Virological and clinical features of acute respiratory failure associated with COVID-19 in pregnancy: a case–control study

OBJECTIVE: Pregnancy is a risk factor for acute respiratory failure (ARF) following severe syndrome coronavirus 2 (SARS-CoV-2) infection. We hypothesised that SARS-CoV-2 viral load in the tract might be higher pregnant intensive care unit (ICU) patients with ARF than non-pregnant ICU as consequence of immunological adaptation during pregnancy. DESIGN: Single-centre, retrospective observational case–control study. SETTING: Adult level 3 French university hospital. PARTICIPANTS: Eligible participants were adults associated disease 2019 (COVID-19) pneumonia. MAIN OUTCOME MEASURE: The primary endpoint study was and patients. RESULTS: 251 included study, including 17 Median gestational age at admission amounted to 28 + 3/7 weeks (interquartile range [IQR], 26 1/7 31 5/7 weeks). Twelve (71%) had an emergency caesarean delivery due maternal failure. independently (–4.6 ± 1.9 cycle threshold; P < 0.05). No clustering or over-represented mutations noted regarding sequences women. Emergency modest but significant improvement arterial oxygenation, amounting 32 12 mmHg needing invasive mechanical ventilation. mortality significantly lower (0 v 35%; Age, Simplified Acute Physiology Score (SAPS) II score, distress independent factors mortality, while pregnancy status virological variables not. CONCLUSIONS: Viral substantially COVID-19 compared ARF. not after adjustment severity.