Oral Plenary Session I and Late-Breaking
Oral Plenary Sessions
Torri D. Metz, MD, MSCI (she/her/hers)
Associate Professor
University of Utah Health
Salt Lake City, UT, United States
Valerie Flaherman, MD
University of California at San Francisco
San Francisco, California, United States
Leah Castro Baucom, MA
RECOVER Patient, Caregiver, or Community Advocate Representative
New York, New York, United States
Jodie A. Dionne, MD
Assistant Professor
Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham
BIRMINGHAM, AL, United States
Rachel S. Gross, MD
New York University Grossman School of Medicine
New York, New York, United States
Leora I. Horwitz, MD
New York University Grossman School of Medicine
New York, New York, United States
Patrick S. Ramsey, MD, MSPH (he/him/his)
Professor, OB/GYN
The University of Texas Health Science Center at San Antonio
San Antonio, TX, United States
Vanessa Jacoby, MD
University of California at San Francisco
San Francisco, California, United States
To estimate the prevalence of post-acute sequelae of SARS-CoV-2 infection (PASC or long COVID) after infection with SARS-Cov-2 during pregnancy, and characterize associated risk factors.
Study Design:
In a prospective, multicenter observational cohort study, individuals who had SARS-CoV-2 infection during pregnancy were enrolled across 41 sites from December 2021 through August 2023. The primary outcome was presence of PASC, as defined by the NIH RECOVER Consortium based on symptoms and severity, at least 6 months after first SARS-CoV-2 infection. Risk factors for PASC were evaluated including sociodemographic and pre-existing clinical characteristics, and SARS-CoV-2 infection severity (oxygen requirement). Univariable and multivariable logistic regression models, with multiple imputation for missing data, were fitted to estimate associations between these characteristics and presence of PASC.
Results:
Overall 1,503 participants were included; 61% had an index SARS-CoV-2 infection on or after December 1, 2021 (i.e., during Omicron variant dominance); and 51% were fully vaccinated prior to infection. The prevalence of PASC at first study visit 6 months or more after infection was 9.3% (95% CI 7.9-10.9%). The most common defining symptoms among individuals with PASC were post-exertional malaise (82%), fatigue (75%) and dizziness (62%). In a multivariable model, obesity (aOR 1.63, 95% CI 1.13-2.44), preexisting depression or anxiety disorder (aOR 2.64, 95% CI 1.80-3.87), economic hardship (self-reported difficulty covering expenses) (aOR 1.66, 95% CI 1.11-2.48), and treatment with oxygen during infection (aOR 1.88, 95% CI 1.01-3.50), were associated with increased odds of developing PASC(Table).
Conclusion:
PASC prevalence after SARS-CoV-2 infection during pregnancy was lower than published NIH RECOVER-Adult cohort estimates of 23%. This finding may reflect differential immune response in pregnancy, differences in sampling strategies, or lower rates of pre-existing comorbidities. Several socioeconomic and clinical characteristics were associated with the development of PASC.