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1.
Voprosy Ginekologii, Akusherstva i Perinatologii ; 21(3):28-35, 2022.
Article in Russian | EMBASE | ID: covidwho-2033519

ABSTRACT

Objective. To assess the effectiveness of different preventive measures for novel coronavirus infection in pregnant women. Patients and Methods. This study included 125 pregnant women hospitalized with moderate to severe laboratory-confirmed SARS-CoV-2 infection between September and November 2021 (the fourth pandemic wave), and 175 pregnant women who were not infected with COVID-19 during the same period. All women in these two groups were comparable for gestational age (II–III trimesters, 24–39 weeks), age (20–40 years), social status, parity, body mass index, and had no known COVID-19 risk factors. Results. Our findings revealed that vaccination 3-5 months before pregnancy (OR = 4.12;95% CI 1.28–13.27;χ2 = 0.022), inconsistent use and/or non-timely replacement of face masks (OR = 5.71;95% CI 2.83–11.51) were associated with the increased risk of COVID-19 in the second and third trimesters of gestation. It was showed that systematic (once in the morning at 24–48-hour intervals) intranasal administration of recombinant interferon alpha-2b (IFN-α;Grippferon) as compared with a single application after exposure to COVID-19 reduced the disease incidence rate and there was no evident risk of illness (OR = 0.08;95% CI 0.05–0.14;19.2% vs 74,3%, p < 0.001). This can be explained by the fact that women were mostly infected in unpredictable conditions (e.g., 29.2% of pregnant women were infected from family members, 23.9% had unknown source of exposure). The use of umifenovir, not currently authorised for the medication-assisted prevention of COVID-19 in pregnant women, and rectal administration of IFN-α suppositories did not reduce the disease incidence rate. Rectal use of IFN-α suppositories by pregnant women off-label increased the incidence (32.0 vs 15.4%, p = 0.001) and risk of developing novel coronavirus infection (OR = 2.58;95% CI 1.48–4.50). Conclusion. There is a need to improve awareness among pregnant women about the mandatory and timely vaccination against COVID-19 during pregnancy and the importance of strict adherence to wearing face masks. Increased efforts should be made to monitor and inform pregnant women about the use of only authorised medication-assisted preventive measures of SARS-CoV-2 infection, such as intranasal administration of recombinant IFN α-2b (Grippferon). During the epidemic rise in COVID-19 cases, the systematic intranasal administration of recombinant interferon-based medication Grippferon (once in the morning at 24–48-hour intervals) is recommended for pregnant women.

2.
Gynecology ; 23(5):421-427, 2021.
Article in Russian | Scopus | ID: covidwho-1599948

ABSTRACT

Aim. To compare risk factors, features of COVID-19 course and outcomes in pregnant women during epidemic increase in incidence in 2020 and 2021. Materials and methods. The study included 163 pregnant women with laboratory-confirmed SARS-CoV-2 infection within May - December 2020 (1st-2nd waves of the epidemic) and 158 pregnant women who had new coronavirus infection within May - August 2021 (3rd wave of the epidemic). Patients in all groups were comparable in age (18-35 years), social status, parity, body mass index, and had no known risk factors for COVID-19. Results. Iron deficiency anemia, smoking, belonging to the Buryat ethnic group were recognized as persistent risk factors for COVID-19 in pregnant women. Over the 1st year of the pandemic, in pregnant women, the following clinical manifestations of novel coronavirus infection were commonly seen: anosmia (87.7%), somnolence (68.7%), shortness of breath even with a mild lung damage (68.1%). In the 3rd wave of the 2nd year of the pandemic, the leading signs and symptoms were cough (70.3% vs 38.7%, p<0.001), runny nose (46.2% vs 3.7%, p<0001), sore throat (367% vs 37%, p<0.001);an increase in body temperature above 38°C (19.6% vs 7,4%, p=0.006), pneumonia detected by computed tomography (61.4% vs 21.4%;p<0.001). There was a significant increase in the incidence of severe lung lesions (with computed tomography 3-4: 17.7% vs 4.9%;p<0.001) and admissions to intensive care units (11.4% vs 6.4%;p= 0041). There was a need for invasive mechanical ventilation (1.89% vs 0%;p=0.118). There was 1 death (0.63% vs 0%;p= 0.492), which was associated with the fulminant course of COVID-19. Conclusion. Persistent COVID-19 confounders in pregnant women who have no known risk factors in the third trimester of gestation are iron deficiency anemia, smoking, and belonging to the Buryat ethnic group. The clinical course of SARS-CoV-2 infection has changed and became more unfavorable: symptoms of acute respiratory disease (cough, runny nose, sore throat) began to prevail, the rate and severity of pneumonia and rate of mortality increased. © 2021 Consilium Medikum. All right reserved.

3.
Gynecology ; 23(3):255-259, 2021.
Article in Russian | Scopus | ID: covidwho-1404294

ABSTRACT

Aim. To identify confounding factors, features of the clinical course and outcomes of COVID-19 in pregnant and non-pregnant patients of early reproductive age who have no known risk factors and premorbid background. Materials and methods. The study included 163 pregnant women in the third trimester of gestation, 100 non-pregnant women with laboratory-confirmed SARS-CoV-2 infection and 100 pregnant women who did not get sick. Patients of all groups were comparable in age (18-35 years), social status, parity, body mass index, had no known risk factors for COVID-19;those who got sick were treated simultaneously. Results. Statistically significant associations were revealed between COVID-19 infection in the pregnant and iron deficiency anemia, vegetovascular dystonia, belonging to the Buryat ethnicity, and smoking. Pregnant women with COVID-19 were more likely to have no symptoms (23.3% vs 5%;p<0.001) or had a mild course of the disease (58.9% vs 24%;p<0.001). In non-pregnant patients, the course of infection was more often moderate (61% vs 14.7%;p<0.001) or severe (10% vs 3.1%;p=0.038). Clinical manifestations of new coronavirus infection (NCV) in pregnant women were dominated by anosmia (87.7% vs 40%;p<0.001), drowsiness (68.7% vs 17%;p<0.001), dyspnea, even with a mild lung lesion (68.1% vs 19%;p<0.001), headache (41.7% vs 24%;p=0.006), arthralgia (29.4% vs 16%;p=0.021), while fever above 38 °C (7.4% vs 28%;p<0.001) and cough (38.7% vs 61%;p<0.001) were much less common. With computed tomography, pneumonia in pregnant women was diagnosed several times less often (21.4% vs 87.4%;p<0.001). In the non-pregnant group, there was one death (1% vs 0%;p=0.201) associated with late hospitalization for severe NCI with grade 4 pulmonary involvement as shown on computed tomography. Conclusion. Confounders of COVID-19 in pregnant women who have no known risk factors in the third trimester of gestation are iron deficiency anemia, vegetovascular dystonia, belonging to the Buryat subpopulation, and smoking. In pregnant women, the main clinical symptoms of SARS-CoV-2 infection, with the exception of loss of smell, were nonspecific and characteristic of the physiological course of late gestation: drowsiness, dyspnea, joint pain. The predominance of mild or asymptomatic forms of infection, the lower incidence of pneumonia, and the absence of deaths in pregnant women suggests a more favorable course of COVID-19 NCI. © 2021 Consilium Medikum. All rights reserved.

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