Author:
Souza Renato T.,Cecatti Jose G.,Pacagnella Rodolfo C.,Ribeiro-Do-Valle Carolina C.,Luz Adriana G.,Lajos Giuliane J.,Nobrega Guilherme M.,Griggio Thayna B.,Charles Charles M.,Bento Silvana F.,Silveira Carla,Surita Fernanda G.,Miele Maria J.,Tedesco Ricardo P.,Fernandes Karayna G.,Martins-Costa Sérgio H. A.,Peret Frederico J. A.,Feitosa Francisco E.,Mattar Rosiane,Traina Evelyn,Cunha Filho Edson V.,Vettorazzi Janete,Haddad Samira M.,Andreucci Carla B.,Guida José P.,Correa Junior Mario D.,Dias Marcos A. B.,De Oliveira Leandro,Melo Junior Elias F.,Luz Marília G. Q.,Costa Maria Laura,Souza Renato T.,Costa Maria Laura,Cecatti Jose G.,Pacagnella Rodolfo C.,Ribeiro-do-Valle Carolina C.,Luz Adriana G.,Lajos Giuliane J.,Nobrega Guilherme M.,Griggrio Thayna B.,Charles Charles M.,Bento Silvana F.,Silveira Carla,Surita Fernanda G.,Miele Maria J.,Metelus Sherly,Castro Lester,Pabon Stephanie,Silva Amanda D.,Junior Paulo S. R.,Sardinha Thais G.,Japenga Rodolfo R.,Urquiza Erica R. F.,Machado Maíra R.,Simões Marcela Maria,Solda Larissa M.,Freitas-Jesus Juliana Vasconcellos,Soeiro Rachel Esteves,Tedesco Ricardo P.,Fernandes Karayna G.,Peres Patrícia B.,Arbeli Cristiane L.,Quevedo Rafael M.,Yamashita Carolina F.,Corradin Julia D.,Bergamini Isabella,Martins-Costa Sérgio H. A.,Ramos José Geraldo L.,Oppermann Maria Lúcia R.,Quadro Laisa S.,Marins Lina,Paniz Érika V.,Xavier Thaís Vicentini,Peret Frederico J. A.,Almeida Marina H. L.,Moura Bruna F. V.,França Lidiane R.,Vieira Hanna,Aquino Rafael B.,Costa Aline C.,Feitosa Francisco E.,Pinheiro Daisy,Cordeiro Denise,Miná Priscila L.,Dornellas Carol,Mattar Rosiane,Traina Evelyn,Yazaki-Sun Sue,Mota Priscilla,Soares Arimaza C.,Cunha Filho Edson V,Vettorazzi Janete,Machado Ellen,Bergmann Anne,Santos Gustavo Raupp,Haddad Samira M.,Tosetto Aline,Savazoni Sabrina,Andreucci Carla B.,Parreira Bruna E.,Guida José P.,Correa Junior Mario D.,Leal Caio,Amana Rayra,Dias Marcos A. B.,Nakamura-Pereira Marcos,Guerra Bruna O.,Gorga Gabriela,De Oliveira Leandro,Oliveira Kevin F. A.,Makyama Mariana Emi Varicoda,Melo Junior Elias F.,Leite Débora F.,Monteiro Isabella,Luz Marília G. Q.,Pereira Isabela R.,Salustrino Clélia Andrade,Pontes Valéria B.,Silva Franco Roberto Allen,Bilibio João Paolo,Brito Gislânia P. F.,Pinto Hana Paula C.,Oliveira Danielle Leal,Guerra Andrezza A.,Moura Andrea O.,Pantoja Natasha,David Fernanda,Silva Alina,
Abstract
AbstractBrazil presented a very high number of maternal deaths and evident delays in healthcare. We aimed at evaluating the characteristics of SARS-CoV-2 infection and associated outcomes in the obstetric population. We conducted a prospective cohort study in 15 Brazilian centers including symptomatic pregnant or postpartum women with suspected COVID-19 from Feb/2020 to Feb/2021. Women were followed from suspected infection until the end of pregnancy. We analyzed maternal characteristics and pregnancy outcomes associated with confirmed COVID-19 infection and SARS, determining unadjusted risk ratios. In total, 729 symptomatic women with suspected COVID-19 were initially included. Among those investigated for COVID-19, 51.3% (n = 289) were confirmed COVID-19 and 48% (n = 270) were negative. Initially (before May 15th), only 52.9% of the suspected cases were tested and it was the period with the highest proportion of ICU admission and maternal deaths. Non-white ethnicity (RR 1.78 [1.04–3.04]), primary schooling or less (RR 2.16 [1.21–3.87]), being overweight (RR 4.34 [1.04–19.01]) or obese (RR 6.55 [1.57–27.37]), having public prenatal care (RR 2.16 [1.01–4.68]), planned pregnancies (RR 2.09 [1.15–3.78]), onset of infection in postpartum period (RR 6.00 [1.37–26.26]), chronic hypertension (RR 2.15 [1.37–4.10]), pre-existing diabetes (RR 3.20 [1.37–7.46]), asthma (RR 2.22 [1.14–4.34]), and anaemia (RR 3.15 [1.14–8.71]) were associated with higher risk for SARS. The availability of tests and maternal outcomes varied throughout the pandemic period of the study; the beginning was the most challenging period, with worse outcomes. Socially vulnerable, postpartum and previously ill women were more likely to present SARS related to COVID-19.