EP04.09: Influence of clinical and anamnestic factors on the severity of the course and early delivery in pregnant women with COVID‐19

To evaluate the influence of clinical and anamnestic factors on the severity of the course and early delivery in pregnant women with covid pneumonia. The COVID-19 pandemic has officially ended, but discussions and analysis of the impact of the past situation on a pregnant woman and her fetus continue. Retrospective cohort single-centre study in a tertiary level Covid hospital. The group of patients (n = 81) was divided into three subgroups: 1 – no respiratory support (n = 13); 2 – received non-invasive respiratory support (n = 52); 3 – required invasive respiratory support (n = 16). Inclusion criteria: severe COVID-19 (positive laboratory test result), gestational age 22.0-41.6 weeks. Statistical analysis: Kruskal-Wallis test, Mann-Whitney test with Holm-Bonferroni correction. Risk of invasive respiratory support is higher in patients with the onset of the disease in pregnancy ≤207(187-233) days (p < 0.001), with an increase in body temperature during illness ≥38.6(38.0-39.0)°C (p = 0.009), saturation in ambient air ≤90.0(87.0-93.0)% (p < 0.001). With this combination of parameters, there is a higher probability of changes in lung structure according to chest CT data ≥77.5(68.2-90.0)% (p < 0.001). Ferritin level in the 3rd was ≥125.0(84.4-268.9)ng/ml (p = 0.001). Amount of amniotic fluid and structure of placenta (lacunae, thickness) were assessed, but have no value for prognosis. Delivery time in the 3rd was ≤210.0(203.5-238.5) days (p < 0.001). Chance of preterm birth in the 3rd is significantly higher (OR = 7.07, 95% CI (1.44;69.02)). In the 3rd the 1st minute Apgar was 2.0(1.5-4.0) points. Anthropometric data of newborns also differed significantly; in patients with invasive respiratory support, body weight of newborns was 1340.0(1050-2360.0)g, birth of small-for-gestational-age children was not recorded. The study revealed the most informative clinical and anamnestic factors of severity and early delivery in pregnant patients with viral pneumonia caused by COVID-19.