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Clinical manifestations of mild and moderate novel coronavirus disease in pregnant women in epidemic dynamics

Objective: To investigate the clinical manifestations of novel coronavirus infection (COVID-19) in pregnant women in epidemic dynamics. Materials and methods: This is a single-center prospective comparative study of three independent groups. The study enrolled 823 pregnant and postpartum women with mild to moderate COVID-19. Patients in Group 1 (n=186), Group 2 (n=412), and Group 3 (n=225) were hospitalized during the first, second, and third waves of the epidemic, respectively. The groups were comparable in age and gestational age. Results: During the epidemic, women of higher parity were exposed to infection. During the first, second, and third waves of the epidemic, 56.45%, 70.29%, and 78.22% of the multiparous women were infected, which could be explained by the possibility of the spread of infection among family members from children. Distinctive features of COVID-19 clinical manifestations included the predominance of pneumonia with scanty clinical symptoms in the second wave increase of exudative symptoms of the respiratory and gastrointestinal tract. The incidence of mild to severe disease progression was increasing: 1/186 (0.5%), 9/412 (2.2%), and 18/225 (8%) pregnant women during the first, second, and third waves, respectively. There was an increased risk of hospitalization for pregnant women with the moderate COVID-19 during the second and third waves (OR=3.9 (95% CI 1.7;8.8);p<0.05). There was an acceleration of the progression of the disease in female patients with each new phase of the epidemic: on the average, by day 9, 6, and 4 days during the first, second, and third waves, respectively, which may indicate an increase in the virus pathogenicity in the epidemic dynamics. Conclusion: In pregnant women, COVID-19 tends to increase the rate of progression and severity of the disease in the dynamics of the epidemic process.