ABSTRACT
Objective: To describe the course of COVID-19 in women with AS during pregnancy and the effect of COVID-19 on AS activity. Material and Methods: 75 pregnant women with confirmed AS (modified New York criteria, 1984) were included for prospective observation. 26 of them were followed during the Covid-19 pandemic (03.2020 -04.2022). The average age of the patients was 33.0 ± 3.9 years, the duration of the disease was 117.0 ± 72 months. The activity according to the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in the 1st, 2nd and 3rd trimesters of pregnancy was 2.0 ± 1.4;2.0 ± 1.4 and 1.9 ± 1.5, respectively. The Ankylosing Spondylitis Disease Activity Score CRP (ASDAS-CRP) was 1.5 [1.3;2.1];1.8 [1.3;2.5] and 1.7 [1.1;2.0], respectively. The delivery period was 38.7 ± 1.6 weeks. Results: COVID-19 was transferred to 4 pregnant women, 3 of them -at the end of the 1st -beginning of the 2nd trimester, one -at 38 weeks of pregnancy. No women have been vaccinated against COVID-19. In 3 cases, the activity of AS was low, in one -high due to axial manifestations and arthritis. In 3 women, the course of COVID-19 was mild, in one -moderate (febrile temperature for more than 3 days);only 1 woman had a dry cough. One pregnant woman canceled AS therapy (certolizumab pegol, CZP), against which the back pain of the inflammatory rhythm increased. In other cases, AS therapy was not canceled, there was no effect of COVID-19 on AS activity. (Table Presented) Conclusion: According to preliminary data, COVID-19 in pregnant women with AS can be characterized by a mild and moderate course. There was no increase in AS activity during ongoing AS therapy.
ABSTRACT
Objective: Describe the course of COVID-19 and its effect on AS activity in women infected within 1 year after childbirth. Material(s) and Method(s): 75 pregnant women with confirmed AS (modified New York criteria, 1984) were included for prospective observation. 22 of them were followed during the COVID-19 pandemic (03.2020 -04.2022) for a maximum of 12 months after childbirth. The average age of the patients was 31.5 +/- 4.3 years, the duration of the disease was 124.8 +/- 75.7 months. The activity according to the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) at 1, 6 and 12 months after delivery was 2.0 +/- 1.3;2.2 +/- 1.3 and 2.5 +/- 2.0, respectively. The Ankylosing Spondylitis Disease Activity Score CRP (ASDAS-CRP) was 2.2 [1.2;2.9];2.0 [1.5;2.8] and 1.7 [1.3;2.3], respectively. Result(s): 4 women suffered COVID-19 within a year after giving birth. None of them have been vaccinated against COVID-19. At the time of infection, the activity of AS in all patients was low, 3 women received certolizumab pegol (CZP). In all cases, COVID-19 proceeded with febrile fever for at least 1 day, while the general symptoms were stopped for a maximum of 7 days. Only 1 woman had a dry cough. The effect of COVID-19 on the activity of AS was not revealed, including 2 patients who canceled CZP. All the women continued lactation. 2 children had mild catarrhal phenomena for 3 days, one child underwent a PCR test, SARS-CoV- 2 RNA was detected. Conclusion(s): According to preliminary data, there is no effect of COVID-19 on initially low AS activity in women during lactation. One of the main symptoms of COVID-19 in all patients was febrile fever, regardless of the time of infection that has passed after childbirth.