Clinico-Radiological Features and Outcomes in Pregnant Women with COVID-19 Pneumonia Compared with Age-Matched Non-Pregnant Women

Abstract

Purpose

To investigate the clinico-radiological findings and outcomes in pregnant women with COVID-19 pneumonia compared to age-matched non-pregnant women.

Methods

A retrospective case-controlled study was conducted to review clinical and CT data of 21 pregnant and 19 age-matched non-pregnant women with COVID-19 pneumonia. Four stages of CT images were analyzed and compared based on the time interval from symptom onset: stage 1 (0–6 days), stage 2 (7–9 days), stage 3 (10–16 days), and stage 4 (>16 days). The initial and follow-up data were analyzed and compared.

Results

Compared with age-matched non-pregnant women, initial absence of fever (13/21, 62%) and normal lymphocyte count (11/21, 52%) were more frequent in pregnant group. The predominant patterns of lung lesions were pure ground-glass opacity (GGO), GGO with consolidation or reticulation, and pure consolidation in both groups. Pure consolidation on chest CT was more common at presentation in pregnant cases. Pregnant women progressed with a higher consolidation frequency compared with non-pregnant group in stage 2 (95% vs 82%). Improvement was identified in stages 3 and 4 for both groups, but consolidation was still more frequent for pregnant women in stage 4. Most patients (38/40, 95%) were grouped as mild or common type. The length of hospitalization between the two groups was similar.

Conclusion

Pregnant women with COVID-19 pneumonia did not present typical clinical features, while developing a relatively more severe disease at imaging with a slower recovery course and experiencing similar outcomes compared with the non-pregnant women.

Keywords:

• COVID-19
• pregnancy
• computed tomography
• outcome

Abbreviations

COVID-19, Coronavirus disease 2019; SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2; GGO, Ground-glass opacity; RT-PCR, Reverse-transcription polymerase chain reaction; IQR, Inter-quartile range.

Data Sharing Statement

All data generated or analyzed of this study are included in this published article. Raw and processed data during the current study are available from the corresponding authors upon reasonable request.

Ethics Statement

This study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Ethics Committee of Maternal and Child Health Hospital of Hubei Province (12/3/2020, 2020-IEC-LW014) and Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine (21/2/2020, XHEC-C-2020-072). We performed a retrospective analysis of patient clinical information and did not conduct experiments on patient specimens. All patient data were maintained with confidentiality. This retrospective study evaluated de-identified data and involved no potential risk to patients. Therefore, the Institutional Ethics Committee waived the need for written informed consent provided by participants.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

All authors declare no potential conflict of interest relevant to this article.