Short-term outcomes of COVID-19 in pregnant women unvaccinated for SARS-CoV-2 in the first, second, and third trimesters: a retrospective study

Abstract

BACKGROUND: Coronavirus disease 2019 (COVID-19) may be asymptomatic or symptomatic in pregnant women. Compared to non-pregnant reproductive-aged women, symptomatic individuals appear to have a higher risk of acquiring severe illness sequelae. OBJECTIVES: We assessed the clinical and laboratory characteristics and outcomes of pregnant COVID-19 patients unvaccinated for severe acute respiratory syndrome coronavirus 2 according to the trimester of pregnancy. DESIGN AND SETTING: This was a retrospective observational study conducted in a tertiary-level hospital in Turkey. METHODS: This retrospective study reviewed the clinical and laboratory characteristics and outcomes of 445 pregnant COVID-19 patients hospitalized during the first, second, and third trimesters of pregnancy and 149 other pregnant women as controls in a tertiary center from April 2020 to December 2021. All participants were unvaccinated. RESULTS: Overall, the study groups were comparable in terms of baseline clinical pregnancy characteristics. There was no clear difference among the study participants with COVID-19 in the first, second, and third trimesters of pregnancy. However, a considerably high number of clinical and laboratory findings revealed differences that were consistent with the inflammatory nature of the disease. CONCLUSIONS:The study results reveal the importance of careful follow-up of hospitalized cases as a necessary step by means of regular clinical and laboratory examinations in pregnant COVID-19 patients. With further studies, after implementing vaccination programs for COVID-19 in pregnant women, these data may help determine the impact of vaccination on the outcomes of pregnant COVID-19 patients.

COVID‐19 and preeclampsia: The unique and the mutually nonexclusive clinical manifestations

“…71 On the other hand, it is also possible that the shared risk fac- patients in the first, second, and third trimesters in terms of rates of disease severity, admission to the ICU, and mode of delivery. 73 However, in another study, the preterm birth rate was significantly higher in the first-trimester participants than in those diagnosed in the second and third trimesters. 28 Figure 1 shows the common risk factors, laboratory and clinical features in PE and COVID-19 and the probable mechanism for the strong association between PE and COVID-19.…”

“…A report by Guleroglu et al. has shown no significant difference among the pregnant COVID‐19 patients in the first, second, and third trimesters in terms of rates of disease severity, admission to the ICU, and mode of delivery 73 . However, in another study, the preterm birth rate was significantly higher in the first‐trimester participants than in those diagnosed in the second and third trimesters 28 …”

Disruption of the Functional Activity of Neutrophil Granulocytes as a Risk Factor for the Development of Lung Damage in Pregnant Women with COVID-19

“…However, Guleroglu F.Y. et al claim that the levels of polymorphonuclear leukocytes and neutrophilic granulocytes in the blood are higher in uninfected SARS-CoV-2 pregnant women than in those with COVID-19 [12]. It is also noted that during pregnancy, neutrophilic granulocytes exhibit increased activity and produce reactive oxygen species, which defines the pro-inflammatory nature of immune responses [13].…”