Features of the course of COVID-19 in pregnant women

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.