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Clinical Presentation of Coronavirus Disease 2019 (COVID-19) in Pregnant and Recently Pregnant People.

  • Author(s): Afshar, Yalda;
  • Gaw, Stephanie L;
  • Flaherman, Valerie J;
  • Chambers, Brittany D;
  • Krakow, Deborah;
  • Berghella, Vincenzo;
  • Shamshirsaz, Alireza A;
  • Boatin, Adeline A;
  • Aldrovandi, Grace;
  • Greiner, Andrea;
  • Riley, Laura;
  • Boscardin, W John;
  • Jamieson, Denise J;
  • Jacoby, Vanessa L;
  • Pregnancy CoRonavIrus Outcomes RegIsTrY (PRIORITY) Study
  • et al.
Abstract

Objective

To describe the clinical presentation, symptomology, and disease course of coronavirus disease 2019 (COVID-19) in pregnancy.

Methods

The PRIORITY (Pregnancy CoRonavIrus Outcomes RegIsTrY) study is an ongoing nationwide prospective cohort study of people in the United States who are pregnant or up to 6 weeks postpregnancy with known or suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We analyzed the clinical presentation and disease course of COVID-19 in participants who tested positive for SARS-CoV-2 infection and reported symptoms at the time of testing.

Results

Of 991 participants enrolled from March 22, 2020, until July 10, 2020, 736 had symptoms of COVID-19 at the time of testing; 594 tested positive for SARS-CoV-2 infection and 142 tested negative in this symptomatic group. Mean age was 31.3 years (SD 5.1), and 37% will nulliparous. Ninety-five percent were outpatients. Participants who tested positive for SARS-CoV-2-infection were a geographically diverse cohort: 34% from the Northeast, 25% from the West, 21% from the South, and 18% from the Midwest. Thirty-one percent of study participants were Latina, and 9% were Black. The average gestational age at enrollment was 24.1 weeks, and 13% of participants were enrolled after pregnancy. The most prevalent first symptoms in the cohort of patients who tested positive for SARS-CoV-2 infection were cough (20%), sore throat (16%), body aches (12%), and fever (12%). Median time to symptom resolution was 37 days (95% CI 35-39). One quarter (25%) of participants who tested positive for SARS-CoV-2 infection had persistent symptoms 8 or more weeks after symptom onset.

Conclusion

COVID-19 has a prolonged and nonspecific disease course during pregnancy and in the 6 weeks after pregnancy.

Clinical trial registration

ClinicalTrials.gov, NCT04323839.

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