Preview

The Clinician

Advanced search

Features of the course of COVID-19 in pregnant women

https://doi.org/10.17650/1818-8338-2023-17-2-K683

Abstract

Aim. To study the features of the course of COVID-19 in pregnant women, the outcomes of a new coronavirus infection and pregnancy, the effect of concomitant pathology on the severity of the course and the frequency of complications of COVID-19.

Materials and methods. In the course of the work, a retrospective analysis of 109 medical histories of pregnant women who were treated in the infectious diseases department in 2021 with a diagnosis of COVID-19 was carried out. Anamnesis, concomitant pathology, results of objective examination, laboratory and instrumental methods of research, therapy, complications, outcomes of COVID-19 and pregnancy were evaluated.

Results. The majority of pregnant women had moderate – 55 % and severe – 24 % COVID-19, 7 % – extremely severe and only 14 % – mild. A third of pregnant women had concomitant pathology, arterial hypertension was the most common; 80 % of pregnant women had complications of COVID-19: cytokine storm – in 50 % of patients, acute respiratory distress syndrome – in 17 %, of which 5 % required artificial lung ventilation. The mortality rate was 4.6 %. The structure of pregnancy complications was dominated by gestational hypertension, gestational diabetes, premature placental abruption, preeclampsia. Complications of childbirth – premature birth and premature discharge of amniotic fluid. However, in most cases, pregnancy (75 %) and childbirth (71 %) proceeded without complications. Women in 95 % of cases were discharged from the hospital with recovery or significant clinical improvement.

Conclusion. Despite the prevalence of moderate and severe forms of COVID-19 in pregnant women, a high percentage of concomitant pathology and complications, in most cases favorable outcomes of both COVID-19 and pregnancy were noted. The presence of hypertension syndrome should probably be considered as a prognostically unfavorable marker of severe course and adverse outcomes of COVID-19 in pregnant women.

About the Authors

E. V. Grigoryeva
V.I. Razumovsky Saratov State Medical University, Health Ministry of Russia
Russian Federation

Elena Vyacheslavovna Grigorieva,

112 Bolshaya Kazachya St., Saratov  410012.



D. A. Tyapkina
V.I. Razumovsky Saratov State Medical University, Health Ministry of Russia
Russian Federation

112 Bolshaya Kazachya St., Saratov  410012.



A. A. Boroday
V.I. Razumovsky Saratov State Medical University, Health Ministry of Russia
Russian Federation

112 Bolshaya Kazachya St., Saratov  410012.



I. S. Blokhin
V.I. Razumovsky Saratov State Medical University, Health Ministry of Russia
Russian Federation

112 Bolshaya Kazachya St., Saratov  410012.



I. E. Kondrashkin
V.I. Razumovsky Saratov State Medical University, Health Ministry of Russia
Russian Federation

112 Bolshaya Kazachya St., Saratov  410012.



M. A. Polidanov
V.I. Razumovsky Saratov State Medical University, Health Ministry of Russia
Russian Federation

112 Bolshaya Kazachya St., Saratov  410012.



A. P. Rebrov
V.I. Razumovsky Saratov State Medical University, Health Ministry of Russia
Russian Federation

112 Bolshaya Kazachya St., Saratov  410012.



References

1. Poorolajal J. The global pandemics are getting more frequent and severe. J Res Health Sci 2021;21(1):е00502. DOI: 10.34172/jrhs.2021.40

2. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). ArcGIS. Johns Hopkins University. Available at: https://coronavirus.jhu.edu/map.html

3. Arutyunov G.P., Tarlovskaya E.I., Arutyunov A.G. et al. International Registry “Analysis of the dynamics of comorbid diseases in patients who have been infected with SARS-CoV-2 (ACTIVE SARS-CoV-2)”. Kardiologiya = Cardiology 2020; 60(11):30–4. (In Russ.)]. DOI: 10.15829/1560-4071-2021-4470

4. Wastnedge E., Reynolds R., van Boeckel S. еt al. Pregnancy and COVID-19. Physiol Rev 2021;101(1):303–18. DOI: 10.1152/physrev.00024.2020

5. Soma-Pillay P., Nelson-Piercy C., Tolppanen H. et al. Physiological changes in pregnancy. Cardiovasc J Afr 2016;27(2):89–94. DOI: 10.5830/CVJA-2016–021

6. Kadir R.A., Kobayashi T., Iba T. et al. COVID-19 coagulopathy in pregnancy: Critical review, preliminary recommendations, and ISTH registry – Communication from the ISTH SSC for Women’s Health. J Thromb Haemost 2020;18(11):3086–98. DOI: 10.1111/jth.15072

7. Dashraath P., Wong J.L.J., Lim M.X.K. et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet. Gynecol 2020;222(6):521–31. DOI: 10./j.ajog.2020.03.021

8. Diriba K., Awulachew E., Getu E. The effect of coronavirus infection (SARS-CoV-2, MERS-CoV, and SARS-CoV) during pregnancy and the possibility of vertical maternal-fetal transmission: a systematic review and meta-analysis. Eur J Med Res 2020;25(1):39. DOI: 10.118/s40001-020-00439-w

9. Andreeva M.D., Karakhalis L.Yu., Penzhoyan G.A. et al. Delivery in the setting of COVID-19 infection: a clinical observation. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie = Obstetrics and gynecology: news, opinions, training. 2020;8(2): 25–35. (In Russ.). DOI: 10.24411/2303-9698-2020-12001

10. Alfaraj S.H., Al-Tawfiq J.A., Memish Z.A. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection during pregnancy: Report of two cases & review of the literature. J Microbiol Immunol Infect 2019;52(3):501–3. DOI: 10.1016/j.jmii.2018.04.005

11. Liu D., Li L., Wu X. et al. Pregnancy and perinatal outcomes of women with coronavirus disease (COVID-19) pneumonia: a preliminary analysis. AJR Am J Roentgenol 2020;215(1):127–32. DOI: 10.2214/AJR.20.23072

12. Pierce-Williams R.A.M., Burd J., Felder L. et al. Clinical course of severe and critical coronavirus disease 2019 in hospitalized pregnancies: a United States cohort study. Am J Obstet Gynecol MFM 2020;2(3)

13. Sakhautdinova I.V., Tayupova I.M., Zasyadkin I.S., Gromenko R.I. Pregnancy, childbirth and perinatal outcomes in the new coronavirus infection COVID-19. Medicinskij vestnik Bashkortostana = Bashkortostan Medical Journal 2021;16(6):47–50. (In Russ.).

14. Capobianco G., Saderi L., Aliberti S. et al. COVID-19 in pregnant women: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2020;252:543–58. DOI: 10.1016/j.ejogrb.2020.07.006

15. Mullins E., Evans D., Viner R.M. et al. Coronavirus in pregnancy and delivery: rapid review. Ultrasound Obstet Gynecol 2020;55(5):586–92. DOI: 10.1002/uog.22014

16. Verma S., Carter E.B., Mysorekar I.U. SARS-CoV2 and pregnancy: An invisible enemy? Am J Reprod Immunol 2020;84(5):e13308. DOI: 10.1111/aji.13308

17. Thompson J.L., Nguyen L.M., Noble K.N. et al. COVID-19-related disease severity in pregnancy. Am J Reprod Immunol 2020;84(5):e13339. DOI: 10.1111/aji.13339

18. Jafari M., Pormohammad A., Sheikh Neshin S.A. et al. Clinical characteristics and outcomes of pregnant women with COVID-19 and comparison with control patients: A systematic review and meta-analysis. Rev Med Virol 2021;31(5):1–16. DOI: 10.1002/rmv.2208

19. Vukolova V.A., Enkova E.V., Ryzhikov Yu.S. Evaluation of the course of pregnancy, childbirth and the condition of the fetus in women with COVID-19. Vestnik novy`x medicinskix texnologij = Bulletin of new medical technologies. 2020;6:56–62. (In Russ.). DOI: 10.24411/2075-4094-2020-16778

20. Schwartz D.A. An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes. Arch Pathol Lab Med 2020;144(7):799–805. DOI: 10.5858/arpa.2020-0901-SA

21. Temporary guidelines "Prevention, diagnosis and treatment of new coronavirus infections". Version 10 (08.02.2021). The Ministry of Health of Russia. Available at: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/054/662/original/Временные_МР_COVID-19_%28v.10%29.pdf

22. Verbic M.D., Gruban J., Kos M.K. Incidence and control of steroid-induced hyperglycaemia in hospitalised patients at a tertiary care centre for lung diseases. Pharmacol Reports 2021;73(3):796–805. DOI: 10.1007/s43440-021-00234-2

23. Hamdy O., Gabbay R.A. Early observation and mitigation of challenges in diabetes management of COVID-19 patients in critical care units. Diabetes Care 2020;43(8):e81–2. DOI: 10.2337/dc20-0944

24. Adamyan R.V., Vecherko V.I., Konysheva O.V., Harchenko E.I. Pregnancy and COVID-19: current issues (literature review). Problemy reprodukcii = Reproduction problems 2021;27(3):70–7 (In Russ). DOI: 10.17116/repro20212703170

25. Baranovskaya E.I. Maternal mortality in the modern world. Akusherstvo, Ginekologiya i Reprodukciya = Obstetrics, gynecology and reproduction 2022;16(3):296–305. (In Russ). DOI: 10.17749/2313-7347/ob.gyn.rep.2022.279


Review

For citations:


Grigoryeva E.V., Tyapkina D.A., Boroday A.A., Blokhin I.S., Kondrashkin I.E., Polidanov M.A., Rebrov A.P. Features of the course of COVID-19 in pregnant women. The Clinician. 2023;17(2):28-38. (In Russ.) https://doi.org/10.17650/1818-8338-2023-17-2-K683

Views: 224


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1818-8338 (Print)
ISSN 2412-8775 (Online)