Post-COVID-19 condition in pregnant and postpartum women: a long-term follow-up, observational prospective study

Background Post-COVID-19 condition has recently been defined as new or persistent common COVID-19 symptoms occurring three months after disease onset. The pathology of the disease is unclear, but immune and vascular factors seem to play a significant role. The incidence, severity, and implications o...

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Detalhes bibliográficos
Autores: Muñoz-Chápuli Gutiérrez, Mar, Sáez Prat, Ainoa, Durán Vila, Ana, Bernal Claverol, Mireia, Payá Martínez, Pilar, Pintado Recarte, María Del Pilar, Viñuela Benéitez, Mamen, Ausín García, Cristina, Cervilla Muñoz, Eva, Navarro, Marisa, González Navarro, Pablo, Álvarez Mon, Melchor, Ortega, Miguel A., León Luis, Juan Antonio
Formato: artículo
Fecha de publicación:2024
País:España
Recursos:Universidad Complutense de Madrid (UCM)
Repositorio:Docta Complutense
Idioma:inglés
OAI Identifier:oai:docta.ucm.es:20.500.14352/115083
Acesso em linha:https://hdl.handle.net/20.500.14352/115083
Access Level:acceso abierto
Palavra-chave:616.98:578.834
578.834:616.98
Post-COVID-19
Long COVID
Pregnancy
Postpartum
Perinatal
COVID-19
Obstetrics
Ciencias Biomédicas
32 Ciencias Médicas
id ES_7bcfd319a604e0e23df435abc847a3bb
oai_identifier_str oai:docta.ucm.es:20.500.14352/115083
network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv Post-COVID-19 condition in pregnant and postpartum women: a long-term follow-up, observational prospective study
title Post-COVID-19 condition in pregnant and postpartum women: a long-term follow-up, observational prospective study
spellingShingle Post-COVID-19 condition in pregnant and postpartum women: a long-term follow-up, observational prospective study
Muñoz-Chápuli Gutiérrez, Mar
616.98:578.834
578.834:616.98
Post-COVID-19
Long COVID
Pregnancy
Postpartum
Perinatal
COVID-19
Obstetrics
Ciencias Biomédicas
32 Ciencias Médicas
title_short Post-COVID-19 condition in pregnant and postpartum women: a long-term follow-up, observational prospective study
title_full Post-COVID-19 condition in pregnant and postpartum women: a long-term follow-up, observational prospective study
title_fullStr Post-COVID-19 condition in pregnant and postpartum women: a long-term follow-up, observational prospective study
title_full_unstemmed Post-COVID-19 condition in pregnant and postpartum women: a long-term follow-up, observational prospective study
title_sort Post-COVID-19 condition in pregnant and postpartum women: a long-term follow-up, observational prospective study
dc.creator.none.fl_str_mv Muñoz-Chápuli Gutiérrez, Mar
Sáez Prat, Ainoa
Durán Vila, Ana
Bernal Claverol, Mireia
Payá Martínez, Pilar
Pintado Recarte, María Del Pilar
Viñuela Benéitez, Mamen
Ausín García, Cristina
Cervilla Muñoz, Eva
Navarro, Marisa
González Navarro, Pablo
Álvarez Mon, Melchor
Ortega, Miguel A.
León Luis, Juan Antonio
author Muñoz-Chápuli Gutiérrez, Mar
author_facet Muñoz-Chápuli Gutiérrez, Mar
Sáez Prat, Ainoa
Durán Vila, Ana
Bernal Claverol, Mireia
Payá Martínez, Pilar
Pintado Recarte, María Del Pilar
Viñuela Benéitez, Mamen
Ausín García, Cristina
Cervilla Muñoz, Eva
Navarro, Marisa
González Navarro, Pablo
Álvarez Mon, Melchor
Ortega, Miguel A.
León Luis, Juan Antonio
author_role author
author2 Sáez Prat, Ainoa
Durán Vila, Ana
Bernal Claverol, Mireia
Payá Martínez, Pilar
Pintado Recarte, María Del Pilar
Viñuela Benéitez, Mamen
Ausín García, Cristina
Cervilla Muñoz, Eva
Navarro, Marisa
González Navarro, Pablo
Álvarez Mon, Melchor
Ortega, Miguel A.
León Luis, Juan Antonio
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad Complutense de Madrid
dc.subject.none.fl_str_mv 616.98:578.834
578.834:616.98
Post-COVID-19
Long COVID
Pregnancy
Postpartum
Perinatal
COVID-19
Obstetrics
Ciencias Biomédicas
32 Ciencias Médicas
topic 616.98:578.834
578.834:616.98
Post-COVID-19
Long COVID
Pregnancy
Postpartum
Perinatal
COVID-19
Obstetrics
Ciencias Biomédicas
32 Ciencias Médicas
description Background Post-COVID-19 condition has recently been defined as new or persistent common COVID-19 symptoms occurring three months after disease onset. The pathology of the disease is unclear, but immune and vascular factors seem to play a significant role. The incidence, severity, and implications of the disease after COVID-19 infection in pregnancy have not been established. We aimed to study the incidence and main risk factors for post-COVID-19 condition in an obstetric population and their implications for maternal and perinatal morbimortality. Methods This is a prospective observational cohort study undertaken including women during pregnancy or at admission for labour with acute COVID-19 infection from March 9th, 2020 to June 11th, 2022. The inclusion criteria were confirmed acute COVID-19 infection during the recruitment period, a lack of significant language barrier and consent for follow-up. Patients were clinically followed-up by telephone via semi structured questionnaires. The exclusion criteria were loss to follow-up, spontaneous miscarriage, and legal termination of pregnancy. Patients were classified into groups according to the severity of symptoms at onset. We included patients from the first six first waves of the pandemic according to national epidemiological data in Spain. We studied the incidence of post-COVID-19 condition and their main demographic, clinical and obstetric risk factors. Findings A total of 409 pregnant women were recruited at acute diagnosis, and 286 were followed-up. The mean time to follow-up was 92 weeks (standard deviation ± 28 weeks; median 100 weeks (Interquartile range: 76; 112)). A total of 140 patients had at least one post-COVID-19 symptom at least three months after acute infection. Neurological (60%) and cutaneous (55%) manifestations were the most frequent findings. The following profiles were identified as presenting a higher risk of post-COVID-19 condition: migrant women born in countries with lower Human Development Index; multiparous women; women with COVID-19 during pregnancy, mainly during the first and third trimesters, and in the first and second waves of the pandemic; women who had a higher number of symptoms; women who had a higher incidence of moderate and severe symptoms; women who required hospitalisation due to COVID-19 complications; and women who were not vaccinated before disease onset. We did not find any significant difference in perinatal results, such as gestational week at delivery, birthweight, the need for neonatal care or 5-min Apgar score, and newborns benefited from a high rate of breastfeeding at discharge. Women who were infected during successive waves of the pandemic had a significant and constant decrease in the risk of post-COVID-19 condition comparing to estimated risk in the first wave (OR: 0.70; 95% CI: 0.62, 0.92). Symptoms tended to resolve over time heterogeneously. Symptoms of myalgia and arthralgia took longer to resolve (mean of 60 weeks and 54 weeks, respectively). In a small but significant proportion of patients, neurological and psycho-emotional symptoms tended to become chronic after 90 weeks. Interpretation At least 34.2% of obstetric patients from our cohort with acute COVID-19 infection presented post-COVID-19 condition symptoms. Demographic and acute disease characteristics as well as specific pregnancy-related risk factors were identified. This is the first study to assess post-COVID-19 condition in pregnant women. Further analysis on the biological pathophysiology of post-COVID-19 is needed to explain the characteristics of the disease.
publishDate 2024
dc.date.none.fl_str_mv 2024
2024-01-01
2024
2024-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.14352/115083
url https://hdl.handle.net/20.500.14352/115083
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Docta Complutense
instname:Universidad Complutense de Madrid (UCM)
instname_str Universidad Complutense de Madrid (UCM)
reponame_str Docta Complutense
collection Docta Complutense
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling Post-COVID-19 condition in pregnant and postpartum women: a long-term follow-up, observational prospective studyMuñoz-Chápuli Gutiérrez, MarSáez Prat, AinoaDurán Vila, AnaBernal Claverol, MireiaPayá Martínez, PilarPintado Recarte, María Del PilarViñuela Benéitez, MamenAusín García, CristinaCervilla Muñoz, EvaNavarro, MarisaGonzález Navarro, PabloÁlvarez Mon, MelchorOrtega, Miguel A.León Luis, Juan Antonio616.98:578.834578.834:616.98Post-COVID-19Long COVIDPregnancyPostpartumPerinatalCOVID-19ObstetricsCiencias Biomédicas32 Ciencias MédicasBackground Post-COVID-19 condition has recently been defined as new or persistent common COVID-19 symptoms occurring three months after disease onset. The pathology of the disease is unclear, but immune and vascular factors seem to play a significant role. The incidence, severity, and implications of the disease after COVID-19 infection in pregnancy have not been established. We aimed to study the incidence and main risk factors for post-COVID-19 condition in an obstetric population and their implications for maternal and perinatal morbimortality. Methods This is a prospective observational cohort study undertaken including women during pregnancy or at admission for labour with acute COVID-19 infection from March 9th, 2020 to June 11th, 2022. The inclusion criteria were confirmed acute COVID-19 infection during the recruitment period, a lack of significant language barrier and consent for follow-up. Patients were clinically followed-up by telephone via semi structured questionnaires. The exclusion criteria were loss to follow-up, spontaneous miscarriage, and legal termination of pregnancy. Patients were classified into groups according to the severity of symptoms at onset. We included patients from the first six first waves of the pandemic according to national epidemiological data in Spain. We studied the incidence of post-COVID-19 condition and their main demographic, clinical and obstetric risk factors. Findings A total of 409 pregnant women were recruited at acute diagnosis, and 286 were followed-up. The mean time to follow-up was 92 weeks (standard deviation ± 28 weeks; median 100 weeks (Interquartile range: 76; 112)). A total of 140 patients had at least one post-COVID-19 symptom at least three months after acute infection. Neurological (60%) and cutaneous (55%) manifestations were the most frequent findings. The following profiles were identified as presenting a higher risk of post-COVID-19 condition: migrant women born in countries with lower Human Development Index; multiparous women; women with COVID-19 during pregnancy, mainly during the first and third trimesters, and in the first and second waves of the pandemic; women who had a higher number of symptoms; women who had a higher incidence of moderate and severe symptoms; women who required hospitalisation due to COVID-19 complications; and women who were not vaccinated before disease onset. We did not find any significant difference in perinatal results, such as gestational week at delivery, birthweight, the need for neonatal care or 5-min Apgar score, and newborns benefited from a high rate of breastfeeding at discharge. Women who were infected during successive waves of the pandemic had a significant and constant decrease in the risk of post-COVID-19 condition comparing to estimated risk in the first wave (OR: 0.70; 95% CI: 0.62, 0.92). Symptoms tended to resolve over time heterogeneously. Symptoms of myalgia and arthralgia took longer to resolve (mean of 60 weeks and 54 weeks, respectively). In a small but significant proportion of patients, neurological and psycho-emotional symptoms tended to become chronic after 90 weeks. Interpretation At least 34.2% of obstetric patients from our cohort with acute COVID-19 infection presented post-COVID-19 condition symptoms. Demographic and acute disease characteristics as well as specific pregnancy-related risk factors were identified. This is the first study to assess post-COVID-19 condition in pregnant women. Further analysis on the biological pathophysiology of post-COVID-19 is needed to explain the characteristics of the disease.ElsevierUniversidad Complutense de Madrid20242024-01-0120242024-01-01journal articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.14352/115083reponame:Docta Complutenseinstname:Universidad Complutense de Madrid (UCM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:docta.ucm.es:20.500.14352/1150832026-06-02T12:44:21Z
score 15,81155

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