Pregnant patients can serve as a model for the success of the clinical and public health response during public health emergencies as they are typically in frequent contact with the medical system. Population-based estimates of SARS-CoV-2 infections in pregnancy are unknown due to incomplete ascertainment of pregnancy status or inclusion of only single centers or hospitalized cases. Whether pregnant women were protected by the public health response or through their interactions with obstetrical providers in the early pandemic is poorly understood. Objective(s) To estimate the SARS-CoV-2 infection rate in pregnancy and examine disparities by race/ethnicity and English-language proficiency in Washington State. Study Design Pregnant patients with a polymerase chain reaction (PCR)-confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection diagnosed between March 1-June 30, 2020 were identified within 35 hospitals/clinic systems capturing 61% of annual deliveries in Washington State. Infection rates in pregnancy were estimated overall and by Washington State Accountable Community of Health (ACH) region and cross-sectionally compared to SARS-CoV-2 infection rates in similarly aged adults in Washington State. Race/ethnicity and language used for medical care among the pregnant patients were compared to recent data from Washington State. Results A total of 240 pregnant patients with SARS-CoV-2 infections were identified during the study period with 70.7% from minority racial and ethnic groups. The principal findings in our study are: 1) The SARS-CoV-2 infection rate in pregnancy was 13.9/1,000 deliveries (95% confidence interval [CI], 8.3-23.2) compared to 7.3/1,000 (95%CI 7.2-7.4) in 20-39 year old adults in Washington State (Rate Ratio [RR] 1.7, 95%CI 1.3-2.3), 2) the SARS-CoV-2 infection rate reduced to 11.3/1000 (95%CI 6.3-20.3) when excluding 45 cases of SARS-CoV-2 detected through asymptomatic screening (RR 1.3, 95%CI 0.96-1.9), 3) the proportion of SARS-CoV-2 cases in pregnancy among most non-white racial/ethnic groups was 2-4 fold higher than the race and ethnicity distribution of women in Washington State who delivered live births in 2018, and 5) the proportion of SARS-CoV-2 infected pregnant patients receiving medical care in a non-English language was higher than estimates of limited English proficiency in Washington State (30.4% versus 7.6%). Conclusions The SARS-CoV-2 infection rate in pregnant people was 70% higher than similarly aged adults in Washington State, which could not be completely explained by universal screening at delivery. Pregnant patients from nearly all racial/ethnic minority groups and patients receiving medical care in a non-English...

Counseling in maternal–fetal medicine: SARS‐CoV‐2 infection in pregnancy

“…ethnicity). A recent study from Washington State found that the SARS‐CoV‐2 infection rate was significantly higher in pregnant patients compared with adults (both males and females) of similar age, and this difference remained after excluding pregnant patients with SARS‐CoV‐2 infection detected through asymptomatic screening strategies (before procedures or delivery) 17 . However, most pregnancies with SARS‐CoV‐2 were among women from racial and ethnic minority groups.…”

Correlation between Pregnancy Status and Severe Corona-Virus Disease Characterized by Cytokine Storm: Systematic Review and Meta-Analysis

“…In one study, in pregnancy, the case fatality rate of 25%, ICU admission (50%), and mechanical ventilation (33%), compared with the non-pregnant population (20%) was experienced (Martens & Kalgi, 2016), which may be implicated by immune responses in pregnancy. In addition, pregnancy may propagate respiratory infections and increase the risk of hospitalization (Lokken et al, 2021). A study also eluded that, complications of severity with other SARD are enhanced in pregnancy (Wastnedge et al, 2021).…”

Impacto da Covid-19 entre gestantes pretas e pardas: revisão integrativa da literatura / Impact of Covid-19 among black and mulatto pregnant women: integrative literature review

“…(A1) realizado no estado de Washington, com 46 mulheres grávidas que foram admitidas em hospital com infecção por coronavírus, quase todas as gestantes com infecção por SARS-COV-2, a maioria estava no segundo ou terceiro trimestre, 2 tinham síndrome respiratória aguda grave e 44 eram sintomáticas, 7 mulheres foram hospitalizadas, incluindo 1 internada na unidade de terapia intensiva, ocorreram 8 partos durante o período do estudo, sendo 1 parto prematuro com 33 semanas de gestação para melhorar o estado pulmonar da gestante. A doença se desenvolveu em cerca de 15% das pacientes grávidas (Lokken et al, 2021).…”