Middle Eastern Respiratory Syndrome and Pregnancy [18J]

Martens, Mark G.; Kalgi, Bharati

doi:10.1097/01.aog.0000483787.93122.d5

Cited by 3 publications

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“…The association between pregnancy and illness severity due to other respiratory viruses such as MERS has been investigated previously. In one study, the case fatality (25%), ICU admission (50%), and mechanical ventilation (33%) rates were increased in the pregnant population compared with those of the nonpregnant population (20%) [ 58 ], which may be related to abnormal immune responses in pregnancy. Additionally, pregnancy may propagate respiratory infections and increase the risk of hospitalization [ 59 ].…”

Section: Discussionmentioning

confidence: 99%

Association of Pregnancy With Coronavirus Cytokine Storm: Systematic Review and Meta-analysis

Muthuka

Kiptoo

Oluoch

et al. 2022

JMIR Pediatr Parent

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Background COVID-19 was first identified in Wuhan, China, in December 2019, spreading to the rest of the globe, becoming a pandemic. Some studies have shown an association between pregnancy status and severe COVID-19 with a cytokine storm, whereas others have shown contrasting results. Objective The aim of this study was to examine the relationship between pregnancy status and the clinical COVID-19 severity characterized by the cytokine storm through a systematic review and meta-analysis. Methods We searched the Google Scholar, PubMed, Scopus, Web of Science, and Embase databases to identify clinical studies suitable for inclusion in this meta-analysis. Studies reporting pregnancy status and comparing the COVID-19 severity cytokine storm outcome were included. COVID-19 severity characterized by a cytokine storm was described using parameters such as intensive care unit admission, invasive mechanical ventilation, mechanical ventilation, hospital admission, pro- and anti-inflammatory cytokine levels, consolidation on chest computed tomography scan, pulmonary infiltration, extreme fevers as characteristic of a cytokine storm, syndromic severity, higher neutrophil count indicative of a cytokine storm, and severe COVID-19 presentation. Results A total of 17 articles including data for 840,332 women with COVID-19 were included. This meta-analysis revealed a correlation between positive pregnancy status and severe COVID-19 with a cytokine storm (random-effects model odds ratio [OR] 2.47, 95% CI 1.63-3.73; P<.001), with a cumulative incidence of 6432 (14.1%) and 24,352 (3.1%) among pregnant and nonpregnant women with COVID-19, respectively. The fixed-effects model also showed a correlation between pregnancy status and severe COVID-19 with a cytokine storm (OR 7.41, 95% CI 7.02-7.83; P<.001). Considerable heterogeneity was found among all pooled studies (I²=98%, P<.001). Furthermore, the updated analysis showed substantially low heterogeneity (I²=29 %, P=.19), and the funnel plot revealed no publication bias. The subanalysis between single-center and multicenter studies demonstrated similar heterogeneity (I2=72% and 98%, respectively). Sensitivity analysis on each subgroup revealed that pregnancy was significantly related to severe COVID-19 with a cytokine storm from single-center studies (fixed-effects model OR 3.97, 95% CI 2.26-6.95; P<.001) with very low heterogeneity (I²=2%, P=.42). Conclusions Being pregnant is clearly associated with experiencing a severe course of COVID-19 characterized by a cytokine storm. The COVID-19 pandemic should serve as an impetus for further research on pregnant women diagnosed with COVID-19 to map out the salient risk factors associated with its severity. Trial Registration PROSPERO CRD42021242011; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=242011.

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Section: Discussionmentioning

confidence: 99%

Association of Pregnancy With Coronavirus Cytokine Storm: Systematic Review and Meta-analysis

Muthuka

Kiptoo

Oluoch

et al. 2022

JMIR Pediatr Parent

View full text Add to dashboard Cite

show abstract

“…The association between pregnancy and illness severity due to other respiratory viruses has been investigated previously. 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).…”

Section: Discussionmentioning

confidence: 99%

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

Muthuka

Kiptoo

Oluoch

et al. 2021

Preprint

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Background. Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SAR2-COV-2) that identified first in Wuhan, China, in December 2019, rapidly spreading to the rest of the globe, becoming a pandemic. Some studies have eluded to an association between pregnancy status and severe COVID-19 cytokine storm, some, in contrast, have demonstrated such. The aim of the current study was to find the relationship between pregnancy status and clinical COVID-19 severity characterized by cytokine storm through a systematic review and meta-analysis approach. Methods. We searched Google Scholar, PubMed, Scopus, Web of Science, and Embase databases to identify clinical studies suitable for inclusion in this meta-analysis. Studies reporting pregnancy status and comparing the COVID-19 severity cytokine storm outcome were included. The COVID-19 severity characterized by cytokine storm was described using parameters such as; Intensive Care Unit Admission, Invasive Mechanical Ventilation, Mechanical Ventilation, Hospital Admission, Pro and Inflammatory cytokine levels, consolidation on chest CT scan, pulmonary infiltration, extreme fevers as characteristic of cytokine storm, syndromic severity, higher neutrophil count indicative of cytokine storm and severe COVI-19 presentation. Results. A total of 17 articles detailing 840332 COVID-19 women were included. Our meta-analysis revealed a relationship between positive pregnancy status and severe COVID-19 cytokine storm case (random effect model, OR=2.47; 95% CI: 1.63-3.73; P < 0.0001), with a cumulative incidence of 6432 (14.1%) among the pregnant women with COVID-19 and 24352 (3.1%) among the non-pregnant women with COVI-19. Further to this, we found that the sub-analysis between Single Centre and Multiple Centre studies demonstrated seemingly the same as heterogeneity (I2 = 72 and (I2 = 98), respectively. Sensitivity analysis on each sub-group revealed that pregnancy was significantly related to severe COVID-19 with cytokine storm from single Centre studies, (fixed effect model, OR= 3.97; 95% CI: 2.26-6.95; P< 0.00001) with very low heterogeneity (I2 = 2 %; P = 0.42). Conclusion. Being pregnant is clearly associated with experiencing a severe COVID-19 characterized by a cytokine storm. The SARS-COV-2 epidemic should serve as an impetus for pregnant women diagnosed with COVID-19, and map out salient risk factors associated with its severity. The trial is registered with the International Prospective Register of Systematic Reviews (PROSPERO) CRD42021242011.

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“…Análogamente, la fisiología del embarazo caracterizada por periodos pro y antiinflamatorios de adaptación del aloinjerto fetal (5) hace suponer que las gestantes son un grupo propenso a infecciones virales (6,7), entre ellas el SARS-CoV-2, según sugieren recientes publicaciones (8,9). Epidemias anteriores por coronavirus humanos como el SARS-CoV-1 y el MERS-CoV, causantes de graves estragos sanitarios en 2003 y 2012, respectivamente, sugieren que las gestantes son un grupo de riesgo que generó alta incidencia de complicaciones maternas y perinatales (10,11), e incluso mortalidad (12). Al día de hoy, aún es prematuro afirmar si el COVID-19 asociado al embarazo genera mayor o menor impacto en los resultados maternos y perinatales, pues la generación de evidencias científicas en población obstétrica todavía sigue su curso.…”

Section: Introductionunclassified

Manifestaciones clínicas y resultados materno-perinatales del COVID-19 asociado al embarazo: Una revisión sistemática

Chilipio-Chiclla¹,

Campos-Correa²

2020

RISMF

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Objetivo: Evaluar las manifestaciones clínicas y resultados materno-perinatales de la infección por COVID-19 asociada al embarazo. Material y métodos: Se revisaron ocho bases de datos electrónicas (Science Direct, Pubmed, Lilacs, Scielo, Redalyc, LitCovid, EBSCO y Scopus). Se consideraron estudios primarios a texto completo en idioma español e inglés; publicados entre el 01 de enero y 15 de mayo de 2020; y realizados en gestantes con diagnóstico confirmado de COVID-19 (reacción en cadena polimerasa con transcripción inversa [RT-PCR]. Resultados: Se incluyeron 15 estudios que informaron 224 casos de infección por COVID-19 asociada al embarazo, principalmente en gestantes del tercer trimestre (13/15). La tos y fiebre fueron las principales manifestaciones clínicas reportadas en todas las investigaciones. Menos de la tercera parte de estudios muestran al dolor abdominal como manifestación obstétrica que motiva la búsqueda de atención. El antecedente epidemiológico de exposición y las alteraciones en exámenes auxiliares de laboratorio (linfopenia y PCR elevado, principalmente) son reportadas con regular frecuencia. La enfermedad por COVID-19 asociado al embarazo se presenta principalmente de forma leve; asimismo, la mortalidad e ingreso a UCI son resultados maternos exclusivamente asociados a las pocas presentaciones severas. La cesárea es la vía de culminación mayormente empleada, siendo en pocos casos la neumonía por COVID-19 la indicación citada. El bajo peso al nacer y el ingreso a UCIN son resultados perinatales descritos en 9 de 15 estudios, existiendo poca mortalidad perinatal. Solo en tres estudios se reporta que existe transmisión vertical. Conclusión: La enfermedad por COVID-19 asociado al embarazo se reporta principalmente en gestantes de tercer trimestre, con fiebre y tos presentes a la admisión, siendo mayormente casos leves. Asimismo, genera pocas complicaciones materno-perinatales; sin embargo, en casos severos la morbimortalidad es más frecuente.

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Middle Eastern Respiratory Syndrome and Pregnancy [18J]

Cited by 3 publications

References 0 publications

Association of Pregnancy With Coronavirus Cytokine Storm: Systematic Review and Meta-analysis

Association of Pregnancy With Coronavirus Cytokine Storm: Systematic Review and Meta-analysis

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

Manifestaciones clínicas y resultados materno-perinatales del COVID-19 asociado al embarazo: Una revisión sistemática

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