tetano
Editor, Senior Moderator
J Clin Med
. 2022 Jan 28;11(3):701.
doi: 10.3390/jcm11030701.
Pregnant and Postpartum Women Requiring Intensive Care Treatment for COVID-19-First Data from the CRONOS-Registry
Magdalena Sitter[SUP] 1 [/SUP], Ulrich Pecks[SUP] 2 [/SUP], Mario Rüdiger[SUP] 3 [/SUP], Sabine Friedrich[SUP] 1 [/SUP], Sara Fill Malfertheiner[SUP] 4 [/SUP], Alexander Hein[SUP] 5 [/SUP], Josefine T Königbauer[SUP] 6 [/SUP], Karin Becke-Jakob[SUP] 7 [/SUP], Janine Zöllkau[SUP] 8 [/SUP], Babett Ramsauer[SUP] 9 [/SUP], Katharina Rathberger[SUP] 4 [/SUP], Constanza A Pontones[SUP] 5 [/SUP], Katrina Kraft[SUP] 10 [/SUP], Patrick Meybohm[SUP] 1 [/SUP], Christoph Härtel[SUP] 11 [/SUP], Peter Kranke[SUP] 1 [/SUP], Cronos Network
Affiliations
Abstract
(1) Background: Data on coronavirus 2 infection during pregnancy vary. We aimed to describe maternal characteristics and clinical presentation of SARS-CoV-2 positive women requiring intensive care treatment for COVID-19 during pregnancy and postpartum period based on data of a comprehensive German surveillance system in obstetric patients. (2) Methods: Data from COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS), a prospective multicenter registry for SARS-CoV-2 positive pregnant women, was analyzed with respect to ICU treatment. All women requiring intensive care treatment for COVID-19 were included and compared regarding maternal characteristics, course of disease, as well as maternal and neonatal outcomes. (3) Results: Of 2650 cases in CRONOS, 101 women (4%) had a documented ICU stay. Median maternal age was 33 (IQR, 30-36) years. COVID-19 was diagnosed at a median gestational age of 33 (IQR, 28-35) weeks. As the most invasive form of COVID-19 treatment interventions, patients received either continuous monitoring of vital signs without further treatment requirement (n = 6), insufflation of oxygen (n = 30), non-invasive ventilation (n = 22), invasive ventilation (n = 28), or escalation to extracorporeal membrane oxygenation (n = 15). No significant clinical differences were identified between patients receiving different forms of ventilatory support for COVID-19. Prevalence of preterm delivery was significantly higher in women receiving invasive respiratory treatments. Four women died of COVID-19 and six fetuses were stillborn. (4) Conclusions: Our cohort shows that progression of COVID-19 is rare in pregnant and postpartum women treated in the ICU. Preterm birth rate is high and COVID-19 requiring respiratory support increases the risk of poor maternal and neonatal outcome.
Keywords: ARDS; COVID-19; SARS-CoV-2; maternal critical care; obstetrics; pregnancy.
. 2022 Jan 28;11(3):701.
doi: 10.3390/jcm11030701.
Pregnant and Postpartum Women Requiring Intensive Care Treatment for COVID-19-First Data from the CRONOS-Registry
Magdalena Sitter[SUP] 1 [/SUP], Ulrich Pecks[SUP] 2 [/SUP], Mario Rüdiger[SUP] 3 [/SUP], Sabine Friedrich[SUP] 1 [/SUP], Sara Fill Malfertheiner[SUP] 4 [/SUP], Alexander Hein[SUP] 5 [/SUP], Josefine T Königbauer[SUP] 6 [/SUP], Karin Becke-Jakob[SUP] 7 [/SUP], Janine Zöllkau[SUP] 8 [/SUP], Babett Ramsauer[SUP] 9 [/SUP], Katharina Rathberger[SUP] 4 [/SUP], Constanza A Pontones[SUP] 5 [/SUP], Katrina Kraft[SUP] 10 [/SUP], Patrick Meybohm[SUP] 1 [/SUP], Christoph Härtel[SUP] 11 [/SUP], Peter Kranke[SUP] 1 [/SUP], Cronos Network
Affiliations
- PMID: 35160161
- DOI: 10.3390/jcm11030701
Abstract
(1) Background: Data on coronavirus 2 infection during pregnancy vary. We aimed to describe maternal characteristics and clinical presentation of SARS-CoV-2 positive women requiring intensive care treatment for COVID-19 during pregnancy and postpartum period based on data of a comprehensive German surveillance system in obstetric patients. (2) Methods: Data from COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS), a prospective multicenter registry for SARS-CoV-2 positive pregnant women, was analyzed with respect to ICU treatment. All women requiring intensive care treatment for COVID-19 were included and compared regarding maternal characteristics, course of disease, as well as maternal and neonatal outcomes. (3) Results: Of 2650 cases in CRONOS, 101 women (4%) had a documented ICU stay. Median maternal age was 33 (IQR, 30-36) years. COVID-19 was diagnosed at a median gestational age of 33 (IQR, 28-35) weeks. As the most invasive form of COVID-19 treatment interventions, patients received either continuous monitoring of vital signs without further treatment requirement (n = 6), insufflation of oxygen (n = 30), non-invasive ventilation (n = 22), invasive ventilation (n = 28), or escalation to extracorporeal membrane oxygenation (n = 15). No significant clinical differences were identified between patients receiving different forms of ventilatory support for COVID-19. Prevalence of preterm delivery was significantly higher in women receiving invasive respiratory treatments. Four women died of COVID-19 and six fetuses were stillborn. (4) Conclusions: Our cohort shows that progression of COVID-19 is rare in pregnant and postpartum women treated in the ICU. Preterm birth rate is high and COVID-19 requiring respiratory support increases the risk of poor maternal and neonatal outcome.
Keywords: ARDS; COVID-19; SARS-CoV-2; maternal critical care; obstetrics; pregnancy.