Postcovid syndrome in pregnant women

Objective: To assess the prevalence and characteristics of postcovid syndrome (PCS) in pregnant women who have not concomitant comorbid pathology.

Materials and methods: To assess the independent impact of the novel coronavirus infection on the development of PCS, the investigation involved women who had no known risk factors: those who are younger than 35 years, are without overweight/obesity, diabetes mellitus, chronic hypertension, and other somatic and chronic infectious diseases, who experienced COVID-19 in July to October 2021.

A study group consisted of patients without uncomplicated pregnancy (n=111); a comparison group included non-pregnant women (n=181). SARS-CoV-2 was identified by a polymerase chain reaction assay in the nasopharyngeal material in all cases. The symptoms of PCS were considered to be the clinical manifestations that were absent before COVID-19 and appeared not earlier than 4 weeks from the onset of the disease and lasted at least 2 months, which could not be explained by alternative diagnoses. The statistical database had been formed on the basis of primary medical documentation and an interview of the patients according to a special questionaire with an assessment of the existing symptoms on a 10-score scale.

Results: The pregnant women were 2.0 and 6.6 times more likely to have been ill with moderate and severe COVID infection, respectively, as compared with non-pregnant women (χ²=16.42; p<0.001; OR=2.99 (95% CI, 1.68; 5.35); p<0.001), which caused the increased risk of their hospitalization (OR=3.59 (95% CI, 2.06; 6.25); p<0.001). The incidence of PCS had no differences and amounted to 93.7 and 97.2%, respectively (p>0.05). PCS in the pregnant women was more frequently manifested by the development of dyspnea (37.8% vs 26.5%) (χ²=4.13; p=0.043; OR=1.69 (95% CI, 1.02; 2.80); p<0.05); moreover, the severity of the symptom did not differ in the comparison groups. Coughing and frequent urination occurred with same frequency in the pregnant and non-pregnant women, but their intensity prevailed in the maternal group. The pregnant women were less likely to have hair loss (46.8% vs 60.8% (χ²=5.4; p=0.021) with the symptom severity in the groups. Headache occurred less frequently in the pregnant women (30.6% vs 43.1% (χ²=4.52; p=0.034) and was less intensive (3.0 (2.6; 5.2) vs 5.0 (5.0; 5.9) scores (p=0.047). Other PCS symptoms (fatigue/easy fatigability, myalgia, weight loss, chest pain, palpitation, memory impairment, sleep disorders, depression, etc.) were recorded with the same frequency and severity.

Conclusion: Our investigation has demonstrated the widespread prevalence of PCS in young initially somatically healthy pregnant and non-pregnant women. The obtained facts regarding the symptoms identified in the pregnant women can be partly explained by physiological gestational changes in the mother’s body. However, further large-scale and longer-term investigations are needed to elucidate the pathophysiological mechanisms of the development of PCS and its possible consequences in pregnant women.