Clinical characteristics and outcomes of childbearing-age women with Coronavirus disease 2019 in Wuhan: a retrospective, single-center study

Background: Since December 2019, an outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread rapidly in Wuhan and worldwide. However, previous studies on pregnant patients were limited.

Objective: The objective of our study was to evaluate the clinical characteristics and outcomes of pregnant and non-pregnant women with COVID-19.

Methods: This study retrospectively collected epidemiological, clinical, laboratory, imaging, management, and outcome data of 43 childbearing-age women patients (including 17 pregnant and 26 non-pregnant patients) who presented with laboratory confirmed of COVID-19 in Tongji Hospital, Wuhan, China, from January 19 to March 2, 2020. Clinical outcomes were followed up to March 28, 2020.

Results: Of 43 childbearing-age women in this study, none developed severe adverse illness and or died. The median ages of pregnant and non-pregnant women were 33.0 and 33.5 years, respectively. Pregnant women had a markedly higher proportion of history exposure to hospitals within two weeks before onset (53% vs 19%, P=.02), and a lower proportion of other family members affected (24% vs 73%%, P=.004). Fever (47% vs 69%) and cough (53% vs 46%) were common onset of symptoms for two groups. Abdominal pain (24%), vaginal bleeding (6%), reduced fetal movement (6%), and increased fetal movement (13%) were observed at onset in pregnant patients. Higher neutrophil and lower lymphocyte percent were observed in pregnant group (79% vs 56%, P<.001; 15% vs 33%, P<.001, respectively). In both groups, we observed elevated concentration of high sensitivity C-reactive protein, erythrocyte sedimentation rate, aminotransferase and lactate dehydrogenase. Concentrations of alkaline phosphatase and D-dimer in pregnant group were significantly higher than those of non-pregnant group (119.0 vs 48.0 U/L, P<.001; 2.1vs 0.3μg/mL, P<.001). Both pregnant (4/10; 40%) and non-pregnant (8/15; 53%) women were tested positive for influenza A virus. A majority of pregnant and non-pregnant groups received antiviral (76% vs 96%) and antibiotic (76% vs 88%) therapy. Additionally, both pregnant (2/11; 18%) and non-pregnant (2/19; 11%) recovered women re-detected positive for SARS-CoV-2 after discharge.

Conclusions: The epidemiology, clinical and laboratory features of pregnant women with COVID-19 were diverse and atypical, which increased the difficulty of diagnosis. Most pregnant women with COVID-19 were mild and moderate, and rarely developed severe pneumonia and severe adverse outcomes.