Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the culprit pathogen of coronavirus disease 2019 (COVID-19), continues to threaten physical and economic well-being worldwide.
A news item published on the preprint server medRxiv* determines how the pandemic has affected pregnant women in Mexico.
The high-threat prestige of pregnant women exposed to SARS-CoV-2 was established due to the various physiological adjustments during pregnancy that increase the likelihood of a hyperinflammatory reaction to the infection. After SARS-CoV-2 infection, this type of formulated reaction, often referred to as cytokine storm, has been linked to severe disease, multi-organ disorders, and an increasing threat of mortality. Pregnancy-related adjustments come with a postulated change in the cellular immune population to the Th2 phenotype. , reduced levels of herbal killer (NK) cells that reduce the ability of the innate immune formula to neutralize SARS-CoV-2, altered progesterone levels, altered number, as receptors, increasing tension in the lungs due to uterine growth, and a less potent cough that predisposes secretions to remain in those organs.
Hypercoagulable pregnancy also suggests a more severe end result of COVID-19, which is even differently related to thromboembolism in one-third of patients.
Previous studies have shown a three times greater threat of COVID-19 mortality in pregnant women than in uninfected women.
This study used pregnancy registries from the National Epidemiological Surveillance System of the Epidemiology Branch. All COVID-19 cases were known exact definitions, adding the presence of a positive opposite transcriptase polymerase chain reaction (RT-PCR) test.
The age ranged from 12 to 49 years, with an average of 28 and 27 years for SARS-CoV-2 positive and negative pregnantArray respectively.
The researchers also explored the effect of other non-disease variables on COVID-19 mortality in this group. The case fatality rate (CFR) was also calculated.
Of the women in this study, 20% required hospitalization and approximately 8% developed pneumonia, with a mortality rate of just over 1%. the fact that only about 70% of those deaths concerned men, some of whom were 60 or older.
The average age of non-survivors is about 32 years, higher than the average age of 28 years for survivors, such as the time between onset of symptoms and presentation, as indicated at the time of registration.
Survivors gave the impression on the record of an average of 4 days after symptom onset, compared with five days for non-survivors. Thus, delayed referral for care was associated with a greater threat of mortality.
Almost 80% of deaths in the cohort were due to pneumonia, which had been reported in previous studies. The presence of this complication increased the death rate by almost nine.
The presence of other underlying or coexisting medical conditions did not pose the threat of death from COVID-19, in all likelihood because their prevalence was very low in this group.
The lowest threat of death among younger women between 12 and 19 years old is 0. 4%. In contrast, a death threat of 3. 7% was reported in pregnant women aged 40 to 49.
The threat of mortality is five times higher in pregnant women aged 40 to 49 years compared to the total CFR. Despite this, part of the deaths occurred among women aged 30 to 39, while part of the survivors were between 20 and 29 years old.
However, as indicated by outpatient care, other people with mild illness had minimal risk of death. More than 90% of deaths occurred in hospitalized patients.
Smoking does not appear to pose a threat of COVID-19 mortality during pregnancy.
Overall, the mortality rate among pregnant women is particularly lower than the overall mortality rate in Mexico. This may be because most pregnancies in Mexico involve young women, indicating that their gender and relative youth acted as points of protection against the fatal COVID-19.
The researchers did not specify gestational age at diagnosis, as that knowledge was not in the knowledge base. This would possibly have affected the death rate and would merit inclusion in long-term studies.
Pregnancy with pneumonia should be monitored and treated thoroughly because of the particularly high threat of pneumonia-related mortality.
medRxiv publishes initial clinical reports that are not peer-reviewed and therefore are not considered conclusive clinical practices/health-related behaviors, nor are they treated as established information.
Written By
Dr. Liji Thomas is an obstetrician and gynecologist, graduating from Government Medical College, University of Calicut, Kerala, in 2001. Liji served as a full-time obstetrics/gynecology representative at a personal hospital for a few years after graduating. She praised many patients facing disorders such as pregnancy and infertility, and has had a rate of more than 2,000 deliveries, striving to achieve a general rather than operative delivery.
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