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Characteristics and treatment of hospitalized pregnant women with COVID-19.
Sekkarie, Ahlia; Woodruff, Rebecca; Whitaker, Michael; Kramer, Michael R; Zapata, Lauren B; Ellington, Sascha R; Meaney-Delman, Dana M; Pham, Huong; Patel, Kadam; Taylor, Christopher A; Chai, Shua J; Kawasaki, Breanna; Meek, James; Openo, Kyle P; Weigel, Andy; Leegwater, Lauren; Como-Sabetti, Kathryn; Ropp, Susan L; Muse, Alison; Bennett, Nancy M; Billing, Laurie M; Sutton, Melissa; Talbot, H Keipp; Hill, Mary; Havers, Fiona P.
  • Sekkarie A; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA (Drs Sekkarie and Woodruff, Mr Whitaker, Drs Zapata, Ellington, and Meaney-Delman, Ms Pham, Mr Kadam, and Drs Taylor and Havers); Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA (Dr
  • Woodruff R; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA (Drs Sekkarie and Woodruff, Mr Whitaker, Drs Zapata, Ellington, and Meaney-Delman, Ms Pham, Mr Kadam, and Drs Taylor and Havers); United States Public Health Service Commissioned Corps, Rockville, MD (Drs Woodruff, Zapat
  • Whitaker M; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA (Drs Sekkarie and Woodruff, Mr Whitaker, Drs Zapata, Ellington, and Meaney-Delman, Ms Pham, Mr Kadam, and Drs Taylor and Havers).
  • Kramer MR; Epidemiology Department, Rollins School of Public Health, Emory University, Atlanta, GA (Dr Kramer).
  • Zapata LB; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA (Drs Sekkarie and Woodruff, Mr Whitaker, Drs Zapata, Ellington, and Meaney-Delman, Ms Pham, Mr Kadam, and Drs Taylor and Havers); United States Public Health Service Commissioned Corps, Rockville, MD (Drs Woodruff, Zapat
  • Ellington SR; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA (Drs Sekkarie and Woodruff, Mr Whitaker, Drs Zapata, Ellington, and Meaney-Delman, Ms Pham, Mr Kadam, and Drs Taylor and Havers).
  • Meaney-Delman DM; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA (Drs Sekkarie and Woodruff, Mr Whitaker, Drs Zapata, Ellington, and Meaney-Delman, Ms Pham, Mr Kadam, and Drs Taylor and Havers).
  • Pham H; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA (Drs Sekkarie and Woodruff, Mr Whitaker, Drs Zapata, Ellington, and Meaney-Delman, Ms Pham, Mr Kadam, and Drs Taylor and Havers).
  • Patel K; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA (Drs Sekkarie and Woodruff, Mr Whitaker, Drs Zapata, Ellington, and Meaney-Delman, Ms Pham, Mr Kadam, and Drs Taylor and Havers); General Dynamics Information Technology, Atlanta, GA (Mr Patel).
  • Taylor CA; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA (Drs Sekkarie and Woodruff, Mr Whitaker, Drs Zapata, Ellington, and Meaney-Delman, Ms Pham, Mr Kadam, and Drs Taylor and Havers).
  • Chai SJ; California Emerging Infections Program, Oakland, CA (Dr Chai); Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, GA (Dr Chai).
  • Kawasaki B; Colorado Department of Public Health and Environment, Denver, CO (Ms Kawasaki).
  • Meek J; Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, CT (Mr Meek).
  • Openo KP; Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA (Dr Openo); Georgia Emerging Infections Program, Georgia Department of Public Health, Atlanta, GA (Dr Openo); Foundation for Atlanta Veterans Education and Research, Atlanta Veterans Affairs Medical Center, Atlanta, GA
  • Weigel A; Iowa Department of Public Health, Des Moines, IA (Mr Weigel).
  • Leegwater L; Michigan Department of Health and Human Services, Lansing, MI (Ms Leegwater).
  • Como-Sabetti K; Minnesota Department of Health, Saint Paul, MN (Ms Como-Sabetti).
  • Ropp SL; New Mexico Department of Health, Santa Fe, NM (Dr Ropp).
  • Muse A; New York State Department of Health, Albany, NY (Ms Muse).
  • Bennett NM; University of Rochester School of Medicine and Dentistry, Rochester, NY (Dr Bennett).
  • Billing LM; Ohio Department of Health, Columbus, OH (Ms Billing).
  • Sutton M; Public Health Division, Oregon Health Authority, Portland, OR (Dr Sutton).
  • Talbot HK; Vanderbilt University School of Medicine, Nashville, TN (Dr Talbot).
  • Hill M; Salt Lake County Health Department, Salt Lake City, UT (Ms Hill).
  • Havers FP; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA (Drs Sekkarie and Woodruff, Mr Whitaker, Drs Zapata, Ellington, and Meaney-Delman, Ms Pham, Mr Kadam, and Drs Taylor and Havers); United States Public Health Service Commissioned Corps, Rockville, MD (Drs Woodruff, Zapat
Am J Obstet Gynecol MFM ; 4(6): 100715, 2022 Aug 12.
Article in English | MEDLINE | ID: covidwho-2035677
ABSTRACT

BACKGROUND:

Pregnant women less frequently receive COVID-19 vaccination and are at increased risk for adverse pregnancy outcomes from COVID-19.

OBJECTIVE:

This study aimed to first, describe the vaccination status, treatment, and outcomes of hospitalized, symptomatic pregnant women with COVID-19, and second, estimate whether treatment differs by pregnancy status among treatment-eligible (ie, requiring supplemental oxygen per National Institutes of Health guidelines at the time of the study) women. STUDY

DESIGN:

From January to November 2021, the COVID-19-Associated Hospitalization Surveillance Network completed medical chart abstraction for a probability sample of 2715 hospitalized women aged 15 to 49 years with laboratory-confirmed SARS-CoV-2 infection. Of these, 1950 women had symptoms of COVID-19 on admission, and 336 were pregnant. We calculated weighted prevalence estimates of demographic and clinical characteristics, vaccination status, and outcomes among pregnant women with symptoms of COVID-19 on admission. We used propensity score matching to estimate prevalence ratios and 95% confidence intervals of treatment-eligible patients who received remdesivir or systemic steroids by pregnancy status.

RESULTS:

Among 336 hospitalized pregnant women with symptomatic COVID-19, 39.6% were non-Hispanic Black, 24.8% were Hispanic or Latino, and 61.9% were aged 25 to 34 years. Among those with known COVID-19 vaccination status, 92.9% were unvaccinated. One-third (32.7%) were treatment-eligible. Among treatment-eligible pregnant women, 74.1% received systemic steroids and 61.4% received remdesivir. Among those that were no longer pregnant at discharge (n=180), 5.4% had spontaneous abortions and 3.5% had stillbirths. Of the 159 live births, 29.0% were preterm. Among a propensity score-matched cohort of treatment-eligible hospitalized women of reproductive age, pregnant women were less likely than nonpregnant women to receive remdesivir (prevalence ratio, 0.82; 95% confidence interval, 0.69-0.97) and systemic steroids (prevalence ratio, 0.80; 95% confidence interval, 0.73-0.87).

CONCLUSION:

Most hospitalized pregnant patients with symptomatic COVID-19 were unvaccinated. Hospitalized pregnant patients were less likely to receive recommended remdesivir and systemic steroids compared with similar hospitalized nonpregnant women. Our results underscore the need to identify opportunities for improving COVID-19 vaccination, implementation of treatment of pregnant women, and the inclusion of pregnant women in clinical trials.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid / Vaccines Language: English Journal: Am J Obstet Gynecol MFM Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid / Vaccines Language: English Journal: Am J Obstet Gynecol MFM Year: 2022 Document Type: Article