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Grand Rounds

More from the PRIORITY Registry: Pregnancy and COVID-19 Symptoms

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BACKGROUND AND PURPOSE:

  • Afshar et al. (Obstetrics & Gynecology, 2020) describe the clinical findings and disease course of COVID-19 in pregnancy

METHODS:

  • Prospective cohort study (March 22, 2020 through July 10, 2020)
  • Data sources
    • Ongoing PRIORITY (Pregnancy CoRonavIrus Outcomes RegIsTrY) registry study (US)
  • Participants
    • Pregnant or ≤6 weeks postpartum
    • Known or suspected SARS-CoV-2 infection

RESULTS:

  • 991 participants
    • Mean (SD) age: 31.3 (5.1) years
    • Nulliparous: 37%
    • Outpatient: 95%
    • Mean gestational age: 24w1d
    • Postpartum enrollment: 13%  
  • Geographical distribution
    • Northeast: 34% | West: 25% | South: 21% | Midwest: 18%
  • Race/Ethnicity
    • Latina: 31% | Black: 9%
  • Symptomatic at testing: 736 patients
    • Tested positive: 594 patients
    • Tested negative: 142 patients
  • Most common symptoms within first week of diagnosis
    • Cough: 46% | Fatigue: 38% | Headache: 25%
  • Fever was only present in 12%
  • Time to symptom resolution
    • Median time: 37 days (95% CI, 35 to 39 days)
  • Symptom persistence
    • By week 3: 52% asymptomatic
    • By week 4: 60% asymptomatic
    •  At 8 weeks: 25% of patients still had lingering symptoms

CONCLUSION:

  • While most pregnant women with COVID-19 had resolutions of symptoms by 3 weeks, a quarter of patients diagnosed in pregnancy or postpartum still had symptoms at 2 months follow-up
  • Fever was less common compared to studies in non-pregnant cohorts previously reported in the literature

The authors conclude

…presenting symptoms in this primarily outpatient cohort of pregnant patients differ from those in nonpregnant populations, with a lower prevalence of fever and higher rates of fatigue, body aches, and headaches

Learn More – Primary Sources:

Clinical Presentation of Coronavirus Disease 2019 (COVID-19) in Pregnant and Recently Pregnant People

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Related ObG Topics:

Findings from PRIORITY: Outcomes in Infants Born to Women with COVID-19
The UKOSS COVID-19 Pregnancy Registry: Update on 427 Patients Admitted to Hospital

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