Perinatal outcomes in pregnant women with COVID-19 in Siberia and the Russian Far East

OBJECTIVE

To assess the incidence and perinatal outcomes of COVID-19 in pregnant women in the Far Eastern and Siberian Federal Districts of Russian Federation over 10 months of a pandemic.

MATERIALS AND METHODS

This was secondary analysis of Public Data basis on 25 Dec 2020. Statistics included descriptive statistics, analysis of contingency tables, which assessed the value of χ², the achieved significance level (p).

RESULTS

During the first year of the SARS-CoV-2 pandemic, 8485 cases of COVID-19 were registered in pregnant women in the Far Eastern Federal District and the Siberian Federal District, accounting for 5.9% of registered pregnant women and 1.71% of the total affected population. The morbidity rate in pregnant women was 3.02 times higher than in the general population: 5933.2 vs 1960.8 per 100 thousand population. 27.4% of mothers had asymptomatic disease; 52.7% - mild; 16.6% - moderate, 2.5% - severe, 0.5% - critical disease. The incidence of hospitalization in ICU of pregnant women was higher relative to the general population (3.57% vs 2.24%, p < .001), but the frequency of mechanical ventilation was lower (0.48% vs 1.05%, p < .001). Preterm delivery had 18.3% (p < .001 CS - 42.0%. The mortality rate in pregnant women was 0.14% vs 1.95% - in the general population (p < .001). Perinatal mortality was 37 cases (1.56%), of which there were 31 stillbirths (1.26%), and 6 (0.25%) cases of early neonatal mortality. 148 (6.2%) COVID-19(+) newborns were identified, despite anti-epidemic measures.

CONCLUSION

The incidence of COVID-19 in pregnant women in Siberia and the Far East is higher than in the general population, but the disease is characterized by a milder. Women with COVID-19 have a high rate of preterm birth and CS. 148 (6.2%) newborns isolated COVID-19.

[Psychoautonomic disorders in patients with hypertension, stage I and possibilities of their treatment]

The article is devoted to the study of psychoautonomic features of patients with essential hypertension stage 1. The authors present the results of the clinical and psychological examinations of 62 patients with this pathology. These results show an increase in the levels of state and trait anxiety, which confirms the leading role of the psycho-emotional sphere in the formation of hypertensive reactions. This study evaluated the efficacy of the drug adaptol usage during 8 weeks in daily dose 1500 mg divided into three parts in the treatment of this group of patients. The results clearly demonstrate the positive effect of adaptol on psychoautonomic adaptation of patients with essential hypertension stage 1.

COVID-19 in pregnant and non-pregnant women of early reproductive age

Aim. To identify confounding factors, features of the clinical course and outcomes of COVID-19 in pregnant and non-pregnant patients of early reproductive age who have no known risk factors and premorbid background. Materials and methods. The study included 163 pregnant women in the third trimester of gestation, 100 non-pregnant women with laboratory-confirmed SARS-CoV-2 infection and 100 pregnant women who did not get sick. Patients of all groups were comparable in age (1835 years), social status, parity, body mass index, had no known risk factors for COVID-19; those who got sick were treated simultaneously. Results. Statistically significant associations were revealed between COVID-19 infection in the pregnant and iron deficiency anemia, vegetovascular dystonia, belonging to the Buryat ethnicity, and smoking. Pregnant women with COVID-19 were more likely to have no symptoms (23.3% vs 5%; p0.001) or had a mild course of the disease (58.9% vs 24%; p0.001). In non-pregnant patients, the course of infection was more often moderate (61% vs 14.7%; p0.001) or severe (10% vs 3.1%; p=0.038). Clinical manifestations of new coronavirus infection (NCV) in pregnant women were dominated by anosmia (87.7% vs 40%; p0.001), drowsiness (68.7% vs 17%; p0.001), dyspnea, even with a mild lung lesion (68.1% vs 19%; p0.001), headache (41.7% vs 24%; p=0.006), arthralgia (29.4% vs 16%; p=0.021), while fever above 38 C (7.4% vs 28%; p0.001) and cough (38.7% vs 61%; p0.001) were much less common. With computed tomography, pneumonia in pregnant women was diagnosed several times less often (21.4% vs 87.4%; p0.001). In the non-pregnant group, there was one death (1% vs 0%; p=0.201) associated with late hospitalization for severe NCI with grade 4 pulmonary involvement as shown on computed tomography. Conclusion. Confounders of COVID-19 in pregnant women who have no known risk factors in the third trimester of gestation are iron deficiency anemia, vegetovascular dystonia, belonging to the Buryat subpopulation, and smoking. In pregnant women, the main clinical symptoms of SARS-CoV-2 infection, with the exception of loss of smell, were nonspecific and characteristic of the physiological course of late gestation: drowsiness, dyspnea, joint pain. The predominance of mild or asymptomatic forms of infection, the lower incidence of pneumonia, and the absence of deaths in pregnant women suggests a more favorable course of COVID-19 NCI.