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1.
BMC Pregnancy Childbirth ; 21(1): 658, 2021 Sep 28.
Article in English | MEDLINE | ID: covidwho-1770502

ABSTRACT

BACKGROUND: Whilst the impact of Covid-19 infection in pregnant women has been examined, there is a scarcity of data on pregnant women in the Middle East. Thus, the aim of this study was to examine the impact of Covid-19 infection on pregnant women in the United Arab Emirates population. METHODS: A case-control study was carried out to compare the clinical course and outcome of pregnancy in 79 pregnant women with Covid-19 and 85 non-pregnant women with Covid-19 admitted to Latifa Hospital in Dubai between March and June 2020. RESULTS: Although Pregnant women presented with fewer symptoms such as fever, cough, sore throat, and shortness of breath compared to non-pregnant women; yet they ran a much more severe course of illness. On admission, 12/79 (15.2%) Vs 2/85 (2.4%) had a chest radiograph score [on a scale 1-6] of ≥3 (p-value = 0.0039). On discharge, 6/79 (7.6%) Vs 1/85 (1.2%) had a score ≥3 (p-value = 0.0438). They also had much higher levels of laboratory indicators of severity with values above reference ranges for C-Reactive Protein [(28 (38.3%) Vs 13 (17.6%)] with p < 0.004; and for D-dimer [32 (50.8%) Vs 3(6%)]; with p < 0.001. They required more ICU admissions: 10/79 (12.6%) Vs 1/85 (1.2%) with p=0.0036; and suffered more complications: 9/79 (11.4%) Vs 1/85 (1.2%) with p=0.0066; of Covid-19 infection, particularly in late pregnancy. CONCLUSIONS: Pregnant women presented with fewer Covid-19 symptoms but ran a much more severe course of illness compared to non-pregnant women with the disease. They had worse chest radiograph scores and much higher levels of laboratory indicators of disease severity. They had more ICU admissions and suffered more complications of Covid-19 infection, such as risk for miscarriage and preterm deliveries. Pregnancy with Covid-19 infection, could, therefore, be categorised as high-risk pregnancy and requires management by an obstetric and medical multidisciplinary team.


Subject(s)
COVID-19 , Intensive Care Units/statistics & numerical data , Pregnancy Complications, Infectious , Premature Birth , Radiography, Thoracic , Symptom Assessment , Abortion, Spontaneous/epidemiology , Abortion, Spontaneous/etiology , C-Reactive Protein/analysis , COVID-19/blood , COVID-19/epidemiology , COVID-19/therapy , COVID-19/transmission , Case-Control Studies , Female , Fibrin Fibrinogen Degradation Products/analysis , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical/prevention & control , Male , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/physiopathology , Pregnancy Complications, Infectious/therapy , Pregnancy Complications, Infectious/virology , Pregnancy Outcome/epidemiology , Pregnancy, High-Risk , Premature Birth/epidemiology , Premature Birth/etiology , Radiography, Thoracic/methods , Radiography, Thoracic/statistics & numerical data , SARS-CoV-2/isolation & purification , Severity of Illness Index , Symptom Assessment/methods , Symptom Assessment/statistics & numerical data , United Arab Emirates/epidemiology
2.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-312171

ABSTRACT

Background: Whilst the impact of Covid-19 infection in pregnant women has been examined, there is a scarcity of data on pregnant women in the Middle East. Thus, the aim of this study was to examine the impact of Covid-19 infection on pregnant women in the United Arab Emirates population. Methods: A case-control study was carried out to compare the clinical course and outcome of pregnancy in 79 pregnant women with Covid-19 and 85 non-pregnant women with Covid-19 admitted to Latifa Hospital in Dubai between March and June 2020. Results: On admission, most pregnant women (69/79;87%) were either asymptomatic or suffered mild respiratory symptoms, much like non-pregnant women. The main symptoms, observed in both groups, were fever, cough, headache, runny nose and myalgia. In early pregnancy four women had spontaneous miscarriages. However, severe Covid-19 illness, ICU admission, intubation and complications were observed in late pregnancy in 10/79 (13%) women with prior comorbidities. During the study period, 31/79 women delivered: 22 (70%) had a lower segment Caesarean section, 16 for obstetric reasons and 6 for severe Covid-19 pneumonia;and 12 had a preterm delivery. Postoperatively, none showed significant improvement on account of early delivery. Sepsis, acute renal failure and acute respiratory distress syndrome were the most common complications observed. The neonatal outcome was comparable to that of the general obstetric population, even though 12/31 (38%) were preterm and had to be admitted to the neonatal ICU. Two neonates, born by vaginal delivery, tested positive for Covid-19 after delivery. Both were asymptomatic and tests were negative within 72 hours. It was not possible to ascertain whether vertical transmission occurred in utero. Conclusions: Severe Covid-19 illness, ICU admission, intubation, complications and preterm deliveries were observed in late pregnancy in women with comorbidities. Pregnancy with Covid-19 infection, could, therefore, be categorised as high-risk pregnancy. It was not possible to confirm whether vertical transmission of Covid-19 had occurred during the third trimester of pregnancy.

3.
Cureus ; 14(1): e20998, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1632162

ABSTRACT

BACKGROUND:  Coronavirus disease 2019 (COVID-19) and other respiratory infections have been attributed to causing severe disease and pneumonia in pregnant women because of physiological stress and alterations in the immune system during pregnancy. Pregnant women are prone to develop serious outcomes for both mother and child when infected by previous coronaviruses, but there is a paucity of data regarding clinical characteristics and maternal-fetal outcomes in COVID-19. Moreover, various laboratory and radiological parameters are scarcely studied in pregnant women in the third trimester who develop severe COVID-19. Therefore, we conducted this study to assess and compare the maternal-fetal outcomes of critically ill pregnant women with COVID-19 pneumonia who required admission to the intensive care unit (ICU). MATERIALS AND METHODS:  We conducted this retrospective observational study at a tertiary care hospital affiliated with an academic center in the United Arab Emirates. A total of 123 patients in their third trimester were included in the study from December 1, 2020, to March 31, 2021, comprising 30 cases of severe or critical COVID-19 and 93 mild to moderate COVID-19 patients. We collected and analyzed maternal demographic data and radiological and biochemical profiles. We also compared maternal-fetal outcomes. RESULTS:  Thirty patients (24.3%) were admitted to the ICU, and eight required invasive ventilation. Severe COVID-19 pneumonia was significantly associated with higher mortality (20% vs. 0%; p < 0.001), postpartum complications (50% vs. 9.67%; p < 0.001), and increased overall hospital stay than mild to moderate COVID-19 (p < 0.001). In addition, the primary indication for intervention in severe cases was worsening of COVID-19 pneumonia, and pregnant patients had significantly greater chances of undergoing delivery by Cesarean section (80% vs. 40.8%; p = 0.01). Neonates born to severe COVID-19 patients had significantly higher chances of being born preterm (76.6% vs. 35.7%; p < 0.001) and had low birth weight (46.6% vs. 13.9%; p-value = 0.002). There were four stillbirth cases, two vertical transmission cases, and no neonatal deaths. CONCLUSIONS:  This study assessed and compared maternal-fetal outcomes of critically ill pregnant women with COVID-19 pneumonia who required admission to the ICU because of the paucity of data in this patient demographic. Pregnant women with severe COVID-19 have high mortality, peripartum complications, increased hospital stay, and are more likely to undergo Cesarean section delivery because of COVID-19 progression than pregnant patients with less severe forms of COVID-19. The newborns born to such mothers may be premature and have low birth weights but have similar mortality to those born to mothers with mild to moderate COVID-19.

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