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Chandy S, Kumar H, Pearl S, Basu S, M G, Sankar J, Manoharan A, Ramaiah S, Anbarasu A. Whole genome analysis reveals unique traits of SARS-CoV-2 in pediatric patients. Gene 2024; 919:148508. [PMID: 38670399 DOI: 10.1016/j.gene.2024.148508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/10/2024] [Accepted: 04/23/2024] [Indexed: 04/28/2024]
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) continues to challenge the global healthcare with emerging variants and higher infectivity as well as morbidities. This study investigated potential age-related variations through genomic characterization of the virus under common clinical settings. A cohort comprising 71 SARS-CoV-2 strains from both infected infants and accompanying adults, diagnosed via RT-PCR at a tertiary pediatric hospital and research center, underwent Illumina paired-end sequencing. The subsequent analysis involved standard genomic screening, phylogeny construction, and mutational analyses. The analyzed SARSCoV- 2 strains were compared with globally circulating variants. The overall distribution revealed 67.61 % Delta, 25.7 % Omicron, and 1 % either Kappa or Alpha variants. In 2021, Delta predominated at ∼ 94 %, with Alpha/Kappa accounting for around 5 %. However, in 2022, over 94 % of the samples were Omicron variants, signifying a substantial shift from Delta dominance. Delta variants constituted 69.5 % of infections in adults and 78.5 % in infants, while Omicron variants were responsible for 31 % of cases in infants and 18 % in adults. The Spike region harbored the majority of mutations, with T19R being the most prevalent mutation in the Delta lineage. Notably, the frequencies of this mutation varied between infants and adults. In Omicron samples, G142D emerged as the most prevalent mutation. Our dataset predominantly featured clade 21A and lineage B.1.617.2. This study underscores the differential clinical presentations and genomic characteristics of SARS-CoV-2 in pediatric patients and accompanying adults. Understanding the dynamic evolution of the SARS- CoV-2 in both pediatric and adults can help in strengthening prophylactic measures.
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Affiliation(s)
- Sara Chandy
- The CHILDS Trust Medical Research Foundation (CTMRF), 12-A, Nageswara Road, Nungambakkam, Chennai 600034, Tamil Nadu, India
| | - Hithesh Kumar
- Department of Bio-Sciences, School of Biosciences and Technology (SBST), Vellore Institute of Technology (VIT), Vellore 632014, India; Medical and Biological Computing Laboratory, SBST, VIT, Vellore 632014, India
| | - Sara Pearl
- Medical and Biological Computing Laboratory, SBST, VIT, Vellore 632014, India; Department of Integrative Biology, School of Biosciences and Technology (SBST), Vellore Institute of Technology (VIT), Vellore 632014, India
| | - Soumya Basu
- Medical and Biological Computing Laboratory, SBST, VIT, Vellore 632014, India; Department of Biotechnology, NIST University, Berhampore 761008, India
| | - Gurumoorthy M
- The CHILDS Trust Medical Research Foundation (CTMRF), 12-A, Nageswara Road, Nungambakkam, Chennai 600034, Tamil Nadu, India
| | - Janani Sankar
- The CHILDS Trust Medical Research Foundation (CTMRF), 12-A, Nageswara Road, Nungambakkam, Chennai 600034, Tamil Nadu, India
| | - Anand Manoharan
- Kanchi Kamakoti CHILDS Trust Hospital (KKCTH), 12-A, Nageswara Road, Nungambakkam, Chennai 600034, Tamil Nadu, India
| | - Sudha Ramaiah
- Department of Bio-Sciences, School of Biosciences and Technology (SBST), Vellore Institute of Technology (VIT), Vellore 632014, India; Medical and Biological Computing Laboratory, SBST, VIT, Vellore 632014, India
| | - Anand Anbarasu
- Medical and Biological Computing Laboratory, SBST, VIT, Vellore 632014, India; Department of Biotechnology, School of Biosciences and Technology (SBST), Vellore Institute of Technology (VIT), Vellore 632014, India.
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Nair S, Tshabalala K, Slingers N, Vanleeuw L, Basu D, Abdullah F. Feasibility of Provision and Vaccine Hesitancy at a Central Hospital COVID-19 Vaccination Site in South Africa after Four Waves of the Pandemic. Diseases 2024; 12:113. [PMID: 38920545 PMCID: PMC11202450 DOI: 10.3390/diseases12060113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 04/30/2024] [Accepted: 05/22/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND As mortality declined significantly during the fourth and fifth waves compared to previous waves, the question of the future role of COVID-19 vaccination arose among both experts and the public in South Africa. Turning attention away from the general public, now considered to be at very low risk of severe COVID-19 disease, a commonly held view was that the vaccination campaign should focus only on those who remain highly vulnerable to severe disease and death from COVID-19. Primary amongst this group are patients with common chronic diseases attending hospital outpatient departments. We hypothesized that providing COVID-19 vaccinations on-site at a central hospital will increase uptake for the patients with co-morbid chronic conditions who need them most in the Omicron phase of the pandemic. AIM Evaluate the acceptability, need, and uptake of a hospital-based vaccination site for patients attending the medical hospital outpatient departments. OBJECTIVES To assess vaccination uptake, coverage, and hesitancy in people attending a central hospital, to determine factors associated with and influencing vaccination uptake, and to document implementation and assess acceptability of the vaccination project among staff and persons attending the hospital. METHODS Mixed-methods study using quantitative and qualitative methods. RESULTS Of the 317 participants enrolled in the study, 229 (72%) had already received at least one dose of the COVID-19 vaccine. A total of 296 participants were eligible for a first vaccination, additional vaccination, or booster vaccination according to the South African Department of Health guidelines. Of those previously vaccinated, 65% opted for an additional dose on the day it was offered (same day). Only 13 previously unvaccinated participants (15% of vaccine naïve participants) opted for vaccination, increasing vaccine coverage with at least one dose from 72% to 76%. Approximately 24% (n = 75) of all participants refused vaccination (vaccine hesitant). Variables tested for an association with vaccination status demonstrated that age reached statistical significance. Emerging themes in the qualitative analysis included perceptions of vulnerability, vaccine safety and efficacy concerns, information gaps regarding vaccinations, the value of convenience in the decision to vaccinate, and the role of health promoters. CONCLUSIONS This study has shown that it is logistically acceptable to provide a vaccination site at a large hospital targeting patients attending outpatient services for chronic medical conditions. This service also benefits accompanying persons and hospital staff. Access and convenience of the vaccination site influence decision-making, increasing the opportunity to vaccinate. However, vaccine hesitancy is widespread with just under one-quarter of all those offered vaccinations remaining unvaccinated. Strengthening health education and patient-clinician engagement about the benefits of vaccination is essential to reach highly vulnerable populations routinely attending hospital outpatient departments with an appropriate vaccination program.
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Affiliation(s)
- Shanal Nair
- Steve Biko Academic Hospital, Pretoria 0001, South Africa; (K.T.); (D.B.); (F.A.)
- Department of Public Health Medicine, School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa
| | - Khanyisile Tshabalala
- Steve Biko Academic Hospital, Pretoria 0001, South Africa; (K.T.); (D.B.); (F.A.)
- Department of Public Health Medicine, School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa
| | - Nevilene Slingers
- Office of AIDS and TB Research, South African Medical Research Council, Pretoria 0001, South Africa; (N.S.); (L.V.)
| | - Lieve Vanleeuw
- Office of AIDS and TB Research, South African Medical Research Council, Pretoria 0001, South Africa; (N.S.); (L.V.)
| | - Debashis Basu
- Steve Biko Academic Hospital, Pretoria 0001, South Africa; (K.T.); (D.B.); (F.A.)
- Department of Public Health Medicine, School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa
| | - Fareed Abdullah
- Steve Biko Academic Hospital, Pretoria 0001, South Africa; (K.T.); (D.B.); (F.A.)
- Department of Public Health Medicine, School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa
- Office of AIDS and TB Research, South African Medical Research Council, Pretoria 0001, South Africa; (N.S.); (L.V.)
- Division of Infectious Diseases, Department of Internal Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa
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Kusi Amponsah A, Boateng EA, Armah J, Dompim JK, Gyamfi D, Lomotey A, Annobil FA, Amankrah AE, Youshah RA, Beauty EU, Diji F, Bam V. The psychosocial experiences of pregnant women in the early stages of the COVID-19 pandemic: A retrospective qualitative study. PLoS One 2024; 19:e0299219. [PMID: 38416742 PMCID: PMC10901345 DOI: 10.1371/journal.pone.0299219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 02/05/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Pregnant women are among the most vulnerable and suffer the most during pandemics, according to earlier studies. Pregnant women had to seek healthcare for both themselves and their unborn child(ren) in the wake of the COVID-19 pandemic, which was unprecedented. Pregnant women's psychosocial experiences during pandemics are crucial since they both directly and indirectly affect the course of pregnancy and childbirth. The study therefore sought to explore the psychosocial experiences of pregnant women during the COVID-19 pandemic. METHODS In this retrospective qualitative study, 15 nursing mothers who were attending a postnatal clinic at the Kwame Nkrumah University of Science and Technology (KNUST) hospital in Ghana were recruited. Individual interviews were conducted with mothers who were pregnant between March and December 2020. The audio-recorded interviews were transcribed verbatim and inductively analysed into themes. RESULTS Nursing mothers were aged 25-30 years and had infants ranging from 5 months to 15 months. Thirteen (13) were married and two were single. Two (2) major themes and five (5) subthemes emerged from the study. The unpleasant feelings connected to the potential for contracting COVID-19 and experiencing stress were described by the theme, "Fear and Stress". Participants' social experiences (support from significant others), alterations in daily routine and the economic impact because of the pandemic were presented as the "Socioeconomic impact". CONCLUSION Pregnant women go through several challenges during pregnancy such as perceived stress and anxiety. These are likely to heighten during a pandemic, as presented in the study. They therefore need emotional and psychosocial support in such uncertain times to improve outcomes of pregnancy.
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Affiliation(s)
- Abigail Kusi Amponsah
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Nursing Sciences, University of Turku, Turku, Finland
| | - Edward Appiah Boateng
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jerry Armah
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joana Kyei Dompim
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Douglas Gyamfi
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alberta Lomotey
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Faithful Adwoa Annobil
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Amena Ekua Amankrah
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Rifka Abdallah Youshah
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Elizabeth Uzoka Beauty
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Francis Diji
- Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- St. Martins Catholic Hospital, Kumasi, Ghana
| | - Victoria Bam
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Lapinsky SC, Baxter NN, Sutradhar R, Everett K, Porter J, Kwong JC, Fell DB, Snelgrove JW, Campbell DM, Simpson AN. A Population-Based Test-Negative Matched Case-Control Analysis of SARS-CoV-2 Vaccine Effectiveness Among Pregnant People in Ontario, Canada. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2024; 46:102239. [PMID: 37839731 DOI: 10.1016/j.jogc.2023.102239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE Pregnancy is a risk factor for severe SARS-CoV-2 infection, which can result in adverse pregnancy outcomes, thus making understanding vaccine effectiveness (VE) in this population important. This study aimed to assess the VE of mRNA COVID-19 vaccines against symptomatic SARS-CoV-2 infection and COVID-19-related hospitalization in pregnant people. METHODS Population-based matched test-negative case-control study of pregnant people aged 18-49 years, of 12 or more weeks gestation in Ontario, Canada, symptomatic with possible SARS-CoV-2 infection, and having at least 1 positive (n = 1842) or negative (n = 8524) real-time polymerase chain reaction (RT-PCR) SARS-CoV-2 test between December 14, 2020, and December 31, 2021. The exposure was receipt of ≥1 dose of mRNA COVID-19 vaccine versus no vaccination. Exposure was further stratified by number and recency of doses. The primary outcome was a positive SARS-CoV-2 RT-PCR test. As a secondary outcome, VE for COVID-19-related hospitalization was assessed. RESULTS In the primary outcome analysis, there were 1821 positive cases, matched to 1821 negative controls. The mean (SD) maternal age was 31 (5) years. When compared to those unvaccinated, receipt of ≥1 dose was associated with an estimated VE of 39% (95% CI 29%-48%) for symptomatic infection, and 85% (95% CI 72%-92%) for COVID-19 hospitalization. VE estimates demonstrated waning with increased time since last vaccination. CONCLUSIONS mRNA COVID-19 vaccines provide protection against symptomatic COVID-19 illness and are highly effective at preventing severe illness in pregnant people. The observed effect of vaccine waning highlights the importance of booster doses to provide optimal protection for pregnant people.
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Affiliation(s)
- Stephanie C Lapinsky
- Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Obstetrics and Gynecology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
| | - Nancy N Baxter
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Department of Surgery, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada; School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Rinku Sutradhar
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Karl Everett
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Joan Porter
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Jeffrey C Kwong
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Dalla Lana School of Public Health, Centre for Vaccine-Preventable Diseases, and Department of Family and Community Medicine, University of Toronto, ON, Canada; Public Health Ontario, Toronto, ON, Canada; University Health Network, Toronto, ON, Canada
| | - Deshayne B Fell
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada; Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada
| | - John W Snelgrove
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Maternal-Fetal Medicine, Mount Sinai Hospital, Department of Obstetrics & Gynaecology, University of Toronto, Toronto, ON, Canada
| | - Douglas M Campbell
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada; Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Pediatrics, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Andrea N Simpson
- Department of Obstetrics and Gynecology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada; Department of Obstetrics and Gynecology, St. Michael's Hospital/Unity Health Toronto, Toronto, ON, Canada
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5
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Madrid J, Agarwal P, Müller-Peltzer K, Askani M, Benning L, Selig M, Diehl P, Kalbhenn J, Trummer G, Utzolino S, Wengenmayer T, Busch HJ, Stolz D, Rieg S, Panning M, Schlett CL, Bamberg F, Askani E. Vaccination protects against acute respiratory distress syndrome (ARDS) in hospitalized patients with COVID-19. Clin Exp Med 2024; 24:21. [PMID: 38280024 PMCID: PMC10822002 DOI: 10.1007/s10238-023-01293-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/28/2023] [Indexed: 01/29/2024]
Abstract
This study aimed to analyze the effect of COVID-19 vaccination on the occurrence of ARDS in hospitalized COVID-19 patients. The study population of this retrospective, single-center cohort study consisted of hospitalized COVID-19 patients with known vaccination status and chest computed tomography imaging between July 2021 and February 2022. The impact of vaccination on ARDS in COVID-19 patients was assessed through logistic regression adjusting for demographic differences and confounding factors with statistical differences determined using confidence intervals and effect sizes. A total of 167 patients (69% male, average age 58 years, 95% CI [55; 60], 42% fully vaccinated) were included in the data analysis. Vaccinated COVID-19 patients had a reduced relative risk (RR) of developing ARDS (RR: 0.40, 95% CI [0.21; 0.62]). Consequently, non-vaccinated hospitalized patients had a 2.5-fold higher probability of developing ARDS. This risk reduction persisted after adjusting for several confounding variables (RR: 0.64, 95% CI [0.29; 0.94]) in multivariate analysis. The protective effect of COVID-19 vaccination increased with ARDS severity (RR: 0.61, 95% CI [0.37; 0.92]). Particularly, patients under 60 years old were at risk for ARDS onset and seemed to benefit from COVID-19 vaccination (RR: 0.51, 95% CI [0.20; 0.90]). COVID-19 vaccination showed to reduce the risk of ARDS occurrence in hospitalized COVID-19 patients, with a particularly strong effect in patients under 60 years old and those with more severe ARDS.
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Affiliation(s)
- Julian Madrid
- Department of Cardiology, Pneumology, Angiology, Acute Geriatrics and Intensive Care, Ortenau Klinikum, Klostenstraße 19, 77933, Lahr/Schwarzwald, Germany.
| | - Prerana Agarwal
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Katharina Müller-Peltzer
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Marvin Askani
- Department of Protestant Theology, Faculty of Theology, University of Heidelberg, Heidelberg, Germany
| | - Leo Benning
- University Emergency Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Mischa Selig
- G.E.R.N. Research Center for Tissue Replacement, Regeneration and Neogenesis, Department of Orthopedics and Trauma Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Philipp Diehl
- Department of Cardiology, Pneumology, Angiology, Acute Geriatrics and Intensive Care, Ortenau Klinikum, Klostenstraße 19, 77933, Lahr/Schwarzwald, Germany
| | - Johannes Kalbhenn
- Department of Anesthesiology and Intensive Care Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Georg Trummer
- Department of Cardiovascular Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Stefan Utzolino
- Department of General and Visceral Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tobias Wengenmayer
- Interdisciplinary Medical Intensive Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Hans-Jörg Busch
- University Emergency Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Daiana Stolz
- Clinic of Respiratory Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Siegbert Rieg
- Division of Infectious Diseases, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marcus Panning
- Institute of Virology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Esther Askani
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
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Shakibfar S, Zhao J, Li H, Nordeng H, Lupattelli A, Pavlovic M, Sandve GK, Nyberg F, Wettermark B, Hajiebrahimi M, Andersen M, Sessa M. Machine learning-driven development of a disease risk score for COVID-19 hospitalization and mortality: a Swedish and Norwegian register-based study. Front Public Health 2023; 11:1258840. [PMID: 38146473 PMCID: PMC10749372 DOI: 10.3389/fpubh.2023.1258840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/20/2023] [Indexed: 12/27/2023] Open
Abstract
Aims To develop a disease risk score for COVID-19-related hospitalization and mortality in Sweden and externally validate it in Norway. Method We employed linked data from the national health registries of Sweden and Norway to conduct our study. We focused on individuals in Sweden with confirmed SARS-CoV-2 infection through RT-PCR testing up to August 2022 as our study cohort. Within this group, we identified hospitalized cases as those who were admitted to the hospital within 14 days of testing positive for SARS-CoV-2 and matched them with five controls from the same cohort who were not hospitalized due to SARS-CoV-2. Additionally, we identified individuals who died within 30 days after being hospitalized for COVID-19. To develop our disease risk scores, we considered various factors, including demographics, infectious, somatic, and mental health conditions, recorded diagnoses, and pharmacological treatments. We also conducted age-specific analyses and assessed model performance through 5-fold cross-validation. Finally, we performed external validation using data from the Norwegian population with COVID-19 up to December 2021. Results During the study period, a total of 124,560 individuals in Sweden were hospitalized, and 15,877 individuals died within 30 days following COVID-19 hospitalization. Disease risk scores for both hospitalization and mortality demonstrated predictive capabilities with ROC-AUC values of 0.70 and 0.72, respectively, across the entire study period. Notably, these scores exhibited a positive correlation with the likelihood of hospitalization or death. In the external validation using data from the Norwegian COVID-19 population (consisting of 53,744 individuals), the disease risk score predicted hospitalization with an AUC of 0.47 and death with an AUC of 0.74. Conclusion The disease risk score showed moderately good performance to predict COVID-19-related mortality but performed poorly in predicting hospitalization when externally validated.
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Affiliation(s)
- Saeed Shakibfar
- Department of Drug Design and Pharmacology, Pharmacovigilance Research Center, University of Copenhagen, Copenhagen, Denmark
- Department of Drug Design and Pharmacology, Drug Safety Group, University of Copenhagen, Copenhagen, Denmark
| | - Jing Zhao
- Department of Pharmacy, Pharmacoepidemiology and Drug Safety Research Group, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
- UiO: RealArt Convergence Environment, University of Oslo, Oslo, Norway
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Huiqi Li
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hedvig Nordeng
- Department of Pharmacy, Pharmacoepidemiology and Drug Safety Research Group, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
- UiO: RealArt Convergence Environment, University of Oslo, Oslo, Norway
| | - Angela Lupattelli
- Department of Pharmacy, Pharmacoepidemiology and Drug Safety Research Group, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
- UiO: RealArt Convergence Environment, University of Oslo, Oslo, Norway
| | - Milena Pavlovic
- UiO: RealArt Convergence Environment, University of Oslo, Oslo, Norway
- Department of Informatics, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Geir Kjetil Sandve
- UiO: RealArt Convergence Environment, University of Oslo, Oslo, Norway
- Department of Informatics, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Björn Wettermark
- Department of Pharmacy, Pharmacoepidemiology and Social Pharmacy, Uppsala University, Uppsala, Sweden
| | | | - Morten Andersen
- Department of Drug Design and Pharmacology, Pharmacovigilance Research Center, University of Copenhagen, Copenhagen, Denmark
| | - Maurizio Sessa
- Department of Drug Design and Pharmacology, Drug Safety Group, University of Copenhagen, Copenhagen, Denmark
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Nkobetchou M, Leruez-Ville M, Guilleminot T, Roux N, Petrilli G, Guimiot F, Saint-Frison MH, Deryabin I, Ville Y, Faure-Bardon V. SARS-CoV-2 infection as cause of in-utero fetal death: regional multicenter cohort study. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023; 62:867-874. [PMID: 37519281 DOI: 10.1002/uog.27439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/27/2023] [Accepted: 07/07/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE Placental infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can lead to placental insufficiency and in-utero fetal death (IUFD). The objective of this study was to confirm and quantify the extent to which fetoplacental infection with SARS-CoV-2 is a cause of fetal death. METHODS This was a multicenter retrospective cohort study of fetal deaths that underwent postmortem examination between January 2020 and January 2022 in three fetal pathology units in Paris, France. All cases of IUFD and termination of pregnancy (TOP) occurring in 31 maternity hospitals in the Paris region undergo detailed placental pathological examination in these units. Databases were searched for cases of IUFD and TOP. Cases with fetal malformation or cytogenetic abnormality were excluded to avoid bias. We included cases of IUFD with a placental or undetermined cause and cases of TOP in the context of severe intrauterine growth restriction (IUGR). Placentas were sent to a single virology unit for reverse-transcription polymerase chain reaction (RT-PCR) testing by a single laboratory technician blinded to the initial postmortem examination report. Our primary endpoint was the proportion of positive placental SARS-CoV-2 RT-PCR tests in the cohort. RESULTS Among 147 722 deliveries occurring over 2 years, 788 postmortem examinations for IUFD and TOP for severe IUGR were recorded, of which 462 (58.6%) were included. A total of 13/462 (2.8%) placentas tested positive for SARS-CoV-2 by RT-PCR. Wild-type virus and alpha and delta variants were identified. All positive cases had histological lesions consistent with placental dysfunction. There was a strong correlation between SARS-CoV-2 placentitis and the presence of chronic intervillositis and/or massive fibrin deposits in the placenta. When both lesion types were present, the specificity and negative predictive value for the diagnosis of placental SARS-CoV-2 infection were 0.99 (95% CI, 0.98-1.00) and 0.96 (95% CI, 0.94-0.98), respectively. CONCLUSIONS At the height of the SARS-CoV-2 pandemic, the cause of more than half of fetal deaths in the Paris area was determined by postmortem analysis to be of placental or undetermined origin. Of these cases, 2.8% were due to placental SARS-CoV-2 infection with a specific pattern of histological involvement. This study highlights the need for SARS-CoV-2 screening in stillbirth assessment. The impact of vaccination coverage remains to be established. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M Nkobetchou
- EA 73-28, Paris Cité University, Necker University Hospital, Paris, France
- Maternity Department, Necker University Hospital, Paris, France
| | - M Leruez-Ville
- EA 73-28, Paris Cité University, Necker University Hospital, Paris, France
- Virology Department, Necker University Hospital, Paris, France
| | - T Guilleminot
- EA 73-28, Paris Cité University, Necker University Hospital, Paris, France
- Virology Department, Necker University Hospital, Paris, France
| | - N Roux
- Histopathology Department, Necker University Hospital, Paris, France
| | - G Petrilli
- Histopathology Department, Necker University Hospital, Paris, France
| | - F Guimiot
- Histopathology Department, Robert Debré Hospital, Paris, France
| | | | - I Deryabin
- Histopathology Department, Trousseau Hospital, Paris, France
| | - Y Ville
- EA 73-28, Paris Cité University, Necker University Hospital, Paris, France
- Maternity Department, Necker University Hospital, Paris, France
| | - V Faure-Bardon
- EA 73-28, Paris Cité University, Necker University Hospital, Paris, France
- Maternity Department, Necker University Hospital, Paris, France
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8
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Sourouni M, Germeyer A, Feißt M, Balzer A, Köster H, Minte A, Brüggmann D, Kohll C, Reinhardt K, Möginger M, Leonhardt A, Banz-Jansen C, Bohlmann M, Fröhlich C, Backes C, Hager D, Kaup L, Hollatz-Galuschki E, Engelbrecht C, Markfeld-Erol F, Hagenbeck C, Schäffler H, Winkler J, Stubert J, Rathberger K, Lüber L, Hertlein L, Machill A, Richter M, Berghäuser M, Weigel M, Morgen M, Horn N, Jakubowski P, Riebe B, Ramsauer B, Sczesny R, Schäfer-Graf UM, Schrey S, Kehl S, Lastinger J, Seeger S, Parchmann O, Iannaccone A, Rohne J, Gattung L, Morfeld CA, Abou-Dakn M, Schmidt M, Glöckner M, Jebens A, Sondern KM, Pecks U, Schmitz R, Möllers M. Multiple Gestation as a Risk Factor for SARS-CoV-2-Associated Adverse Maternal Outcome: Data From the COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS). Geburtshilfe Frauenheilkd 2023; 83:1508-1518. [PMID: 38046525 PMCID: PMC10689107 DOI: 10.1055/a-2196-6224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/22/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Studies have shown that pregnant women with COVID-19 have a higher risk of intensive care unit admission and invasive mechanical ventilation support than non-pregnant women. Pregnancy-associated physiological changes in respiratory function may contribute to the elevated risk. Alteration in lung volumes and capacities are attributed to the mechanical impediment caused by the growing fetus. Multiple pregnancies may therefore compromise functional lung capacity earlier than singleton pregnancies and contribute to severe respiratory symptoms of COVID-19. Materials and Methods A total of 5514 women with a symptomatic SARS-CoV-2 infection during pregnancy registered in the COVID-19 Related Obstetric and Neonatal Outcome Study were included. The COVID-19-related adverse maternal outcomes were compared in 165 multiple versus 5349 singleton pregnancies. Combined adverse maternal outcome was defined as presence of COVID-19-related hospitalization and/or pneumonia and/or oxygen administration and/or transfer to ICU and/or death. Multivariate logistic regression was used to estimate the odds ratios and 95% confidence intervals were calculated. Results The frequency of dyspnea, likelihood of developing dyspnea in a defined pregnancy week and duration of the symptomatic phase of the COVID-19 infection did not differ between the two groups. On average, COVID-19-related combined adverse outcome occurred earlier during pregnancy in women expecting more than one child than in singleton pregnancies. The overall incidence of singular and combined COVID-19-associated adverse maternal outcomes was not significantly different between groups. However, regression analysis revealed that multiple gestation, preconceptional BMI > 30 kg/m 2 and gestational age correlated significantly with an increased risk of combined adverse maternal outcome. Conversely, maternal age and medically assisted reproduction were not significant risk factors for combined adverse maternal outcome. Conclusion Our data show that multiple gestation alone is a risk factor for COVID-19-associated combined adverse maternal outcome. Moreover, severe courses of COVID-19 in women expecting more than one child are observed earlier in pregnancy than in singleton pregnancies.
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Affiliation(s)
- Marina Sourouni
- Gynäkologische Endokrinologie und Fertilitätsstörungen, University Hospital Heidelberg, Heidelberg, Germany
- Gynecology and Obstetrics, University Hospital Münster, Münster, Germany
| | - Ariane Germeyer
- Gynäkologische Endokrinologie und Fertilitätsstörungen, University Hospital Heidelberg, Heidelberg, Germany
| | - Manuel Feißt
- Universitätsklinikum Heidelberg, Institut für Medizinische Biometrie, Heidelberg, Germany
| | - Alexandra Balzer
- Universitätsklinikum Heidelberg, Institut für Medizinische Biometrie, Heidelberg, Germany
| | | | - Annemarie Minte
- Department of Obstetrics and Gynecology, Cristophorus Hospital, Coesfeld, Germany
| | - Dörthe Brüggmann
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Frankfurt, Frankfurt am Main, Germany
| | - Celine Kohll
- Gynäkologie und Geburtshilfe, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Kristin Reinhardt
- Geburtshilfe und Pränatalmedizin, Universitätsklinikum Halle, Halle, Germany
| | - Michaela Möginger
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Giessen und Marburg, Standort Marburg, Marburg, Germany
| | - Anja Leonhardt
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Chemnitz gGmbH, Chemnitz, Germany
| | - Constanze Banz-Jansen
- Gynäkologie und Geburtshilfe, Evangelisches Klinikum Bethel gGmbH, Bielefeld, Germany
| | - Michael Bohlmann
- Zentrum für Gynäkologie und Geburtshilfe, St. Elisabethen-Krankenhaus Lörrach gGmbH, Lörrach, Germany
| | | | - Clara Backes
- Klinik für Gynäkologie und Geburtshilfe, Schön Hospital Munich Harlaching, München, Germany
| | - Dietrich Hager
- Klinik für Gynäkologie und Geburtshilfe, Thüringen-Kliniken Saalfeld-Rudolstadt, Thüringen, Germany
| | - Lisa Kaup
- Dr. Geisenhofer Clinic for Gynecology and Obstetrics, München, Germany
| | | | | | | | - Carsten Hagenbeck
- Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany
| | - Hening Schäffler
- Klinik für Gynäkologie und Geburtshilfe, Ulm University Hospital, Ulm, Germany
| | - Jennifer Winkler
- Klinik und Poliklinik für Gynäkologie und Geburtshilfe, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Johannes Stubert
- Dept. of Gynecology and Obstetrics, University of Rostock, Rostock, Germany
| | - Katharina Rathberger
- Klinik für Frauenheilkunde und Geburtshilfe, Hospital St. Hedwig of the Order of St. John, Regensburg, Germany
| | - Laura Lüber
- Klinik für Gynäkologie und Geburtshilfe, Oberschwaben Hospital Group, Ravensburg, Germany
| | - Linda Hertlein
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, LMU, München, Germany
| | - Antonia Machill
- Department of Obstetrics and Gynecology, Vinzenz Pallotti Hospital, Bensberg, Germany
| | - Manuela Richter
- Neonatologie, Kinderkrankenhaus auf der Bult, Hannover, Germany
| | - Martin Berghäuser
- Klinik für Kinderheilkunde, Florence-Nightingale-Krankenhaus, Düsseldorf, Germany
| | - Michael Weigel
- Frauenklinik, Leopoldina-Krankenhaus der Stadt Schweinfurt GmbH, Schweinfurt, Germany
| | - Mirjam Morgen
- Klinik für Gynäkologie und Geburtshilfe, St. Vincenz-Krankenhaus, Datteln, Germany
| | - Nora Horn
- Klinik für Gynäkologie und Geburtshilfe, Sana Klinikum Lichtenberg, Berlin, Germany
| | - Peter Jakubowski
- Department of Gynecology and Obstetrics, University of Tübingen, Tübingen, Germany
| | - Bastian Riebe
- Klinik für Gynäkologie und Geburtshilfe, Klinikum Links der Weser gGmbH, Bremen, Germany
| | - Babett Ramsauer
- Klinik für Geburtsmedizin, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Robert Sczesny
- Klinik für Gynäkologie und Geburtshilfe, Marienhaus Hospital Saint Elisabeth Neuwied, Neuwied, Germany
| | | | - Susanne Schrey
- Abteilung für Geburtsmedizin, Uniklinik Leipzig, Leipzig, Germany
| | - Sven Kehl
- Gynecology & Obstetrics, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Julia Lastinger
- Gynecology, Obstetrics and Gynecological Endocrinology, Kepler University Hospital, Linz, Austria
| | - Sven Seeger
- Klinik für Geburtshilfe, Krankenhaus St. Elisabeth und St. Barbara Halle, Halle, Germany
| | - Olaf Parchmann
- Klinik für Gynäkologie und Geburtshilfe, HELIOS Hospital Sangerhausen, Sangerhausen, Germany
| | - Antonella Iannaccone
- Klinik für Gynäkologie und Geburtshilfe, University Hospital Essen, Essen, Germany
| | - Jens Rohne
- Klinik für Gynäkologie und Geburtshilfe, Maria Heimsuchung Caritas Klinik Pankow, Berlin, Germany
| | - Luise Gattung
- Klinik für Gynäkologie und Geburtshilfe, Bad Salzungen Hospital, Bad Salzungen, Germany
| | | | - Michael Abou-Dakn
- Klinik für Gynäkologie, St. Joseph Krankenhaus Berlin-Tempelhof, Berlin, Germany
| | - Markus Schmidt
- Gynecology & Obstetrics, Sana Kliniken Duisburg GmbH, Duisburg, Germany
| | - Michaela Glöckner
- Abteilung für Gynäkologie und Geburtshilfe, Hospital Memmingen, Memmingen, Germany
| | - Anja Jebens
- Abteilung für Gynäkologie und Geburtshilfe, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | | | | | - Ralf Schmitz
- Gynecology and Obstetrics, University Hospital Münster, Münster, Germany
| | - Mareike Möllers
- Gynecology and Obstetrics, University Hospital Münster, Münster, Germany
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9
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Sinaci S, Tanacan A, Besimoglu B, Menekse Beser D, Uyan Hendem D, Tugrul Ersak D, Atalay A, Kaya E, Ozden Tokalioglu E, Cankar Dal H, Ocal DF, Erdem D, Izdes S, Moraloglu Tekin O, Ates İ, Turan S, Sahin D. Adverse outcomes and maternal complications in pregnant women with severe-critical COVID-19: a tertiary center experience. J Perinat Med 2023; 51:874-885. [PMID: 37134274 DOI: 10.1515/jpm-2022-0564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/19/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES This study aimed to present perinatal outcomes, clinical challenges, and basic ICU management in pregnant women with severe-critical COVID-19 at our tertiary referral center. METHODS In this prospective cohort study, patients were divided into two groups, whether they survived or not. Clinical characteristics, obstetric and neonatal outcomes, initial laboratory test results and radiologic imaging findings, arterial blood gas parameters at ICU admission, and ICU complications and interventions were compared between groups. RESULTS 157 of the patients survived, and 34 of the patients died. Asthma was the leading health problem among the non-survivors. Fifty-eight patients were intubated, and 24 of them were weaned off and discharged healthfully. Of the 10 patients who underwent ECMO, only 1 survived (p<0.001). Preterm labor was the most common pregnancy complication. Maternal deterioration was the most common indication for a cesarean section. Higher neutrophil-to-lymphocyte-ratio (NLR) values, the need for prone positioning, and the occurrence of an ICU complication were important parameters that influenced maternal mortality (p<0.05). CONCLUSIONS Overweight pregnant women and pregnant women with comorbidities, especially asthma, may have a higher risk of mortality related to COVID-19. A worsening maternal health condition can lead to increased rates of cesarean delivery and iatrogenic prematurity.
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Affiliation(s)
- Selcan Sinaci
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Atakan Tanacan
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Berhan Besimoglu
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Dilek Menekse Beser
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Derya Uyan Hendem
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Duygu Tugrul Ersak
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Aysegul Atalay
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Ecem Kaya
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Eda Ozden Tokalioglu
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Hayriye Cankar Dal
- Clinic of Anaesthesiology and Reanimation, Department of Intensive Care, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Doga Fatma Ocal
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Deniz Erdem
- Clinic of Anaesthesiology and Reanimation, Department of Intensive Care, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- University of Health Sciences, Ankara City Hospital, Istanbul, Türkiye
| | - Seval Izdes
- Clinic of Anaesthesiology and Reanimation, Department of Intensive Care, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- University of Health Sciences, Ankara City Hospital, Istanbul, Türkiye
| | - Ozlem Moraloglu Tekin
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- General Internal Medicine, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - İhsan Ates
- General Internal Medicine, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- University of Health Sciences, Ankara City Hospital, Istanbul, Türkiye
| | - Sema Turan
- Clinic of Anaesthesiology and Reanimation, Department of Intensive Care, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- University of Health Sciences, Ankara City Hospital, Istanbul, Türkiye
| | - Dilek Sahin
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- University of Health Sciences, Ankara City Hospital, Istanbul, Türkiye
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10
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Boustani P, Eslamian L, Aleyasin A, Jamal A, Eshraghi N, Ghaemi M. Maternal and perinatal outcomes in pregnant women with COVID-19 in a referral academic center in Iran. Int J Reprod Biomed 2023; 21:767-769. [PMID: 37969564 PMCID: PMC10643680 DOI: 10.18502/ijrm.v21i9.14403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 04/18/2023] [Accepted: 06/11/2023] [Indexed: 11/17/2023] Open
Abstract
The Article Abstract is not available.
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Affiliation(s)
- Paria Boustani
- Student Research Committee, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Laleh Eslamian
- Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ashraf Aleyasin
- Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ashraf Jamal
- Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Eshraghi
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Marjan Ghaemi
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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11
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Frallonardo L, Vimercati A, Novara R, Lepera C, Ferrante I, Chiarello G, Cicinelli R, Mongelli M, Brindicci G, Segala FV, Santoro CR, Bavaro DF, Laforgia N, Cicinelli E, Saracino A, Di Gennaro F. Use of Sotrovimab in a cohort of pregnant women with a high risk of COVID 19 progression: a single-center experience. Pathog Glob Health 2023; 117:513-519. [PMID: 36896940 PMCID: PMC10262799 DOI: 10.1080/20477724.2023.2188839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
Neutralizing monoclonal antibodies (mAbs) have been shown to reduce disease progression in patients with underlying predisposing conditions. Unfortunately, there is no evidence on the use of Sotrovimab in pregnant women. Herein we present a case series of pregnant women who received mAbs with Sotrovimab following the Italian Drug Agency (AIFA) indications. Since February 1, 2022 all pregnant women - regardless of gestational age - admitted to Obstetrics & Gynaecology of Policlinico University of Bari, with positive nasopharyngeal NAAT for SARS-CoV-2 were screened according to the AIFA indications for Sotrovimab and, if eligible, were proposed for treatment. Data on COVID-19, pregnancy, delivery, newborn outcomes, and adverse events were collected. From February 1 to May 15, 2022, 58 pregnant women were screened. Fifty (86%) patients were eligible, 19 of them (32.7%) denied their consent, in 18 cases (31%), the drug was temporarily unavailable, and the remaining 13 (22%) were treated with Sotrovimab. Out of these 13 patients, 6 (46%) were in the 3rd and 7 (54%) in the 2nd trimester of pregnancy. None of the 13 patients experienced adverse reactions due to Sotrovimab and all had a good clinical outcome. Furthermore, evaluating pre- and post-infusion clinical status and hematochemical profile, a reduction in D-dimers and an increase in SARS-CoV-2 antibodies (p < 0.01) during the 72 h following the infusion were observed. Our data, the first on the use of Sotrovimab in pregnant women, showed the safety and efficacy drug profile and its potential crucial role in preventing COVID-19 disease progression.
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Affiliation(s)
- Luisa Frallonardo
- Clinic of Infectious Diseases, University of "Aldo Moro" Department of Precision and Regenerative Medicine and Ionian Area - (DiMePRe-J), University of Bari "Aldo Moro", Piazza Giulio Cesare n. 11 Cap, Bari, Italy
| | | | - Roberta Novara
- Clinic of Infectious Diseases, University of "Aldo Moro" Department of Precision and Regenerative Medicine and Ionian Area - (DiMePRe-J), University of Bari "Aldo Moro", Piazza Giulio Cesare n. 11 Cap, Bari, Italy
| | - Cherola Lepera
- Clinic of Obstetrics & Gynaecology, University of "Aldo Moro", Bari, Italy
| | - Ilaria Ferrante
- Clinic of Obstetrics & Gynaecology, University of "Aldo Moro", Bari, Italy
| | - Giulia Chiarello
- Clinic of Obstetrics & Gynaecology, University of "Aldo Moro", Bari, Italy
| | - Rossana Cicinelli
- Clinic of Obstetrics & Gynaecology, University of "Aldo Moro", Bari, Italy
| | - Michele Mongelli
- Clinic of Obstetrics & Gynaecology, University of "Aldo Moro", Bari, Italy
| | - Gaetano Brindicci
- Clinic of Infectious Diseases, University of "Aldo Moro" Department of Precision and Regenerative Medicine and Ionian Area - (DiMePRe-J), University of Bari "Aldo Moro", Piazza Giulio Cesare n. 11 Cap, Bari, Italy
| | - Francesco Vladimiro Segala
- Clinic of Infectious Diseases, University of "Aldo Moro" Department of Precision and Regenerative Medicine and Ionian Area - (DiMePRe-J), University of Bari "Aldo Moro", Piazza Giulio Cesare n. 11 Cap, Bari, Italy
| | - Carmen Rita Santoro
- Clinic of Infectious Diseases, University of "Aldo Moro" Department of Precision and Regenerative Medicine and Ionian Area - (DiMePRe-J), University of Bari "Aldo Moro", Piazza Giulio Cesare n. 11 Cap, Bari, Italy
| | - Davide Fiore Bavaro
- Clinic of Infectious Diseases, University of "Aldo Moro" Department of Precision and Regenerative Medicine and Ionian Area - (DiMePRe-J), University of Bari "Aldo Moro", Piazza Giulio Cesare n. 11 Cap, Bari, Italy
| | - Nicola Laforgia
- U.O.C. Neonatology and NICU Policlinico Bari, University of Bari "Aldo Moro", Bari, Italy
| | - Ettore Cicinelli
- Clinic of Obstetrics & Gynaecology, University of "Aldo Moro", Bari, Italy
| | - Annalisa Saracino
- Clinic of Infectious Diseases, University of "Aldo Moro" Department of Precision and Regenerative Medicine and Ionian Area - (DiMePRe-J), University of Bari "Aldo Moro", Piazza Giulio Cesare n. 11 Cap, Bari, Italy
| | - Francesco Di Gennaro
- Clinic of Infectious Diseases, University of "Aldo Moro" Department of Precision and Regenerative Medicine and Ionian Area - (DiMePRe-J), University of Bari "Aldo Moro", Piazza Giulio Cesare n. 11 Cap, Bari, Italy
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12
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Losier A, Gupta G, Caldararo M, Dela Cruz CS. The Impact of Coronavirus Disease 2019 on Viral, Bacterial, and Fungal Respiratory Infections. Clin Chest Med 2023; 44:407-423. [PMID: 37085229 PMCID: PMC9968485 DOI: 10.1016/j.ccm.2022.11.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Although coronavirus disease 2019 (COVID-19) remains an ongoing threat, concerns regarding other respiratory infections remain. Throughout the COVID-19 pandemic various epidemiologic trends have been observed in other respiratory viruses including a reduction in influenza and respiratory syncytial virus infections following onset of the COVID-19 pandemic. Observations suggest that infections with other respiratory viruses were reduced with social distancing, mask wearing, eye protection, and hand hygiene practices. Coinfections with COVID-19 exist not only with other respiratory viruses but also with bacterial pneumonias and other nosocomial and opportunistic infections. Coinfections have been associated with increased severity of illness and other adverse outcomes.
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Affiliation(s)
- Ashley Losier
- Department of Internal Medicine, Section of Pulmonary and Critical Care Medicine, Yale University School of Medicine, New Haven, CT 06511, USA.
| | - Gayatri Gupta
- Department of Internal Medicine, Section of Pulmonary and Critical Care Medicine, Yale University School of Medicine, New Haven, CT 06511, USA
| | - Mario Caldararo
- Veteran's Affairs Connecticut Healthcare System, West Haven, CT 06516, USA
| | - Charles S Dela Cruz
- Department of Internal Medicine, Section of Pulmonary and Critical Care Medicine, Yale University School of Medicine, New Haven, CT 06511, USA
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13
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Acceptance and Risk Perception of COVID-19 Vaccination among Pregnant and Non Pregnant Women in Sub-Saharan Africa: A Cross-Sectional Matched-Sample Study. Vaccines (Basel) 2023; 11:vaccines11020484. [PMID: 36851361 PMCID: PMC9964765 DOI: 10.3390/vaccines11020484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/16/2023] [Accepted: 02/18/2023] [Indexed: 02/22/2023] Open
Abstract
This study aims to evaluate the acceptance and risk perception of pregnant and non pregnant women towards COVID-19 vaccines using a cross-sectional matched-sample study approach. A web-based questionnaire with closed- and open-ended questions was administered to adults older than 18 years in the sub-Saharan African (SSA) region. Respondents (n = 131) were grouped based on their pregnancy status (54 pregnant and 77 non pregnant women) and matched for comparison by age. The matched groups were compared using the chi-square test and the t-test where appropriate. Compared to non pregnant women, pregnant women reported significantly lower risk perception scores of COVID-19 infection (3.74 vs. 5.78, p < 0.001) and were less likely to take the COVID-19 vaccine (odds ratio = 0.12, 95% confidence interval (CI) 0.06-0.27, p < 0.001). A similar proportion of pregnant and non pregnant women believed in false information about the COVID-19 vaccine, and 40% of unvaccinated pregnant women (n = 40) were concerned about the safety of the vaccine. After adjustment, women's education, marital status, belief in misconceptions and risk perception were associated with non-vaccination among pregnant women. The content analysis revealed that pregnant women refused the vaccine due to mistrust of their countries' health systems, concerns about the country where the vaccines were manufactured and a lack of confidence in the production process of the vaccines. This study shows the poor acceptance of COVID-19 vaccines among pregnant women in SSA, who perceived a lower risk of COVID-19 infection. Understanding the reasons for non-acceptance and the motivation to accept the COVID-19 vaccine could guide the development of health education and promotion programmes, and aid governments and policymakers in implementing targeted policy changes.
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Wainstock T, Sergienko R, Orenshtein S, Sheiner E. Factors associated with COVID-19 vaccination likelihood during pregnancy. Int J Gynaecol Obstet 2023; 161:478-484. [PMID: 36651802 DOI: 10.1002/ijgo.14680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 11/12/2022] [Accepted: 01/13/2023] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To identify maternal background, medical and gynecological characteristics associated with COVID-19 vaccination likelihood, in the context where COVID-19 vaccination rates among pregnant women are significantly lower than the general population. METHODS In a retrospective cohort study, including all women who delivered between January and September 2021, background and medical history, including current and previous pregnancies diagnoses, were compared between vaccinated and unvaccinated women. Multivariable logistic models were used to identify factors associated with vaccination for the entire population, and for the two distinctive populations included in the study (Bedouin Arabs and Jewish women). RESULTS The study population included 7017 women, of whom 1925 (27.4%) were vaccinated during pregnancy. According to the multivariable analysis, unvaccinated mothers were younger with lower socioeconomic score. They were more likely to be Bedouin Arabs, have a poor obstetrical history or recurrent pregnancy loss, and insufficient prenatal care. Additional risk factors were inconsistent between the two ethnicities included in the study. CONCLUSIONS Ethnicity, insufficient prenatal care, and having a poor obstetric history were consistently associated with lower vaccination among pregnant women. These factors should be considered in future plans aimed at increasing vaccination among pregnant women.
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Affiliation(s)
- Tamar Wainstock
- Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ruslan Sergienko
- Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Shani Orenshtein
- Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Descriptive analysis of deaths associated with COVID-19 in Fiji, 15 April to 14 November 2021. Western Pac Surveill Response J 2022; 13:1-8. [PMID: 36817498 PMCID: PMC9912270 DOI: 10.5365/wpsar.2022.13.4.964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective There is limited published information about deaths due to coronavirus disease 2019 (COVID-19) in Fiji, the World Health Organization's Western Pacific Region and low- and middle-income countries. This report descriptively analyses deaths directly associated with COVID-19 in Fiji by age group, sex, ethnicity, geographical location, vaccination status and place of death for the first 7 months of the 2021 community outbreak. Methods A retrospective analysis was conducted of deaths directly associated with COVID-19 that occurred from 15 April to 14 November 2021 in Fiji. Death rates per 100 000 population were calculated by using divisional population estimates obtained from medical zone nurses in 2021. Results A total of 1298 deaths relating to COVID-19 were reported, with 696 directly associated with COVID-19 and therefore included in the analysis. Of these, 71.1% (495) were reported from the Central Division, 54.6% (380) occurred among males, 75.6% (526) occurred among people of indigenous (iTaukei) ethnicity and 79.5% (553) occurred among people who were unvaccinated. Four deaths were classified as maternal deaths. The highest percentage of deaths occurred in those aged 370 years (44.3%, 308), and the majority of deaths (56.6%, 394) occurred at home. Discussion At-risk populations for COVID-19 mortality in Fiji include males, iTaukei peoples, and older (370 years) and unvaccinated individuals. A high proportion of deaths occurred either at home or during the first 2 days of hospital admission, potentially indicating both a reluctance to seek medical care and a health-care system that was stressed during the peak of the outbreak.
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Iacob D, Enatescu I, Dima M, Bernad E, Pantea M, Bozgan D, Bernad S, Craina M. First Neonates with Vertical Transmission of SARS-CoV-2 Infection in Late Pregnancy in West Part of Romania: Case Series. Diagnostics (Basel) 2022; 12:diagnostics12071668. [PMID: 35885572 PMCID: PMC9324313 DOI: 10.3390/diagnostics12071668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 07/03/2022] [Accepted: 07/07/2022] [Indexed: 12/26/2022] Open
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic has exposed the vulnerable neonatal population to unknown risks. Given that herd immunity is has not been reached, the entire population is susceptible to Severe Acute Respiratory Syndrome Coronavirus 2 Virus(SARS-CoV-2) infection. The arising concern about the vertical transmission of neonatal complications caused by the novel coronavirus is a continuous challenge for managing newborns, considering the rare cases and unclear guidelines. Therefore, a retrospective study was conducted in a tertiary unit from Timisoara, Romania. Of the 283 newborns born during the study period, only 3 neonates were diagnosed with SARS-CoV-2 infection in the first 24 h of life (DOL-0). The present study plans to identify the findings, including clinical features, laboratory characteristics, and outcomes of newborns with vertical transmission of SARS-CoV-2. All infected neonates were confirmed with COVID-19 by Reverse-Transcriptase Polymerase Chain Reaction (RT-PCR) from nasal aspirates and were isolated in the neonatology department. They were the first and the only neonate infected at birth from the West part of Romania. The clinical findings were unremarkable except for one neonate who developed mild respiratory distress syndrome. Elevated IgG-specific anti-SARS-CoV-2 serum levels were found in one newborn. Swab samples in DOL-0 strengthened the awareness of vertical transmission, although peripartum SARS-CoV-2 infection does not seem responsible for severe symptoms. We conclude that vertical transmission is rare in late pregnancy. Even if the studied newborns showed mild forms of COVID-19, it is essential to note that newborns represent a particular category of patients. More studies are needed to complete the observations of this study.
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Affiliation(s)
- Daniela Iacob
- Department of Neonatology, “Victor Babes” University of Medicine and Pharmacy, EftimieMurgu Square no 2, 300041 Timisoara, Romania; (D.I.); (I.E.); (M.D.); (M.P.)
| | - Ileana Enatescu
- Department of Neonatology, “Victor Babes” University of Medicine and Pharmacy, EftimieMurgu Square no 2, 300041 Timisoara, Romania; (D.I.); (I.E.); (M.D.); (M.P.)
| | - Mirabela Dima
- Department of Neonatology, “Victor Babes” University of Medicine and Pharmacy, EftimieMurgu Square no 2, 300041 Timisoara, Romania; (D.I.); (I.E.); (M.D.); (M.P.)
| | - Elena Bernad
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, EftimieMurgu Square no 2, 300041 Timisoara, Romania;
- Correspondence:
| | - Manuela Pantea
- Department of Neonatology, “Victor Babes” University of Medicine and Pharmacy, EftimieMurgu Square no 2, 300041 Timisoara, Romania; (D.I.); (I.E.); (M.D.); (M.P.)
| | - Daiana Bozgan
- Clinic of Neonatology, “PiusBrinzeu” County Emergency Hospital, 300723 Timisoara, Romania;
| | - Sandor Bernad
- Romanian Academy Timisoara Branch, Mihai Viteazul Avenue, 24, 300275 Timisoara, Romania;
| | - Marius Craina
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, EftimieMurgu Square no 2, 300041 Timisoara, Romania;
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The Benefits of Vaccination against SARS-CoV-2 during Pregnancy in Favor of the Mother/Newborn Dyad. Vaccines (Basel) 2022; 10:vaccines10060848. [PMID: 35746456 PMCID: PMC9228905 DOI: 10.3390/vaccines10060848] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/16/2022] [Accepted: 05/24/2022] [Indexed: 12/14/2022] Open
Abstract
When the first vaccines against SARS-CoV-2 emerged, pregnant women were excluded from clinical trials, so vaccine recommendations were initially adjourned, with late initiation for this populational category. The present study aims to quantify the serum and breastmilk values of SARS-CoV-2 spike protein antibodies in both the mother and her newborn after complete vaccination during pregnancy. Ninety-one vaccinated patients were included, some of whom presented COVID-19 infection during pregnancy. In the delivery room, venous blood was collected from the mother and umbilical cord blood from her offspring. All samples were processed using the ECLIA (electrochemiluminescence) method. Breastmilk was collected and tested during the third postnatal day. The highest maternal serum values were 19,523 U/mL (detection limit > 0.8 U/mL) and in breastmilk, 206.7 U/mL. Every single newborn had antibody values higher than 0, with a mean serum value (M = 5288.37, SD = 5661.49) significantly higher than 0, t(90) = 8.91, p < 0.001. Consequently, this study intents to emphasize the importance of vaccination against SARS-CoV-2 during pregnancy. This double kind of neonatal protection, attained by placental and breastmilk transfer, can be accomplished by encouraging vaccination, breastfeeding, bonding, and providing maternal empowerment to participate in her infant’s care.
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Cao H, Abd Aziz NH, Xavier JR, Shafiee MN, Kalok A, Jee B, Salker MS, Singh Y. Dysregulated Exosomes Result in Suppression of the Immune Response of Pregnant COVID-19 Convalescent Women. Front Mol Biosci 2022; 9:869192. [PMID: 35647028 PMCID: PMC9136085 DOI: 10.3389/fmolb.2022.869192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/11/2022] [Indexed: 12/28/2022] Open
Abstract
A successful pregnancy outcome is dependent on a delicate balance between inflammatory and anti-inflammatory processes throughout the different trimesters. Interruption in this balance can lead to an adverse outcome resulting in pregnancy loss. Since late 2019, the emergence of the new SARS-CoV-2 virus has affected lives worldwide, including pregnant women; therefore, there is an urgent need to address different approaches in relation to prevention, diagnostics, and therapeutics. Early pregnancy is affected by SARS-CoV-2 infection leading to fetal demise. Available evidence also suggests that 90% of pregnant women infected with the SARS-CoV-2 virus seem to be asymptomatic. Nonetheless, it is still unclear how COVID-19 affects exosome production in pregnant women recovered from COVID-19 and how these exosomes regulate the adaptive immune response. In this study, we found several exosomes including CD9, CD31, CD40, CD45, CD41b, CD42a, CD62P, CD69, CD81, CD105, and HLA-DRDPDQ in the plasma of COVID-19-recovered pregnant women were significantly less abundant than the control group. Furthermore, to understand how these exosomes affect the adaptive immune response, we co-cultured the peripheral blood mononuclear cells (PBMCs) from healthy control (HC) pregnant women with exosomes of either Preg-HC or Preg-recovered COVID-19 women. We identified that Preg-recovered COVID-19 women have reduced capacity for the inflammatory cytokine TNF-α from cytotoxic CD8+ T cells. In summary, our study highlights that pregnant recovered COVID-19 women have reduced production of several exosomes and possess fewer immunogenic properties. Our study implicates that exosomes can control inflammation and antigen presentation capacity of immune cells, thus limiting the infection in pregnant women.
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Affiliation(s)
- Hang Cao
- Department of Women’s Health, Research Institute for Women’s Health, University of Tübingen, Tübingen, Germany
| | - Nor Haslinda Abd Aziz
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Janet Raja Xavier
- Department of Women’s Health, Research Institute for Women’s Health, University of Tübingen, Tübingen, Germany
| | - Mohamad Nasir Shafiee
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Aida Kalok
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Babban Jee
- Department of Health Research, Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - Madhuri S. Salker
- Department of Women’s Health, Research Institute for Women’s Health, University of Tübingen, Tübingen, Germany
| | - Yogesh Singh
- Department of Women’s Health, Research Institute for Women’s Health, University of Tübingen, Tübingen, Germany
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
- NGS Competence Centre Tübingen (NCCT), University of Tübingen, Tübingen, Germany
- *Correspondence: Yogesh Singh,
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19
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Adverse Mental Health Sequelae of COVID-19 Pandemic in the Pregnant Population and Useful Implications for Clinical Practice. J Clin Med 2022; 11:jcm11082072. [PMID: 35456165 PMCID: PMC9032065 DOI: 10.3390/jcm11082072] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/31/2022] [Accepted: 04/03/2022] [Indexed: 02/05/2023] Open
Abstract
The COVID-19 pandemic has increased risk of disturbances in the functioning of everyday life, directly or indirectly has influenced the risk of mental disorders in the most vulnerable populations, including pregnant women. The aim of this study was to analyze adverse mental health effects in the pregnant population during the COVID-19 pandemic, investigate risk factors for adverse mental health outcomes, identify protective factors, and create practical implications for clinical practice, bearing in mind the need to improve perinatal mental healthcare during such pandemics. Qualitative research was conducted in the electronic databases PubMed and Web of Sciences for the keywords COVID-19, pregnancy, depression, anxiety, and telemedicine for relevant critical articles (n = 3280) published from 2020 until October 2021, outlining the outcomes of control studies, meta-analysis, cross-sectional studies, face-to-face evaluation survey studies, remotely administered survey studies, and observational studies regarding the main topic; all were evaluated. Mental health problems among pregnant women linked to the COVID-19 pandemic, in most cases, show symptoms of depression, anxiety, insomnia, and PTSD and may cause adverse outcomes in pregnancy and fetus and newborn development, even at later stages of life. Therefore, useful implications for clinical practice for improving the adverse mental health outcomes of pregnant women associated with the COVID-19 pandemic are highly desirable. Our research findings support and advocate the need to modify the scope of healthcare provider practice in the event of a disaster, including the COVID-19 pandemic, and may be implemented and adopted by healthcare providers as useful implications for clinical practice.
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20
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Citu IM, Citu C, Margan MM, Craina M, Neamtu R, Gorun OM, Burlea B, Bratosin F, Rosca O, Grigoras ML, Motoc A, Malita D, Neagoe O, Gorun F. Calcium, Magnesium, and Zinc Supplementation during Pregnancy: The Additive Value of Micronutrients on Maternal Immune Response after SARS-CoV-2 Infection. Nutrients 2022; 14:nu14071445. [PMID: 35406057 PMCID: PMC9003126 DOI: 10.3390/nu14071445] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 02/04/2023] Open
Abstract
Magnesium may contribute to the immune response during and after SARS-CoV-2 infection by acting as a cofactor for immunoglobulin production and other processes required for T and B cell activity. Considering magnesium as a recommended dietary supplement during pregnancy and the possible role of magnesium deficiency in COVID-19 and its complications, the current study sought to determine the effect of magnesium and magnesium-containing nutritional supplements on the immune response following SARS-CoV-2 infection in pregnant women, as well as to observe differences in pregnancy outcomes based on the supplements taken during pregnancy. The study followed a cross-sectional design, where patients with a history of SARS-CoV-2 infection during their pregnancy were surveyed for their preferences in nutritional supplementation and their profile compared with existing records from the institutional database. A cohort of 448 pregnant women with COVID-19 during 22 months of the pandemic was assembled, out of which 13.6% took a magnesium-only supplement, and 16.5% supplemented their diet with a combination of calcium, magnesium, and zinc. Around 60% of patients in the no-supplementation group had the SARS-CoV-2 anti-RBD lower than 500 U/mL, compared with 50% in those who took magnesium-based supplements. A quantity of magnesium >450 mg in the taken supplements determined higher levels of antibody titers after COVID-19. Low magnesium dosage (<450 mg) was an independent risk factor for a weak immune response (OR-1.25, p-value = 0.003). The observed findings suggest supplementing the nutritional intake of pregnant women with magnesium-based supplements to determine higher levels of SARS-CoV-2 anti-RBD antibodies, although causality remains unclear.
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Affiliation(s)
- Ioana Mihaela Citu
- Department of Internal Medicine I, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Cosmin Citu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
- Correspondence: ; Tel.: +40-(722)-322-877
| | - Madalin-Marius Margan
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
| | - Marius Craina
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
| | - Radu Neamtu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
| | - Oana Maria Gorun
- Department of Obstetrics and Gynecology, Municipal Emergency Clinical Hospital Timisoara, 300202 Timisoara, Romania; (O.M.G.); (B.B.)
| | - Bogdan Burlea
- Department of Obstetrics and Gynecology, Municipal Emergency Clinical Hospital Timisoara, 300202 Timisoara, Romania; (O.M.G.); (B.B.)
| | - Felix Bratosin
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (F.B.); (O.R.)
| | - Ovidiu Rosca
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (F.B.); (O.R.)
| | - Mirela Loredana Grigoras
- Department of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.L.G.); (A.M.)
| | - Andrei Motoc
- Department of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.L.G.); (A.M.)
| | - Daniel Malita
- Department of Radiology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Octavian Neagoe
- First Department of Surgery, Second Discipline of Surgical Semiology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Florin Gorun
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
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The Risk of Spontaneous Abortion Does Not Increase Following First Trimester mRNA COVID-19 Vaccination. J Clin Med 2022; 11:jcm11061698. [PMID: 35330023 PMCID: PMC8955378 DOI: 10.3390/jcm11061698] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 02/01/2023] Open
Abstract
Clinical trials for COVID-19 vaccines initially excluded pregnant women due to safety concerns, and when the vaccines were authorized for emergency use, they were not recommended for this population. However, observational studies discovered that pregnant women infected with COVID-19 have higher risks of negative pregnancy and delivery outcomes compared to non-pregnant women, raising the question of the risks–benefits of administering COVID-19 vaccines to pregnant women. By mid-2021, there was general consensus on the relative safety of COVID-19 vaccination during pregnancy; therefore, it is critical to investigate the safety issues related to these vaccines, considering the increasing acceptance among pregnant women. To address these concerns, we developed a research project to study the short-term effects and outcomes of COVID-19 vaccination during the first trimester of pregnancy. Our research followed an observational retrospective design for 12 months from the beginning of the vaccination campaign, and included 124 cases of spontaneous abortions and 927 ongoing pregnancies. The odds of spontaneous abortion were non-significant for both versions of the mRNA vaccine (Pfizer BNT162b2 AOR = 1.04, CI = 0.91–1.12; Moderna mRNA-1273 AOR = 1.02, CI = 0.89–1.08). Overall, our data indicated that the risk of spontaneous abortion after mRNA COVID-19 immunization during the first trimester of pregnancy is commensurate with the predicted risk in non-vaccinated pregnant women. These findings contribute to the growing body of information regarding the safety of mRNA COVID-19 vaccination during pregnancy.
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22
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Immunogenicity Following Administration of BNT162b2 and Ad26.COV2.S COVID-19 Vaccines in the Pregnant Population during the Third Trimester. Viruses 2022; 14:v14020307. [PMID: 35215900 PMCID: PMC8878278 DOI: 10.3390/v14020307] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/28/2022] [Accepted: 02/01/2022] [Indexed: 02/04/2023] Open
Abstract
Globally, COVID-19 vaccines are currently being used to prevent transmission and to reduce morbidity and death associated with SARS-CoV-2 infection. Current research reveals that vaccines such as BNT162b2 and Ad26.COV2.S are highly immunogenic and have high short-term effectiveness for most of the known viral variants. Clinical trials showed satisfying results in the general population, but the reluctance in testing and vaccinating pregnant women left this category with little evidence regarding the safety, efficacy, and immunogenicity following COVID-19 vaccination. With the worldwide incidence of COVID-19 remaining high and the possibility of new transmissible SARS-CoV-2 mutations, data on vaccination effectiveness and antibody dynamics in pregnant patients are critical for determining the need for special care or further booster doses. An observational study was developed to evaluate pregnant women receiving the complete COVID-19 vaccination scheme using the BNT162b2 and Ad26.COV2.S, and determine pregnancy-related outcomes in the mothers and their newborns, as well as determining adverse events after vaccination and immunogenicity of vaccines during four months. There were no abnormal findings in pregnancy and newborn characteristics comparing vaccinated versus unvaccinated pregnant women. COVID-19 seropositive pregnant women had significantly higher spike antibody titers than seronegative patients with similar characteristics, although they were more likely to develop fever and lymphadenopathy following vaccination. The same group of pregnant women showed no statistically significant differences in antibody titers during a 4-month period when compared with case-matched non-pregnant women. The BNT162b2 and Ad26.COV2.S vaccines are safe to administer during the third trimester of pregnancy, while their safety, efficacy, and immunogenicity remain similar to those of the general population.
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Almazari I, Bdeir R, Basheer HA. Evaluation of Jordan's citizens' awareness of the emerging Coronavirus (COVID-19) disease: A mixed analysis of the symptoms, transmission, and preventive measures. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001041. [PMID: 36962653 PMCID: PMC10022341 DOI: 10.1371/journal.pgph.0001041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 08/31/2022] [Indexed: 11/18/2022]
Abstract
This study aimed to evaluate Jordan citizens' awareness, knowledge, and practice concerning Coronavirus-19 (COVID-19) symptoms, routes of transmission, and preventive measures. An online self-administered questionnaire was filled out completely by participants (N = 328) from mainly four major cities in Jordan during the period beginning of May-end of September 2020. Participants' main sources of knowledge about COVID-19 were the government websites (87.8%), social media (87.5%), and Television (TV) (81.1%). The majority of participants valued the drizzle of cough from infected individuals (96.3%), direct contact with contaminated surfaces (91.5%), and direct contact with infected individuals (84.5%) as the highest rates of the route of transmission. The highest rates chosen as symptoms of COVID-19 viral infections were high-grade fever (99.1%), troublesome breathing (96.6%), coughing (92.7%), headache (91.2%), and loss of smell and taste (80.8%). The majority of participants (>92%) strongly agreed on the behavioral protective measures such as no face touching, wearing a mask, the use of alcoholic hand disinfectants, and the need for self-isolation. This study showed that the Jordanian citizens were aware of the epidemiology of COVID-19 and related infection preventive measures. This agrees well with the efforts done by the Ministry of health and governmental organizations to spread the necessary information about the virus among citizens.
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Affiliation(s)
- Inas Almazari
- Department of Clinical Pharmacy, Faculty of Pharmacy, Zarqa University, Zarqa, Jordan
| | - Roba Bdeir
- Faculty of Pharmacy, Jadara University, Irbid, Jordan
| | - Haneen A Basheer
- Department of Clinical Pharmacy, Faculty of Pharmacy, Zarqa University, Zarqa, Jordan
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24
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Bewley DJ, Lee J, Popescu O, Oviedo A. SARS-CoV-2 Placental Infection in an Unvaccinated Mother Resulting in Fetal Demise. Cureus 2021; 13:e20833. [PMID: 35141086 PMCID: PMC8800441 DOI: 10.7759/cureus.20833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2021] [Indexed: 12/31/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnancy may have devastating complications including fetal demise. Here, we describe a case of SARS-CoV-2 infection in a second-trimester pregnancy. The placenta demonstrated the presence of SARS-CoV-2 viral RNA along with intervillositis and perivillous fibrin deposition. SARS-CoV-2 directly infects the trophoblastic cells of the placenta through the angiotensin-converting enzyme 2 receptor. This case report details the clinical history of a SARS-CoV-2-infected pregnancy with fetal demise. In addition, we show the images of the placental pathology and SARS-CoV-2 RNA in situ studies.
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Affiliation(s)
- Dominic J Bewley
- Pathology, Burrell College of Osteopathic Medicine, Las Cruces, USA
| | - Jessica Lee
- Pathology, Burrell College of Osteopathic Medicine, Las Cruces, USA
| | - Oana Popescu
- Pathology and Laboratory Medicine, Vernon Jubilee Hospital, Vernon, CAN
| | - Angelica Oviedo
- Pathology and Laboratory Medicine, Burrell College of Osteopathic Medicine, Las Cruces, USA
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