Serra Fabiano Elisei, Rosa Junior Elias Ribeiro, de Rossi Patricia, Francisco Rossana Pulcineli Vieira, Rodrigues Agatha Sacramento
Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo 05508-070, Brazil.
Faculdade de Medicina, Universidade de Santo Amaro (UNISA), São Paulo 04743-030, Brazil.
Vaccines (Basel). 2022 Dec 17;10(12):2172. doi: 10.3390/vaccines10122172.
This study compares the clinical characteristics and disease progression among vaccinated and unvaccinated pregnant and postpartum women who tested positive for different variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using the Brazilian epidemiological data. Data of pregnant or postpartum patients testing positive for SARS-CoV-2 and presenting with coronavirus disease 2019 (COVID-19) from February 2020 to July 2022 were extracted from Brazilian national database. The patients were grouped based on vaccination status and viral variant (original, Gamma, Delta, and Omicron variants), and their demographics, clinical characteristics, comorbidities, symptoms, and outcomes were compared retrospectively. Data of 10,003 pregnant and 2361 postpartum women were extracted from the database. For unvaccinated postpartum women, intensive care unit (ICU) admission was more likely; invasive ventilation need was more probable if they tested positive for the original, Gamma, and Omicron variants; and chances of death were higher when infected with the original and Gamma variants than when infected with other variants. Vaccinated patients had reduced adverse outcome probability, including ICU admission, invasive ventilation requirement, and death. Postpartum women showed worse outcomes, particularly when unvaccinated, than pregnant women. Hence, vaccination of pregnant and postpartum women should be given top priority.
本研究利用巴西的流行病学数据,比较了接种和未接种疫苗的孕妇及产后妇女中,感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)不同变体且检测呈阳性者的临床特征和疾病进展情况。从巴西国家数据库中提取了2020年2月至2022年7月期间SARS-CoV-2检测呈阳性并患有2019冠状病毒病(COVID-19)的孕妇或产后患者的数据。根据疫苗接种状况和病毒变体(原始毒株、伽马毒株、德尔塔毒株和奥密克戎毒株)对患者进行分组,并对其人口统计学特征、临床特征、合并症、症状和结局进行回顾性比较。从数据库中提取了10003名孕妇和2361名产后妇女的数据。对于未接种疫苗的产后妇女,入住重症监护病房(ICU)的可能性更大;如果她们感染原始毒株、伽马毒株和奥密克戎毒株,需要有创通气的可能性更高;感染原始毒株和伽马毒株时的死亡几率高于感染其他变体时。接种疫苗的患者不良结局的概率降低,包括入住ICU、需要有创通气和死亡。产后妇女的结局比孕妇更差,尤其是未接种疫苗的产后妇女。因此,应将孕妇和产后妇女的疫苗接种作为首要任务。