2022, Number 3
Predictors of severity for COVID-19 in obstetric patients with SARS-CoV-2 infection
Full text
Language: Spanish
References: 20
Page:
PDF size: 531.25 Kb.
ABSTRACT
Introduction: Pregnant women are identified as a vulnerable group in any infectious disease outbreak, and are more likely to develop severe COVID-19 illness. Multiple risk factors related to the severity of this disease are described.Objective: To determine the predictors of severity in obstetric patients with COVID-19.
Methods: A retrospective analytical observational case-control study was carried out at the Dr. Luis Díaz Soto Hospital, in the year 2021. The universe consisted of 632 obstetric patients with SARS-CoV-2 infection, who were divided into two groups: the cases formed by the obstetric patients who presented serious adverse results and the control by obstetric patients who did not reach seriousness. Both groups were compared based on the variables composed of the predictors of severity for COVID-19.
Results: From a total of 632 obstetric patients with nasopharyngeal PCR-RT positive for SARS-CoV-2, 141 patients presented adverse maternal outcomes and 491 developed non-serious forms of the disease. Pregnant women in the third trimester (OR 2.4), aged 35 years or older (OR 2.1), with comorbidities: hypertensive disorders (OR 2.7), diabetic disorders (OR 6.2), obese women had a higher risk of severity. (OR 6.9), and altered inflammation markers.
Conclusions: Obstetric patients with SARS-CoV-2 infection, older than 35 years, in the third trimester of pregnancy, with the presence of comorbidities and increased inflammatory biomarkers, have a greater risk of presenting serious adverse outcomes. All of them are predictors of risk of severity for COVID-19.
REFERENCES
De Medeiros KS, Sarmento ACA, Costa APF, Macêdo LTA, da Silva LAS, de Freitas CL, et al. Consequences and implications of the coronavirus disease (COVID-19) on pregnancy and newborns: A comprehensive systematic review and meta-analysis. Int J Gynaecol Obstet. Official organ of the International Federation of Gynaecology and Obstetrics. 2022;156(3):394-405. DOI: https://doi.org/10.1002/ijgo.14015
Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-October 3, 2020. MMWR Morbidity and Mortality Weekly Report. 2020;69(44):1641-7. DOI: https://doi.org/10.15585/mmwr.mm6944e3https://doi.org/10.15585/mmwr.mm6944e3
Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ (Clinical research ed). 2020;370:3320. DOI: https://doi.org/10.1136/bmj.m3320
Maza-Arnedo F, Paternina-Caicedo A, Sosa CG, de Mucio B, Rojas-Suarez J, Say L, et al. Maternal mortality linked to COVID-19 in Latin America: Results from a multi-country collaborative database of 447 deaths. The Lancet Regional Health Americas. 2022;12:100269. DOI: https://doi.org/10.1016/j.lana.2022.100269
Birol Ilter P, Prasad S, Mutlu MA, Tekin AB, O'Brien P, von Dadelszen P, et al. Maternal and perinatal outcomes of SARS-CoV-2 infection in unvaccinated pregnancies during Delta and Omicron waves. Ultrasound in obstetrics & gynecology: the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2022;60(1):96-102. DOI: https://doi.org/10.1002/uog.24916
Smith ER, Oakley E, Grandner GW, Rukundo G, Farooq F, Ferguson K, et al. Clinical risk factors of adverse outcomes among women with COVID-19 in the pregnancy and postpartum period: a sequential, prospective meta-analysis. Am J Obstet Gynecol. 2023;228(2):161-77. DOI: https://doi.org/10.1016/j.ajog.2022.08.038
Ferraz T, Benton SJ, Zareef I, Aribaloye O, Bloise E, Connor KL. Impact of Co-Occurrence of Obesity and SARS-CoV-2 Infection during Pregnancy on Placental Pathologies and Adverse Birth Outcomes: A Systematic Review and Narrative Synthesis. Pathogens (Basel, Switzerland). 2023;12(4). DOI: https://doi.org/10.1146/annurev-immunol-031210-101322
Reichelt AJ, Hirakata VN, Genro VK, Oppermann MLR. A snapshot of the prevalence of endocrine disorders in pregnancies complicated by coronavirus disease 2019: A narrative review with meta-analysis. International journal of gynaecology and obstetrics (IJGO): the official organ of the International Federation of Gynaecology and Obstetrics. 2021;154(2):204-11. DOI: https://doi.org/10.1002/ijgo.13714
La Verde M, Riemma G, Torella M, Cianci S, Savoia F, Licciardi F, et al. Maternal death related to COVID-19: A systematic review and meta-analysis focused on maternal co-morbidities and clinical characteristics. International journal of gynaecology and obstetrics (IJGO): the official organ of the International Federation of Gynaecology and Obstetrics. 2021;154(2):212-9. DOI: https://doi.org/10.1002/ijgo.13726
Khan DSA, Hamid LR, Ali A, Salam RA, Zuberi N, Lassi ZS, et al. Differences in pregnancy and perinatal outcomes among symptomatic versus asymptomatic COVID-19-infected pregnant women: a systematic review and meta-analysis. BMC Pregnancy and Childbirth. 2021;21(1):801. DOI: https://doi.org/10.1186/s12884-021-04250-1
Lassi ZS, Ana A, Das JK, Salam RA, Padhani ZA, Irfan O, et al. A systematic review and meta-analysis of data on pregnant women with confirmed COVID-19: Clinical presentation, and pregnancy and perinatal outcomes based on COVID-19 severity. J Glob Health. 2021;11:05018. DOI: https://doi.org/10.7189/jogh.11.05018