Pregnant people infected with Delta variant more likely to have severe COVID-19, new study

By Dr Deepu Changappa Cheriamane

The Delta variant that caused a surge in COVID-19 cases in the United States this summer is particularly dangerous for pregnant people, new research shows.The research paper says, pregnant people infected with the Delta variant are more likely to have severe COVID-19 cases, and the variant leads to even worse outcomes for unvaccinated pregnant people.

 The findings were published in the American Journal of Obstetrics and Gynecology.

The researchers, prospectively studied pregnant patients diagnosed with SARS-CoV-2 by nasal or nasopharyngeal swab polymerase chain reaction, and Externally tested patients who received care at Parkland were also included in their study. 
Positive tests were grouped into weekly epochs by the date of diagnosis and the maximum severity of symptoms. 
Severe or critical illness was defined as that requiring supplemental oxygen, a high-flow nasal cannula, intensive care unit admission, or mechanical ventilation. The management of asymptomatic or mild-to-moderate illness in pregnancy included symptom treatment with isolation precautions and virtual or in-person follow-up. The routine management of severe or critical illness included the administration of dexamethasone or other therapies according to the National Institutes of Health guidance.The association between severe or critical illness and the week was evaluated for the trend using the Mantel-Haenszel chi-squared test for trend. Local SARS-CoV-2 Delta variant (B.1.617.2) sequencing was performed and the variant predominance was tracked weekly. 
The COVID-19 vaccination rates in pregnancy or immediately after childbith were described.
The authors got the following results
 1515 pregnant patients were diagnosed with COVID-19, and 7 (0.5%) had reinfection >90 days after the initial infection during pregnancy.
 The infections included 690 (45%) patients from labor and delivery or inpatient units, 383 (25%) outpatient, 167 (11%) emergency department, and 282 (19%) external tests. Furthermore, 82 (5.4%) cases with severe or critical illness during pregnancy, were included.
 The authors noted that as the Delta (B.1.617.2) variant predominated locally, both the case volume and the proportion of severe or critical illnesses increased significantly , with over a quarter of pregnant patients requiring admission for severe or critical illness.

 The authors Concluded their study with the following remarks. 
Increased morbidity was observed in pregnancy with COVID-19 during the recent surge with the Delta variant, in population where vaccine acceptance is low.
Here is the concluding remarks of the study "Our results highlight the urgency of the requirement of prevention measures including COVID-19 vaccination during pregnancy"

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