Comparison of the clinical course of COVID-19 disease in pregnant and non-pregnant patients of reproductive age

Abstract

COVID-19 disease is one of the challenges that threaten human health. The infectiousness of this disease ranges from asymptomatic to severe disease (increased breathing rate, hypoxia, significant lung involvement in imaging) or severe (multiple organ failure or respiratory dysfunction and the need for mechanical ventilation or oxygen therapy with a nasal cannula). This study aimed to compare the clinical course of COVID-19 in pregnant and non-pregnant patients of reproductive age (15-45 years). Materials and Methods: 150 pregnant women with COVID-19 and 150 non-pregnant women with COVID-19 were enrolled in Tabriz. Gestational age at diagnosis of COVID-19, age, disease severity, hospitalization, intensive care unit stay, use of mechanical ventilation and pregnancy outcome (premature birth, abortion, stillbirth, postpartum hemorrhage) and death (pregnant and non-pregnant) were recorded and compared between groups as main variables and serum ferritin level as secondary variable. Results: The median age of the pregnant and non-pregnant groups were 32 and 38 years; respectively. The most common comorbidities in the pregnant group were gestational diabetes and hypertension. The median gestational age of pregnant women was 32 weeks + 1 day. Although the frequency of mild disease was higher in pregnant women and the frequency of severe and very severe disease was higher in non-pregnant women, no statistically significant difference was observed. Comparison of final outcome showed that there were 7 cases of mortality in both groups, but there was no difference between the two groups in terms of mortality (p=0.607). The outcome of pregnancy in pregnant women with COVID-19 in 19% (27 cases) was premature birth, 6.7% was abortion, 3.5% was stillbirth, and 6.7% was postpartum bleeding. Out of 27 cases of premature birth, 10 cases were spontaneous and 17 cases were induced, among which 14 cases underwent vaginal delivery and 13 cases underwent cesarean section.