Adverse Maternal Outcomes in Pregnant Women Affected by Severe-Critical COVID-19 Illness: Correlation with Vaccination Status in the Time of Different Viral Strains' Dominancy.
Adverse Maternal Outcomes in Pregnant Women Affected by Severe-Critical COVID-19 Illness: Correlation with Vaccination Status in the Time of Different Viral Strains' Dominancy.
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DOI：
10.3390/vaccines10122061
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发表时间：
2022-11-30
期刊：
影响因子：
7.8
通讯作者：
Cicinelli E
中科院分区：
文献类型：
--
作者：
Vimercati A;De Nola R;Battaglia S;Di Mussi R;Cazzato G;Resta L;Chironna M;Loconsole D;Vinci L;Chiarello G;Marucci M;Cicinelli E
这是一项单中心横断面研究，于2020年9月至2022年4月在意大利巴里的巴里警察妇产科和重症监护病房(ICU)的新冠肺炎部门进行。这项研究旨在确定287名孕妇中需要进入重症监护病房的重症新冠肺炎疾病的患病率，以及SARS-CoV-2变异株、特定大流行浪潮(由野毒株、阿尔法株、德尔塔株和奥米克隆株主导)和严重危重不良孕产妇结局之间的可能相关性。新冠肺炎危重病患病率为2.8%(8/287)，剔除第4波(以奥米克隆为主)后患病率达4.9%(8/163)。与其他变体(Wild，Alpha，Omicron)相比，Delta变体确定了由于严重关键新冠肺炎相关症状而进入ICU的最高风险比和几率。在第三波(Delta)期间，ICU患者接受高免血浆输注(75%)、抗生素治疗(75%)和瑞贝韦(33%)的比率较高；所有患者均经气管插管。在Omicron波期间，患者没有症状或症状很少：大多数(70%)接种了中位数为两剂的疫苗。在阿尔法，特别是三角洲变种的情况下，孕产妇结局恶化，出现严重的关键新冠肺炎相关症状和进入重症监护病房。
This is a monocentric and cross-sectional study conducted at the COVID-19 Division of the Obstetrical and Gynecological Unit and Intensive Care Units (ICUs) of Policlinico di Bari, in Bari, Italy, between September 2020 and April 2022. This study aimed to identify the prevalence of severe-critical COVID-19 illness requiring access to the Intensive Care Unit (ICU) among 287 pregnant patients, and possible correlations between the SARS-CoV-2 variants, the specific pandemic wave (dominated by wild, Alpha, Delta, and Omicron strains), and severe-critical adverse maternal outcomes. The prevalence of severe-critical COVID-19 illness was 2.8% (8/287), reaching 4.9% (8/163) excluding the 4th wave (Omicron dominant). The Delta variant determined the highest risk ratio and odds for access to the ICU due to severe-critical COVID-19-related symptoms compared to the other variants (wild, Alpha, Omicron). During the third wave (Delta), the ICU cases underwent a higher rate of hyperimmune plasma infusion (75%), antibiotic therapy (75%), and remdesivir (33%); all of the patients were intubated. During the Omicron wave, the patients were asymptomatic or with few symptoms: most of them (70%) were vaccinated with a median of two doses. The maternal outcome worsened in the case of Alpha and, especially, Delta variants for severe-critical COVID-19-related symptoms and ICU access.
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期刊：
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影响因子：
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