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Clinical Findings and Disease Severity in Hospitalized Pregnant Women With Coronavirus Disease 2019 (COVID-19).
Obstet Gynecol. 2020 08; 136(2):252-258.OG

Abstract

OBJECTIVE

To investigate the clinical evolution of coronavirus disease 2019 (COVID-19) in hospitalized pregnant women and potential factors associated with severe maternal outcomes.

METHODS

We designed a prospective multicenter cohort study of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who were admitted to 12 Italian maternity hospitals between February 23 and March 28, 2020. Clinical records, laboratory and radiologic examinations, and pregnancy outcomes were collected. A subgroup of patients with severe disease was identified based on intensive care unit (ICU) admission, delivery for respiratory compromise, or both.

RESULTS

Seventy-seven patients were included, 14 of whom had severe disease (18%). Two thirds of the patients in the cohort were admitted during the third trimester, and 84% were symptomatic on admission. Eleven patients underwent urgent delivery for respiratory compromise (16%), and six were admitted to the ICU (8%). One woman received extracorporeal membrane oxygenation; no deaths occurred. Preterm delivery occurred in 12% of patients, and nine newborns were admitted to the neonatal intensive care unit. Patients in the severe subgroup had significantly higher pregestational body mass indexes (BMIs) and heart and respiratory rates and a greater frequency of fever or dyspnea on admission compared with women with a nonsevere disease evolution.

CONCLUSION

In our cohort, one in five women hospitalized with COVID-19 infection delivered urgently for respiratory compromise or were admitted to the ICU. None, however, died. Increased pregestational BMI and abnormal heart and respiratory rates on admission were associated with severe disease.

Authors+Show Affiliations

Department of Woman, Mother and Neonate, L. Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, the Department of Clinical and Biological Sciences, University of Milan, Milan, the Department of Obstetrics and Gynecology, Papa Giovanni XXIII Hospital, Bergamo, the Department of Obstetrics and Gynecology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, the Department of Clinical Sciences and Community Health, University of Milan, Milan, the Department of Obstetrics and Gynecology, A. Manzoni Hospital, ASST Lecco, Lecco, the Department of Obstetrics and Gynecology, University of Pavia, IRCCS Foundation Policlinico San Matteo, Pavia, the Department of Obstetrics and Gynecology, Santa Chiara Hospital, Trento, the Department of Obstetrics and Gynecology, AUSL Piacenza, Piacenza, the Obstetrics and Gynecology Unit, Department of Woman's and Child's Health, University Hospital of Padua, Padua, the Department of Experimental and Clinical Biomedical Sciences "Mario Serio," Obstetrics and Gynecology, University of Florence, Florence, the Department of Maternal Fetal Medicine, Fondazione MBBM, San Gerardo Hospital, University of Milano Bicocca, Monza, the Obstetrics Unit, Mother Infant Department, University Hospital Policlinico of Modena, Modena, and the Obstetrics and Gynecology Unit, Azienda Ospedaliera Bolognini, Seriate, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32433453

Citation

Savasi, Valeria M., et al. "Clinical Findings and Disease Severity in Hospitalized Pregnant Women With Coronavirus Disease 2019 (COVID-19)." Obstetrics and Gynecology, vol. 136, no. 2, 2020, pp. 252-258.
Savasi VM, Parisi F, Patanè L, et al. Clinical Findings and Disease Severity in Hospitalized Pregnant Women With Coronavirus Disease 2019 (COVID-19). Obstet Gynecol. 2020;136(2):252-258.
Savasi, V. M., Parisi, F., Patanè, L., Ferrazzi, E., Frigerio, L., Pellegrino, A., Spinillo, A., Tateo, S., Ottoboni, M., Veronese, P., Petraglia, F., Vergani, P., Facchinetti, F., Spazzini, D., & Cetin, I. (2020). Clinical Findings and Disease Severity in Hospitalized Pregnant Women With Coronavirus Disease 2019 (COVID-19). Obstetrics and Gynecology, 136(2), 252-258. https://doi.org/10.1097/AOG.0000000000003979
Savasi VM, et al. Clinical Findings and Disease Severity in Hospitalized Pregnant Women With Coronavirus Disease 2019 (COVID-19). Obstet Gynecol. 2020;136(2):252-258. PubMed PMID: 32433453.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical Findings and Disease Severity in Hospitalized Pregnant Women With Coronavirus Disease 2019 (COVID-19). AU - Savasi,Valeria M, AU - Parisi,Francesca, AU - Patanè,Luisa, AU - Ferrazzi,Enrico, AU - Frigerio,Luigi, AU - Pellegrino,Antonio, AU - Spinillo,Arsenio, AU - Tateo,Saverio, AU - Ottoboni,Mariacristina, AU - Veronese,Paola, AU - Petraglia,Felice, AU - Vergani,Patrizia, AU - Facchinetti,Fabio, AU - Spazzini,Donata, AU - Cetin,Irene, PY - 2020/5/21/pubmed PY - 2020/8/12/medline PY - 2020/5/21/entrez SP - 252 EP - 258 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 136 IS - 2 N2 - OBJECTIVE: To investigate the clinical evolution of coronavirus disease 2019 (COVID-19) in hospitalized pregnant women and potential factors associated with severe maternal outcomes. METHODS: We designed a prospective multicenter cohort study of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who were admitted to 12 Italian maternity hospitals between February 23 and March 28, 2020. Clinical records, laboratory and radiologic examinations, and pregnancy outcomes were collected. A subgroup of patients with severe disease was identified based on intensive care unit (ICU) admission, delivery for respiratory compromise, or both. RESULTS: Seventy-seven patients were included, 14 of whom had severe disease (18%). Two thirds of the patients in the cohort were admitted during the third trimester, and 84% were symptomatic on admission. Eleven patients underwent urgent delivery for respiratory compromise (16%), and six were admitted to the ICU (8%). One woman received extracorporeal membrane oxygenation; no deaths occurred. Preterm delivery occurred in 12% of patients, and nine newborns were admitted to the neonatal intensive care unit. Patients in the severe subgroup had significantly higher pregestational body mass indexes (BMIs) and heart and respiratory rates and a greater frequency of fever or dyspnea on admission compared with women with a nonsevere disease evolution. CONCLUSION: In our cohort, one in five women hospitalized with COVID-19 infection delivered urgently for respiratory compromise or were admitted to the ICU. None, however, died. Increased pregestational BMI and abnormal heart and respiratory rates on admission were associated with severe disease. SN - 1873-233X UR - https://www.unboundmedicine.com/medline/citation/32433453/Clinical_Findings_and_Disease_Severity_in_Hospitalized_Pregnant_Women_With_Coronavirus_Disease_2019__COVID_19__ L2 - https://doi.org/10.1097/AOG.0000000000003979 DB - PRIME DP - Unbound Medicine ER -