Long COVID after SARS-CoV-2 during pregnancy in the United States
Pregnancy alters immune responses and clinical manifestations of COVID-19, but its impact on Long COVID remains uncertain. This study investigated Long COVID risk in individuals with SARS-CoV-2 infection during pregnancy compared to reproductive-age females infected outside of pregnancy. A retrospective analysis of two U.S. databases, the National Patient-Centered Clinical Research Network (PCORnet) and the National COVID Cohort Collaborative (N3C), identified 29,975 pregnant individuals (aged 18-50) with SARS-CoV-2 infection in pregnancy from PCORnet and 42,176 from N3C between March 2020 and June 2023. At 180 days after infection, estimated Long COVID risks for those infected during pregnancy were 16.47 per 100 persons (95% CI, 16.00-16.95) in PCORnet using the PCORnet computational phenotype (CP) model and 4.37 per 100 persons (95% CI, 4.18-4.57) in N3C using the N3C CP model. Compared to matched non-pregnant individuals, the adjusted hazard ratios for Long COVID were 0.86 (95% CI, 0.83-0.90) in PCORnet and 0.70 (95% CI, 0.66-0.74) in N3C. The observed risk factors for Long COVID included Black race/ethnicity, advanced maternal age, first- and second-trimester infection, obesity, and comorbid conditions. While the findings suggest a high incidence of Long COVID among pregnant individuals, their risk was lower than that of matched non-pregnant females.
Authors
- Rena C. Patel (ORCID: https://orcid.org/0000-0001-9893-5856)
- Thomas W. Carton (ORCID: https://orcid.org/0000-0003-0059-1990)
- Haoyang Li (ORCID: https://orcid.org/0009-0004-8119-6398)
- Mark G. Weiner (ORCID: https://orcid.org/0000-0001-5586-9940)
- Nick Güthe
- Tanzy Love (ORCID: https://orcid.org/0000-0002-7154-0229)
- Ann M. Bruno (ORCID: https://orcid.org/0000-0002-3049-1467)
- Daniel J. Guth (ORCID: https://orcid.org/0000-0003-0937-5282)
- Rainu Kaushal (ORCID: https://orcid.org/0000-0002-4694-2517)
- Ryan McGrath (ORCID: https://orcid.org/0000-0003-4208-1059)
- Emily Hadley (ORCID: https://orcid.org/0000-0003-0074-4344)
- Zhenxing Xu (ORCID: https://orcid.org/0000-0001-9515-523X)
- Elaine Hill (ORCID: https://orcid.org/0000-0003-2494-317X)
- Chengxi Zang (ORCID: https://orcid.org/0000-0002-8244-9551)
- Robert Chew (ORCID: https://orcid.org/0000-0002-6979-1766)
- Kenneth J. Wilkins (ORCID: https://orcid.org/0000-0003-0531-7165)
- Torri D. Metz (ORCID: https://orcid.org/0000-0002-8161-2353)
- Elle Seibert (ORCID: https://orcid.org/0000-0001-6262-3965)
- Nariman Ammar (ORCID: https://orcid.org/0000-0002-5363-2541)
- Fei Wang (ORCID: https://orcid.org/0000-0001-9459-9461)
- Yiye Zhang (ORCID: https://orcid.org/0000-0003-3494-2699)
- Sharad Singh (ORCID: https://orcid.org/0000-0002-2518-9247)
- Yalini Senathirajah
Institutions
- National Institutes of Health (US)
- University of California, Los Angeles (US)
- University of Pittsburgh (US)
- RTI International (US)
- Cornell University (US)
- University of Utah (US)
- Ochsner Medical Center (US)
- University of Rochester Medical Center (US)
- University of Alabama at Birmingham (US)
- National Institute of Diabetes and Digestive and Kidney Diseases (US)
- Office of the Director (US)
- Louisiana Public Health Institute (US)
- Ochin (US)
- Patient Advocate Foundation (US)
- Weill Cornell Medicine (US)
- Illinois State University (US)
- New York University (US)
Publication Details
- Journal
- Nature Communications
- Published
- 2025-04-01
- DOI
- https://doi.org/10.1038/s41467-025-57849-9
- Citations
- 11
- Primary Topic
- COVID-19 Impact on Reproduction
- Type
- article
- Field-Weighted Citation Impact
- 22.63
Funders
- Yale University
- University of Southern California
- Patient-Centered Outcomes Research Institute
- Children's Hospital of Philadelphia
- University of Nebraska Medical Center
- Vanderbilt University
- University of Pennsylvania
- Emory University
- NYU Langone Medical Center
- University of Wisconsin-Madison
- Wake Forest University
- Cincinnati Children's Hospital Medical Center
- Vanderbilt Institute for Clinical and Translational Research
- University of Minnesota
- Loyola University Chicago
- University of Washington
- University of Pittsburgh
- University of Oklahoma
- Institute for Translational Medicine and Therapeutics
- Institute of Clinical and Translational Sciences
- Georgetown University
- University of Rochester
- University of Cincinnati
- Virginia Commonwealth University
- Southern California Clinical and Translational Science Institute
- West Virginia University
- Montana State University
- MedStar Health Research Institute
- Georgetown-Howard Universities Center for Clinical and Translational Science
- Vanderbilt University Medical Center
- Institute of Translational Health Sciences
- Louisiana Clinical and Translational Science Center
- Ochsner Health
- West Virginia Clinical and Translational Science Institute
- National Institutes of Health
- University of Illinois at Urbana-Champaign
- Institute for Clinical and Translational Research, University of Wisconsin, Madison
- University of California, Los Angeles
- Weill Cornell Medical College
- University of California, Davis
- University of California, San Diego
- University of Oklahoma Health Sciences Center
- University of California, San Francisco
- University of Texas Health Science Center at San Antonio
- University of California, Irvine
- Center for Clinical and Translational Research
- University of Colorado Denver
- Center for Clinical and Translational Science, University of Massachusetts
- Center for Clinical and Translational Sciences, University of Texas Health Science Center at Houston
- Translational Research Institute, University of Arkansas for Medical Sciences
- Clinical and Translational Science Institute, University of Florida
- Clinical and Translational Science Center, University of New Mexico
- National Institute of Mental Health
- National Center for Advancing Translational Sciences
- Institute for Integration of Medicine and Science
- Colorado Clinical and Translational Sciences Institute
- Yale Center for Clinical Investigation, Yale School of Medicine
- Institute for Clinical and Translational Science, University of California, Irvine
- Wake Forest Clinical and Translational Science Institute, Wake Forest School of Medicine