Post-COVID syndrome in pregnant women requires doctors' attention

Physicians now realize that the clinical impact of COVID-19 may extend beyond the acute infectious period, affecting the health and quality of life of those affected. That is why in 2020 the International Classification of Diseases (ICD-10) introduced a new classification called "Post COVID-19 condition, unspecified."

As a result of this global health concern, there has been a recent focus on the study and correction of the long-term effects of COVID-19 by physicians of various specialties.

Obstetricians and gynecologists were not excluded from this problem. Specialists at the Ural Research Institute of Maternity and Child Care (Ekaterinburg) studied post-COVID syndrome in women with mild and moderate COVID-19 at various stages of pregnancy. Their original article, which appeared in issue 12 of the journal Obstetrics and Gynecology, reported the results of this study.

To evaluate the clinical manifestations of post-COVID syndrome, the researchers conducted a single-center, prospective cohort study. The study group (n=200) was divided into three subgroups: subgroup 1 (n=22) had NCVI in the 1st trimester, subgroup 2 (n=76) had NCVI in the 2nd trimester, and subgroup 3 (n=102) had NCVI in the third trimester. The control group (n=99) included women without a history of acute respiratory viral infection (ARVI) during pregnancy.

The mean gestational age at the time of the study was 38.3 weeks (37.0–40.2) in the study group and 38.2 weeks (37.1–40.2) in the control group (p=0.1). The time between the disease and the study was more than 20 weeks in subgroup 1 (mean 31.3 (1.1) weeks), 13–20 weeks in subgroup 2 (17.6 (1.1) weeks), and 4–12 weeks in subgroup 3 (6.9 (1.0) weeks).

The results of the study showed that symptoms not explained by an alternative diagnosis were detected in 93.0% of the pregnant women in the study group and 38.4% of the women in the control group (p<0.001).

The most common symptoms in pregnant women of the study and control groups included cognitive impairment (78.0% vs. 19.2%), distortion of smell and taste (47.5% vs. 0.0%), dry mouth (27.5% vs. 9.1%), fatigue when performing household chores (27.0% vs. 9.1%), and weakness (26.0% vs. 8.1%). In the study group, 90.0% and 59.6% of the women in the control group had psychological disorders.

According to researchers, pregnant women with NCVI in the first trimester were significantly more likely to be at risk of developing post-COVID disorders that persisted until full-term pregnancy. They found a correlation between the number of symptoms of post-COVID syndrome and the Hamilton Depression Scale score (r=0.58; 95% CI 0.81–0.89, p <0.001).

The results reported by the researchers suggest the need for rehabilitation in pregnant women after NCVI, depending on the severity and duration of post-COVID symptoms.

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