ABSTRACT
Background and Purpose: Effects of COVID-19 in pregnancy are controversial.1-3 Some studies have found that a high viral load (VL) yields more symptoms,3,4 while others have found no significant differences.5 Some studies have shown pregnant women are not more likely to have a serious illness,2,6,7 while others say pregnancy is at risk for severe disease. 8,9 The purpose of our study is to compare VL values of polymerase chain reaction (PCR) tests between COVID-19 positive pregnant and nonpregnant women. Our secondary aim is to compare the asymptomatic rates among these two groups. Method(s): This case-control study identified women with COVID-19 confirmed by PCR between April-November, 2020. Cycle threshold (Ct), the number of cycles run on PCR to detect COVID-19, is inversely proportional to VL. Each pregnant woman was matched, by BMI and age, to two nonpregnant controls. Statistical analyses included Independent T-Test, Cochran's Q test and repeated measures ANOVA. Result(s): Sixty-four pregnant women were matched to 128 nonpregnant female controls. Race did not differ between the two groups. Ct in asymptomatic cases (Ct=24.1, SD=5.9) was higher (lower viral load) than symptomatic cases (Ct=12.5, SD=7.3) (p<0.001). Ct did not differ between pregnant and non-pregnant females, regardless of symptoms. Symptomatic infection among pregnant women was 54% compared to 87.7% in nonpregnant women (p<0.001). Fever, cough and fatigue were less common in pregnancy, at rates of 20.3% vs 40.7% (p=0.03), 39.1% vs 61.7% (p=0.02), and 4.7% vs 19.6% (p=0.02), respectively. Rates of shortness of breath, loss of taste and/or smell were similar in the two groups. Conclusion(s): Pregnancy did not yield higher viral load than nonpregnancy. VL is higher in symptomatic women than asymptomatic women, which holds true in pregnancy as well. Of all hospital admissions, pregnant women were less symptomatic than nonpregnant women. Correlation between VL and severity of disease needs further investigation.