Department of Obstetrics and Gynecology, University Hospital "Dragisa Misovic", 11000 Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Viruses. 2022 Nov 27;14(12):2648. doi: 10.3390/v14122648.
During the last two and a half years, clinical manifestations, disease severity, and pregnancy outcomes have differed among pregnant patients with SARS-CoV-2 infection. These changes were preceded by the presence of new variants of SARS-CoV-2, known in the literature as variants of concern. The aim of this study is to describe the differences between maternal clinical characteristics and perinatal outcomes among pregnant women with COVID-19 during four waves of the COVID-19 epidemic in Serbia. This retrospective study included a series of 192 pregnant patients who were hospitalized due to the severity of their clinical status of SARS-CoV-2 infection. During four outbreaks of COVID-19 infection in Serbia, we compared and analyzed three sets of variables, including signs, symptoms, and characteristics of COVID-19 infection, clinical endpoints, and maternal and newborn parameters. During the dominance of the Delta variant, the duration of hospitalization was the longest (10.67 ± 1.42 days), the frequency of stillbirths was the highest (17.4%), as well as the frequency of progression of COVID infection (28.9%) and the requirement for non-invasive oxygen support (37%). The dominance of the Delta variant was associated with the highest number of prescribed antibiotics (2.35 ± 0.28), the most common presence of nosocomial infections (21.7%), and the highest frequency of corticosteroid therapy use (34.8%). The observed differences during the dominance of four variants of concern are potential pathways for risk stratification and the establishment of timely and proper treatments for pregnant patients. Early identification of the Delta variant, and possibly some new variants with similar features in the future, should be a priority and, perhaps, even an opportunity to introduce more accurate and predictive clinical algorithms for pregnant patients.
在过去的两年半中，SARS-CoV-2 感染的孕妇的临床表现、疾病严重程度和妊娠结局有所不同。这些变化之前是新的 SARS-CoV-2 变体的出现，这些变体在文献中被称为关注变体。本研究的目的是描述塞尔维亚 COVID-19 流行期间四起期间 COVID-19 孕妇的母体临床特征和围产结局差异。这项回顾性研究包括 192 名因 SARS-CoV-2 感染严重程度而住院的孕妇系列。在塞尔维亚 COVID-19 感染的四起疫情中，我们比较和分析了三组变量，包括 COVID-19 感染的体征、症状和特征、临床终点以及母婴参数。在 Delta 变体占主导地位期间，住院时间最长（10.67±1.42 天），死胎发生率最高（17.4%），COVID 感染进展率（28.9%）和非侵入性氧支持需求率（37%）最高。Delta 变体的主导地位与规定的抗生素数量最多（2.35±0.28）、医院感染最常见（21.7%）以及皮质类固醇治疗使用率最高（34.8%）有关。在四种关注变体占主导地位期间观察到的差异是对孕妇进行风险分层和及时适当治疗的潜在途径。早期识别 Delta 变体，以及未来可能出现的一些具有类似特征的新变体，应是优先事项，甚至可能是为孕妇引入更准确和预测性临床算法的机会。
