Hospitalized pregnant women with COVID 19: differing outcomes among symptomatic and asymptomatic patients

Abstract

Objectives: To compare course of the disease, changes in levels of inflammatory markers, management and outcome of pregnancy in terms of, hospital stay, ICU admission and specific treatment between symptomatic and asymptomatic COVID 19 positive pregnant patients. Methods: Retrospective comparative study was conducted between April 2020 to September 2020 at Sardar Vallabhbhai Patel Institute of Medical Sciences and Research hospital (SVPIMSR) in Ahmedabad, Western India. 182 COVID 19 positive pregnant females were included and divided into 2 groups- symptomatic group A and asymptomatic group B. Parameters like history, laboratory investigations, management, requirement for intensive care and neonatal outcome were compared. Results: 75% patients were asymptomatic (group B) and 25% were symptomatic (group A). Most common symptom was cough (46%). 23 patients (12.6%) had associated comorbidities. In group A, CRP was raised in 21 out of 28 patients while group B in only 47 out of 154 patients (p= <0.0001). Rate of LSCS was higher (69.4%) compared to vaginal deliveries (22.1%) in both groups. Rate of LSCS was higher in group A (75%) compared to group B (55.8%). In group A patients with raised CRP, preterm deliveries were seen in 33.3%, ICU admissions in 28.5% while COVID positive babies in 14.2%, whereas in group B preterm deliveries were 17.2%, no ICU admissions and 8.51% COVID positive babies. All 7 patients requiring ICU admission belonged to group A, out of which 6 were delivered preterm, 4 pregnancies were terminated in maternal interest. Conclusion: Symptomatic patients are at a higher risk in terms of hospital stay, preterm birth, ICU admission and neonatal outcome compared to asymptomatic patients.

Keywords

• covid-19
• pregnancy
• asymptomatic
• symptomatic
• preterm