Management of pregnant women with COVID‐19: A tertiary pandemic center experience on 1416 cases

Şahın, Dilek; Tanaçan, Atakan; Erol, Seyit Ahmet; Yetiskin, Fatma Didem Yucel; Besimoğlu, Berhan; Tokalıoğlu, Eda Özden; Anuk, Ali Taner; Turgut, Ezgi; Ayhan, Şule Göncü; Turgay, Batuhan; Unlu, Serpil; Kanmaz, Gozde; Dinç, Bedia; Özgü-Erdinç, A. Seval; Keskin, Hüseyin Levent; Surel, Aziz Ahmet; Tekın, Özlem Moraloğlu

doi:10.1002/jmv.27423

Cited by 26 publications

(25 citation statements)

References 45 publications

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“…Ankara City Hospital is one of the leading pandemic centers in Turkey dealing with highly complicated COVID-19 patients. Sahin et al regularly updated their experience on pregnant COVID-19 patients and shared their findings with the literature with three published studies [ 23 – 25 ]. The present study is the latest update of this group.…”

Section: Methodsmentioning

confidence: 87%

“…Therefore, physicians dealing with pregnant women should be cautious in the management of infectious diseases in this specific population. As SARS-CoV-2 was also reported to have a more severe course in pregnant patients, follow-up and treatment of these cases should be performed by an experienced multidisciplinary team [ 23 ]. The most important reason for planning the current study was the significant increase observed in intensive care unit admission, obstetric complications, and maternal mortality in pregnant patients with COVID-19 after the variant period.…”

Section: Discussionmentioning

confidence: 99%

“…Although the experience on COVID-19 has increased significantly, it is, unfortunately, difficult to prevent the negative effects of the disease on pregnant women. Thus, encouraging pregnant women for COVID-19 vaccination, early diagnosis of disease, meticulous follow-up, multidisciplinary approach, and administration of appropriate medications seem to be the main strategies for preventing adverse outcomes [ 23 , 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of clinical features and perinatal outcomes between pre-variant and post-variant periods in pregnant women with SARS-CoV-2: analysis of 1935 cases

Şahın

Tanaçan

Anuk

et al. 2022

Arch Gynecol Obstet

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Purpose To compare the clinical features and perinatal outcomes of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the pre-variant and post-variant periods. Methods This prospective cohort study includes pregnant women with SARS-CoV-2 who were followed-up at Ankara City Hospital between 11, March 2020 and 15, September 2021. Demographic features, clinical characteristics and pregnancy outcomes were compared between the pre-variant ( n = 1416) and post-variant ( n = 519) groups. Results The rates of severe and critical cases significantly increased in the post-variant group (9.7% vs 2%, p < 0.001). The rates of respiratory support (26.8% vs 7.3%, p < 0.001), ICU admission (12.9% vs 1.8%, p < 0.001) and maternal mortality (2.9% vs 0.4%, p < 0.001) were significantly higher in the post-variant group. A significant increase was observed for pregnancy complications in the post-variant group (45.6% vs 18.8%, p = 0.007). The rates of preterm delivery (26.4% vs 4.4%, p < 0.001) and NICU admission (34% vs 18.8%, p < 0.001) were significantly higher in the post-variant group. Positive, weak, statistically significant correlations were observed between the post-variant period, disease severity and maternal mortality ( r = 0.19, r = 0.12 and p < 0.001). Conclusion Post-variant COVID-19 period was associated with a severe course of the disease and increased rates of adverse obstetric outcomes in pregnant patients.

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Section: Methodsmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Comparison of clinical features and perinatal outcomes between pre-variant and post-variant periods in pregnant women with SARS-CoV-2: analysis of 1935 cases

Şahın

Tanaçan

Anuk

et al. 2022

Arch Gynecol Obstet

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“…The recommended treatments for COVID-19 infected pregnant women is not much different from those for general population [24] , [25] . After confirmation of COVID-19 infection, assessment about pregnancy trimester [26] , maternal condition, symptoms and severity of the disease is needed. Based on the assessment, physicians can decide treatments and medications such as oxygen supply therapy, steroids, tocilizumab, and remdesivir [25] .…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on pregnant women in South Korea: Focusing on prevalence, severity, and clinical outcomes

Kim

Choi

Lee

et al. 2022

Journal of Infection and Public Health

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Background In the era of coronavirus disease 2019 (COVID-19) pandemic, there is a paucity of information regarding actual prevalence of COVID-19 in pregnant women compared to non-pregnant women. The purpose of this study was to investigate the prevalence of COVID-19 infection and clinical outcome in pregnant women and non-pregnant women. Methods This is a nationwide cross-sectional study in South Korea between January 2020 and February 2021 using the claim database. The primary outcome was the prevalence of COVID-19 in pregnant women, and the secondary outcome was the occurrence of severe COVID-19 illness among infected patients. Severity of COVID-19 was classified into four categories according to WHO ordinal scale. Results The prevalence of COVID-19 infection was lower in pregnant women than non-pregnant women aged 20-44 (0·02% vs. 0·14%, p<0.0001). However, among COVID-19 positive women at age 20-44, pregnant women was at higher risk of oxygen therapy after hospitalization (score 4 in WHO ordinal scale: 6.4% vs. 1.6%, p<0.05). There were no deaths or hospitalized severe disease in pregnant women with COVID-19, although the majority of them (96·2%) were admitted to hospital. On the other hand, 42·3% of non-pregnant women at 20-44 age were admitted to hospital and 0·04% of them died and 0·1% had hospitalized severe disease. Conclusions The prevalence of COVID-19 infection in pregnant women was lower than non-pregnant women in Korea, resulting in relatively small cases of fatality. It has implications that public health policy, such as an effective response to COVID-19 and a powerful preemptive strategy for pregnant women, can lower risk of COVID-19 infection and better clinical outcomes in pregnant women with COVID-19.

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“…Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a major public health problem, with hospitalizations, admissions to the intensive care unit (ICU), and even deaths Compared with nonpregnant women of childbearing age with SARS-CoV-2 infection, pregnant women are more likely to be needed for respiratory support and admitted to an ICU [2]. Pregnant women with SARS-CoV-2 infection are at high risk for adverse perinatal outcomes such as early pregnancy loss, fetal growth retardation, and preterm delivery [3,4].…”

Section: Introductionmentioning

confidence: 99%

Could SARS-CoV-2 Infection Change Fetal Cardiac Output?

Turgut

Sakcak

HENDEM

et al. 2022

Preprint

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Aim: We aimed to examine fetal cardiac output (CO) in patients who recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Materials: This prospective study included 48 pregnant women recovered from SARS-CoV-2 infection and 50 control cases. SARS-CoV-2 infection was diagnosed by polymerase chain reaction (PCR) test in patients. Fetal echocardiographic evaluations were performed at 24-37 weeks of gestation in pregnant women who recovered from the infection and control group. Results: The median value of ultrasound evaluation was 34 (2.6) weeks of gestation in the recovery from the SARS-CoV-2 infection (RSI) group, and 32 (7.6) weeks in the control group (p=0.565). Left cardiac output (LCO) z score was significantly lower in the RSI group than the control group (p=0,041). LCO and combine cardiac output (CCO) z score were significantly lower in the severe disease group than mild, moderate disease groups, and controls (p=0,019 and p=0,013). CCO (mL/min/kg) was decreased in the severe disease group when compared with control and mild disease groups (p=0,044). Fetal distress, preterm delivery rate, and neonatal intensive care unit (NICU) admission were found to be higher in the severe disease group compared to the control group (p=0,010, p=0,009, and p<0,001 respectively). Conclusion: In the present study, fetal cardiac output in pregnant women with recovery from SARS-CoV-2 infection was found significantly decreased, especially in whom had severe diseases. Placental dysfunction and inflammatory cytokines might cause fetal cardiac changes. Further studies could be clarified on the impact of SARS-CoV-2 infection on fetal cardiac function.

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Management of pregnant women with COVID‐19: A tertiary pandemic center experience on 1416 cases

Cited by 26 publications

References 45 publications

Comparison of clinical features and perinatal outcomes between pre-variant and post-variant periods in pregnant women with SARS-CoV-2: analysis of 1935 cases

Comparison of clinical features and perinatal outcomes between pre-variant and post-variant periods in pregnant women with SARS-CoV-2: analysis of 1935 cases

Impact of COVID-19 on pregnant women in South Korea: Focusing on prevalence, severity, and clinical outcomes

Could SARS-CoV-2 Infection Change Fetal Cardiac Output?

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