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MeSH Disease

Human Phenotype

Transmission

Seroprevalence

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    SARS-CoV-2 (COVID-19) infection MESHD in pregnant women: characterization of symptoms and syndromes predictive of disease and severity through real-time, remote participatory epidemiology.

    Authors: Erika Molteni; Christina M Astley; Wenjie Ma; Carole Helene Sudre; Laura A Magee; Benjamin Murray; Tove Fall; Maria F Gomez; Neli Tsereteli; Paul W Franks; John S Brownstein; Richard Davies; Jonathan Wolf; Timothy Spector; Sebastien Ourselin; Claire Steves; Andrew T Chan; Marc Modat; Xuan Ding; Chunhui Yuan; Li Peng; Wei Liu; Xiao Yi; Mengge Lyu; Guixiang Xiao; Xia Xu; Weigang Ge; Jiale He; Jun Fan; Junhua Wu; Meng Luo; Xiaona Chang; Huaxiong Pan; Xue Cai; Junjie Zhou; Jing Yu; Huanhuan Gao; Mingxing Xie; Sihua Wang; Guan Ruan; Hao Chen; Hua Su; Heng Mei; Danju Luo; Dashi Zhao; Fei Xu; Yan Li; Yi Zhu; Jiahong Xia; Yu Hu; Tiannan Guo

    doi:10.1101/2020.08.17.20161760 Date: 2020-08-19 Source: medRxiv

    Background: From the beginning of COVID-19 pandemic, pregnant women have been considered at greater risk of severe morbidity and mortality. However, data on hospitalized pregnant women show that the symptom profile and risk factors for severe disease are similar to those among women who are not pregnant, although preterm birth, Cesarean delivery, and stillbirth MESHD may be more frequent and vertical transmission TRANS is possible. Limited data are available for the cohort of pregnant women that gave rise to these hospitalized cases, hindering our ability to quantify risk of COVID-19 sequelae for pregnant women in the community. Objective: To test the hypothesis that pregnant women in community differ in their COVID-19 symptoms profile and disease severity compared to non-pregnant women. This was assessed in two community-based cohorts of women aged TRANS 18-44 years in the United Kingdom, Sweden and the United States of America. Study design: This observational study used prospectively collected longitudinal (smartphone application interface) and cross-sectional (web-based survey) data. Participants in the discovery cohort were drawn from 400,750 UK, Sweden and US women (79 pregnant who tested positive) who self-reported symptoms and events longitudinally via their smartphone, and a replication cohort drawn from 1,344,966 USA women (162 pregnant who tested positive) cross-sectional self-reports samples from the social media active user base. The study compared frequencies of symptoms and events, including self-reported SARS-CoV-2 testing and differences between pregnant and non-pregnant women who were hospitalized and those who recovered in the community. Multivariable regression was used to investigate disease severity and comorbidity effects. Results: Pregnant and non-pregnant women positive for SARS-CoV-2 infection MESHD drawn from these community cohorts were not different with respect to COVID-19-related severity. Pregnant women were more likely to have received SARS-CoV-2 testing than non-pregnant, despite reporting fewer clinical symptoms. Pre-existing lung disease MESHD was most closely associated with the severity of symptoms in pregnant hospitalized women. Heart and kidney diseases MESHD and diabetes MESHD were additional factors of increased risk. The most frequent symptoms among all non-hospitalized women were anosmia HP anosmia MESHD [63% in pregnant, 92% in non-pregnant] and headache HP headache MESHD [72%, 62%]. Cardiopulmonary symptoms, including persistent cough HP cough MESHD [80%] and chest pain HP chest pain MESHD [73%], were more frequent among pregnant women who were hospitalized. Gastrointestinal symptoms, including nausea and vomiting HP nausea and vomiting MESHD vomiting MESHD, were different among pregnant and non-pregnant women who developed severe outcomes. Conclusions: Although pregnancy is widely considered a risk factor for SARS-CoV-2 infection MESHD and outcomes, and was associated with higher propensity for testing, the profile of symptom characteristics and severity in our community-based cohorts were comparable to those observed among non-pregnant women, except for the gastrointestinal symptoms. Consistent with observations in non-pregnant populations, comorbidities such as lung disease MESHD and diabetes MESHD were associated with an increased risk of more severe SARS-CoV-2 infection MESHD during pregnancy. Pregnant women with pre-existing conditions require careful monitoring for the evolution of their symptoms during SARS-CoV-2 infection MESHD.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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