Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.
DaSLab (Data Science Lab), Department of Statistics, Federal University of Espírito Santo, Vitória/ES, Brazil.
PLoS One. 2023 Feb 7;18(2):e0266792. doi: 10.1371/journal.pone.0266792. eCollection 2023.
Cardiovascular diseases (CVD) are a risk factor for severe cases of COVID-19. There are no studies evaluating whether the presence of CVD in pregnant and postpartum women with COVID-19 is associated with a worse prognosis. In an anonymized open database of the Ministry of Health, we selected cases of pregnant and postpartum women who were hospitalized due to COVID-19 infection and with data regarding their CVD status. In the SIVEP GRIPE data dictionary, CVD is defined as "presence of cardiovascular disease", excluding those of neurological and nephrological causes that are pointed out in another field. The patients were divided into two groups according to the presence or absence of CVD (CVD and non-CVD groups). Among the 1,876,953 reported cases, 3,562 confirmed cases of pregnant and postpartum women were included, of which 602 had CVD. Patients with CVD had an older age (p<0,001), a higher incidence of diabetes (p<0,001) and obesity (p<0,001), a higher frequency of systemic (p<0,001) and respiratory symptoms (p<0,001). CVD was a risk factor for ICU admission (p<0,001), ventilatory support (p = 0.004) and orotracheal intubation in the third trimester (OR 1.30 CI95%1.04-1.62). The group CVD had a higher mortality (18.9% vs. 13.5%, p<0,001), with a 32% higher risk of death (OR 1.32 CI95%1.16-1.50). Moreover, the risk was increased in the second (OR 1.94 CI95%1.43-2.63) and third (OR 1.29 CI95%1.04-1.60) trimesters, as well as puerperium (OR 1.27 CI95%1.03-1.56). Hospitalized obstetric patients with CVD and COVID-19 are more symptomatic. Their management demand more ICU admission and ventilatory support and the mortality is higher.
心血管疾病（CVD）是 COVID-19 重症病例的一个危险因素。目前尚无研究评估 COVID-19 感染的孕产妇中 CVD 的存在是否与预后更差相关。在卫生部的一个匿名开放数据库中，我们选择了因 COVID-19 感染住院且有 CVD 状况数据的孕产妇病例。在 SIVEP GRIPE 数据字典中，CVD 被定义为“存在心血管疾病”，不包括在另一个字段中指出的神经和肾脏原因的 CVD。根据是否存在 CVD（CVD 组和非 CVD 组）将患者分为两组。在报告的 1876953 例病例中，纳入了 3562 例确诊的孕产妇病例，其中 602 例患有 CVD。患有 CVD 的患者年龄较大（p<0.001），糖尿病（p<0.001）和肥胖（p<0.001）发生率较高，全身性（p<0.001）和呼吸系统症状（p<0.001）更常见。CVD 是入住 ICU（p<0.001）、呼吸支持（p=0.004）和第三孕期经口气管插管的危险因素（OR 1.30，95%CI95%1.04-1.62）。CVD 组死亡率较高（18.9% vs. 13.5%，p<0.001），死亡风险增加 32%（OR 1.32，95%CI95%1.16-1.50）。此外，第二（OR 1.94，95%CI95%1.43-2.63）和第三（OR 1.29，95%CI95%1.04-1.60）孕期以及产褥期（OR 1.27，95%CI95%1.03-1.56）的风险也增加了。患有 CVD 和 COVID-19 的住院产科患者症状更明显。他们的治疗需要更多的 ICU 入住和呼吸支持，死亡率更高。
