Study Finds 1 in 10 Pregnant Individuals Who Test Positive For COVID-19 Will Develop Long COVID

According to research published in Obstetrics and Gynecology, approximately 1 in 10 people who test positive for COVID-19 while pregnant will develop long COVID. The investigators that this finding aligns with other research that shows pregnant people infected with COVID-19 are more likely to be hospitalized, die, or experience pregnancy complications (eg, preterm birth, stillborn).¹

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For this multicenter cohort study, individuals who were pregnant during their first time testing positive for COVID-19 from December 2021 to September 2023 were enrolled in the trial, either within 30 days of their infection or at differential time points after. A total of 1502 participants were included in the analysis, with a primary outcome of post-acute sequelae of SARS-CoV-2 infection (PASC, defined as score of ≥12 based on symptoms and severity). Additionally, risk factors—including sociodemographic characteristics, clinical characteristics prior to COVID-19 infection (eg, baseline comorbidities, trimester of infection, vaccination status), and acute infection severity—for PASC were evaluated.²

"This is a critical study as pregnancy and the post-partum period are one of the most vulnerable times in an individual's life," said David Goff, MD, PhD, division director for the Division of Cardiovascular Sciences at the NIH’s National Heart, Lung, and Blood Institute, in a news release. "By better understanding how individual characteristics interact with SARS-CoV-2 infection during pregnancy and lead to an increased risk of long COVID, this study yields important insights to potentially develop targeted interventions for this population."¹

The data show that approximately 61.1% of participants had their first COVID-19 infection either on or after December 1, 2021—during the Omicron variant wave—with 51.4% being fully vaccination prior to infection. A total of 182 patients (12.1%) were enrolled within 30 days of their acute infection. Additionally, the prevalence of PASC was about 9.3% (95% CI, 7.9-10.9%) and measured at a median of 10.3 months (range: 6.1-21.5) following first infection.²

“It was surprising to me that the prevalence was that high. This is something that does continue to affect otherwise reasonably healthy and young populations,” said study co-leader Torri Metz, MD, vice chair of research of obstetrics and gynecology at University of Utah Health, in the news release. “I doubt most obstetric clinicians are as aware of long COVID as perhaps we should be. But people are having these symptoms, and we need to make sure that we’re not forgetting that these could be long-term manifestations of their SARS-CoV-2 infection.”¹

Additionally, the most common symptoms that were associated with individuals who had PASC were post-exertional malaise (77.7%), fatigue (76.3%), and gastrointestinal symptoms (61.2%). Additionally, in a multivariable model, the proportion of PASC-positive with compared to without history of obesity (14.9% vs 7.5%; adjusted odds ratio [aOR]: 1.65, 95% CI, 1.12-2.43), depression or anxiety disorder prior to first infection (14.4% vs 6.1%; aOR 2.64, 95% CI, 1.79-3.88), self-reported economic hardships (12.5% vs 6.9%; aOR 1.57, 95% CI, 1.05-2.34), and treatment with oxygen during acute COVID-19 infection (18.1% vs 8.7%; aOR 1.86, 95% CI, 1.00-3.44) were associated with an increased prevalence of PASC.²

The authors note that to ensure these symptoms weren’t pregnancy-related, a secondary analysis was conducted with people who reported experiencing symptoms over 12 weeks following giving birth. Additionally, the acknowledge that the study may have missed participants whose symptoms resolved earlier.¹

“Our results highlight that people who were pregnant when they got COVID may have significant long-term symptoms after pregnancy, like fatigue even after simple activities that they did before the infection," said senior author Vanessa Jacoby, MD, MAS, director of the Clinical and Translational Science Institute at UCSF, professor of obstetrics, gynecology, and reproductive sciences, in the news release. "We encourage people to speak with their health care provider about persistent symptoms to connect with appropriate support and care.”¹

References

1. University of Utah Health. Nearly one in 10 pregnant people who get COVID will develop long COVID. News release. July 11, 2024. Accessed July 12, 2024. https://www.eurekalert.org/news-releases/1050695

2. Metz TD, Reeder HT, Clifton RG, et al. Post-Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) After Infection During Pregnancy. Obstet Gynecol. Published online July 11, 2024. doi:10.1097/AOG.0000000000005670