Incidence and clinical profiles of COVID-19 pneumonia in pregnant women: A single-centre cohort study from Spain
Rafael San Juan, Patricia Barbero, Mario Fernández‐Ruiz, Francisco López‐Medrano, Manuel Lizasoaín, Pilar Hernández-Jiménez, José Tiago Silva, María Ruiz‐Ruigómez, Laura Corbella, Isabel Rodríguez‐Góncer, María Dolores Folgueira, Antonio Lalueza, Emma Batllori, Inma Mejía, Laura Forcén, Carlos Lumbreras, Antonio García-Burguillo, Alberto Galindo, José María Aguado
Abstract
Background: Information regarding the incidence and characteristics of COVID-19 pneumonia amongst pregnant women is scarce. Methods: Single-centre experience with 32 pregnant women diagnosed with COVID-19 between March 5 to April 5, 2020 at Madrid, Spain. Findings: COVID-19 pneumonia was diagnosed in 615% (32/52) women. Only 187% (6/32) had some underlying condition (mostly asthma). Supplemental oxygen therapy was required in 18 patients (563%), with high-flow requirements in six (187%). Eight patients (250%) fulfilled the criteria for acute distress respiratory syndrome. Invasive mechanical ventilation was required in two patients (62%). Tocilizumab was administered in five patients (156%). Delivery was precipitated due to COVID-19 in three women (94%). All the newborns had a favourable outcome, with no cases of neonatal SARS-CoV-2 transmission. Severe cases of pneumonia requiring supplemental oxygen were more likely to exhibit bilateral alveolar or interstitial infiltrates on chest X-ray (556% vs. 00%; P-value = 0003) and serum C-reactive protein (CRP) levels >10 mg/dL (330% vs. 00%; P-value = 005) at admission than those with no oxygen requirements. Interpretation: Pregnant women with COVID-19 have a high risk of developing pneumonia, with a severe course in more than half of cases. The presence of bilateral kung infiltrates and elevated serum CRP at admission may identify women at-risk of severe COVID-19 pneumonia.