Infectious Disease

COVID-19 results in modifications in prenatal care in 67% of pregnant sufferers with rheumatic illness

January 04, 2021

2 min read

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Disclosure:
Barbhaiya reports on support for the Investigator Award from the Rheumatology Research Foundation. In the study you will find all relevant financial information from all other authors.

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Patients at a major New York rheumatism center who were pregnant reported similar COVID-19 prevalence and disease severity as those who weren’t pregnant, while 67% reported changes in their prenatal care according to the data.

“In the US, New York was an early ‘hot spot’ from March to May 2020.” Gave me Barbhaiya, MD, MPH, of Specialty Surgery Hospital and Weill Cornell Medicine, and colleagues wrote in Arthritis Care and Research. “Pregnant women experience immunological and physiological changes that increase the risk of more serious infectious diseases. In addition, patients with rheumatic diseases may be at increased risk of serious illnesses due to immunodeficiency and the use of immunomodulatory or immunosuppressive drugs. “

Our finding of similar COVID-19 prevalence and disease severity in pregnant and non-pregnant patients needs to be interpreted with caution, but provides useful data for women with systemic rheumatic diseases considering pregnancy during the pandemic, “said Medha Barbhaiya, MD, MPH, and colleagues wrote. Source: Adobe Stock

“It is not known if pregnant patients with rheumatic disease are at higher risk of SARS-CoV-2,” they added. “For previous coronavirus outbreaks (the severe coronavirus with acute respiratory syndrome) [SARS-CoV] Pregnant women were at increased risk of endotracheal intubation, intensive care unit (ICU) admission, kidney failure, and death. “

To analyze the experiences of rheumatic disease patients who were pregnant during the COVID-19 pandemic in New York City, Barbhaiya conducted a survey at the Hospital for Special Surgery. The researchers forwarded the web-based survey to all English-speaking adult patients who had at least one rheumatological visit to the center between April 1, 2018 and April 21, 2020, as well as to an email address. Potential participants received up to three survey invitations between April 24 and May 17, while a subset with missing or incorrect email addresses were contacted by telephone.

Gave me Barbhaiya

As part of the survey, women aged 18 to 50 were asked to indicate their pregnancy status on January 1 and after the survey was completed. Other questions examined the impact of the pandemic on prenatal care and perinatal outcomes. Women who answered the pregnancy questions in the general medical history questionnaire were also included in the analysis. The researchers ended data collection on July 1, 2020 with a total of 7,094 respondents. Among those patients were 1,547 women aged 18 to 50, of whom 61 – or 4% – said they were pregnant during the COVID-19 pandemic.

According to the researchers, the prevalence of self-reported COVID-19 among pregnant and non-pregnant respondents was similar at 8% and 9%, respectively (P = 0.76). In patients with COVID-19, those who were pregnant had shorter symptom duration (P <0.01) and greater loss of smell or taste (P = 0.02) than those who were not pregnant. About three-quarters of women had systemic rheumatic disease with no reported differences in pregnancy or COVID-19 status.

In addition, 67% of pregnant patients said they made changes in prenatal care during the pandemic, and 23% of those after giving birth said the pandemic affected their delivery.

“The COVID-19 pandemic presents a rare opportunity to study the effects of severe infection on pregnant patients with rheumatic disease, which few studies have looked at,” wrote Barbhaiya and colleagues. “Our finding of similar COVID-19 prevalence and disease severity in pregnant and non-pregnant patients should be interpreted with caution, but provides useful data for women with systemic rheumatic diseases considering pregnancy during the pandemic.”

“The shortened overall symptom duration and general loss of smell or taste in pregnant women with COVID-19 also provide preliminary information to help doctors care for pregnant patients during the pandemic,” they added. “As more universal COVID-19 tests are performed on pregnant patients who have been admitted to childbirth, future studies may better assess the impact of the pandemic on perinatal and postpartum outcomes in this unique population.”

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