Pregnancy Can Prolong COVID-19 Symptoms

Women infected with COVID-19 report prolonged effects during pregnancy

UC San Francisco and UCLA researchers found symptoms for pregnant women with COVID-19 can be prolonged, lasting a few months or longer.

In the largest study to date among non-hospitalized pregnant women with COVID-19, these researchers analyzed the clinical course and outcomes of 594 women who tested positive during pregnancy.

While previous research on SARS-CoV-2 infection in pregnancy has primarily centered on hospitalized patients, the new analysis focused on ambulatory patients, who represent the overwhelming majority of adults with the virus.

They found that the most common early symptoms for pregnant women were cough, sore throat, body aches, and fever. 

And, half of the participants still had symptoms after 3-weeks and 25 percent had symptoms after 8-weeks, according to this study published in Obstetrics & Gynecology October 7, 2020.

"We found that pregnant people with COVID-19 can expect a prolonged time with symptoms," said senior author Vanessa L. Jacoby, MD, MAS, vice-chair of research in the Department of Obstetrics, Gynecology, and Reproductive Sciences at UCSF, and co-principal investigator of the national pregnancy study, in the related press release. 

"COVID-19 symptoms during pregnancy can last a long time, and have a significant impact on health and wellbeing."

The PRIORITY study (Pregnancy CoRonavIrus Outcomes RegIsTrY) was launched March 22, 2020, and is an ongoing study in the United States for women who are pregnant and have a confirmed or suspected case of COVID-19. The average gestational age at the time of enrollment in the study was approximately 24 weeks.

Study participants had a mean age of 31 years and were geographically diverse around the USA. Thirty-one percent of the participants were Latina, and 9 percent were Black. 

The researchers found several common symptoms of COVID-19 but were complicated by overlapping symptoms of normal pregnancy, including nausea, fatigue, and congestion. Their findings included the following:

  • Primary first symptoms were cough (20 percent), sore throat (16 percent), body aches (12 percent), and fever (12 percent); by comparison, fever occurs in 43 percent of non-pregnant hospitalized patients
  • Loss of taste or smell was the first symptom in 6 percent of pregnant women
  • Other symptoms included shortness of breath, runny nose, sneezing, nausea, sore throat, vomiting diarrhea, or dizziness
  • 60 percent of women had no symptoms after 4 weeks of illness, but for 25 percent, symptoms persisted, lasting 8 or more weeks
  • The median time for symptoms to resolve was 37 days
  • Medical conditions for some participants included hypertension, pregestational diabetes, asthma, cardiac disease, thyroid disease, anxiety, and depression.

First author Yalda Afshar, M.D., Ph.D., assistant professor in the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, at the David Geffen School of Medicine at UCLA, added: "Despite the potential risks of COVID-19 for pregnant people and their newborns, there are large gaps in our knowledge on the course of the disease and the overall prognosis.”

"Our results can help pregnant women and their clinicians better understand what to expect with COVID-19 infection."

UCSF co-authors are Stephanie L. Gaw, MD, Ph.D.; Valerie J. Flaherman, MD; Brittany D. Chambers, Ph.D., MPH; and W. John Boscardin, Ph.D. From UCLA, co-authors are Deborah Krakow, MD, and Grace Aldrovandi, MD. A full list of authors and affiliations can be found in the study.

The study was supported by the California Health Care Foundation; Centers for Disease Control and Prevention Foundation; Bill and Melinda Gates Foundation; UCSF National Center of Excellence in Women's Health; CTSI grant #UL1 TR000004; and individuals who provided support through the registry's crowdfunding sites.

One author from Weill-Cornell Medical College is a vaccine consultant for GlaxoSmithKline. The remaining authors reported no potential conflicts of interest.

UCSF Health is recognized worldwide for its innovative patient care, reflecting the latest medical knowledge, advanced technologies, and pioneering research.

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