Dataset Information

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection and Pregnancy in Sub-Saharan Africa: A 6-Country Retrospective Cohort Analysis.

ABSTRACT:

Background

Few data are available on COVID-19 outcomes among pregnant women in sub-Saharan Africa (SSA), where high-risk comorbidities are prevalent. We investigated the impact of pregnancy on SARS-CoV-2 infection and of SARS-CoV-2 infection on pregnancy to generate evidence for health policy and clinical practice.

Methods

We conducted a 6-country retrospective cohort study among hospitalized women of childbearing age between 1 March 2020 and 31 March 2021. Exposures were (1) pregnancy and (2) a positive SARS-CoV-2 RT-PCR test. The primary outcome for both analyses was intensive care unit (ICU) admission. Secondary outcomes included supplemental oxygen requirement, mechanical ventilation, adverse birth outcomes, and in-hospital mortality. We used log-binomial regression to estimate the effect between pregnancy and SARS-CoV-2 infection. Factors associated with mortality were evaluated using competing-risk proportional subdistribution hazards models.

Results

Our analyses included 1315 hospitalized women: 510 pregnant women with SARS-CoV-2, 403 nonpregnant women with SARS-CoV-2, and 402 pregnant women without SARS-CoV-2 infection. Among women with SARS-CoV-2 infection, pregnancy was associated with increased risk for ICU admission (adjusted risk ratio [aRR]: 2.38; 95% CI: 1.42-4.01), oxygen supplementation (aRR: 1.86; 95% CI: 1.44-2.42), and hazard of in-hospital death (adjusted sub-hazard ratio [aSHR]: 2.00; 95% CI: 1.08-3.70). Among pregnant women, SARS-CoV-2 infection increased the risk of ICU admission (aRR: 2.0; 95% CI: 1.20-3.35), oxygen supplementation (aRR: 1.57; 95% CI: 1.17-2.11), and hazard of in-hospital death (aSHR: 5.03; 95% CI: 1.79-14.13).

Conclusions

Among hospitalized women in SSA, both SARS-CoV-2 infection and pregnancy independently increased risks of ICU admission, oxygen supplementation, and death. These data support international recommendations to prioritize COVID-19 vaccination among pregnant women.

SUBMITTER: Nachega JB

PROVIDER: S-EPMC9214158 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Pregnancy in Sub-Saharan Africa: A 6-Country Retrospective Cohort Analysis.

Nachega Jean B JB Sam-Agudu Nadia A NA Machekano Rhoderick N RN Rosenthal Philip J PJ Schell Sonja S de Waard Liesl L Bekker Adrie A Gachuno Onesmus W OW Kinuthia John J Mwongeli Nancy N Budhram Samantha S Vannevel Valerie V Somapillay Priya P Prozesky Hans W HW Taljaard Jantjie J Parker Arifa A Agyare Elizabeth E Opoku Akwasi Baafuor AB Makarfi Aminatu Umar AU Abdullahi Asara M AM Adirieje Chibueze C Ishoso Daniel Katuashi DK Pipo Michel Tshiasuma MT Tshilanda Marc B MB Bongo-Pasi Nswe Christian C Ditekemena John J Sigwadhi Lovemore Nyasha LN Nyasulu Peter S PS Hermans Michel P MP Sekikubo Musa M Musoke Philippa P Nsereko Christopher C Agbeno Evans K EK Yeboah Michael Yaw MY Umar Lawal W LW Ntakwinja Mukanire M Mukwege Denis M DM Birindwa Etienne Kajibwami EK Mushamuka Serge Zigabe SZ Smith Emily R ER Mills Edward J EJ Otshudiema John Otokoye JO Mbala-Kingebeni Placide P Tamfum Jean-Jacques Muyembe JM Zumla Alimuddin A Tsegaye Aster A Mteta Alfred A Sewankambo Nelson K NK Suleman Fatima F Adejumo Prisca P Anderson Jean R JR Noormahomed Emilia V EV Deckelbaum Richard J RJ Stringer Jeffrey S A JSA Mukalay Abdon A Taha Taha E TE Fowler Mary Glenn MG Wasserheit Judith N JN Masekela Refiloe R Mellors John W JW Siedner Mark J MJ Myer Landon L Kengne Andre-Pascal AP Yotebieng Marcel M Mofenson Lynne M LM Langenegger Eduard E

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20221101 11

<h4>Background</h4>Few data are available on COVID-19 outcomes among pregnant women in sub-Saharan Africa (SSA), where high-risk comorbidities are prevalent. We investigated the impact of pregnancy on SARS-CoV-2 infection and of SARS-CoV-2 infection on pregnancy to generate evidence for health policy and clinical practice.<h4>Methods</h4>We conducted a 6-country retrospective cohort study among hospitalized women of childbearing age between 1 March 2020 and 31 March 2021. Exposures were (1) preg ...[more]

PMID: 36130257

Similar Datasets

Project description:The incidence and death toll due to SARS-CoV-2 infection varied time-to-time; and depended on several factors, including severity (viral load), immune status, age, gender, vaccination status, and presence of comorbidities. The RNA genome of SARS-CoV-2 has mutated and produced several variants, which were classified by the SARS-CoV-2 Interagency Group (SIG) into four major categories. The first category; “Variant Being Monitored (VBM)”, consists of Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), Delta (B.1.617.2), Epsilon (B.1.427, B.1.429), Eta (B.1.525), Iota (B.1.526), Kappa (B.1.617.1), Mu (B.1.621), and Zeta (P.2); the second category; “Variants of Concern” consists of Omicron (B.1.1.529). The third and fourth categories include “Variants of Interest (VOI)”, and “Variants of High Consequence (VOHC)”, respectively, and contain no variants classified currently under these categories. The surge in VBM and VOC poses a significant threat to public health globally as they exhibit altered virulence, transmissibility, diagnostic or therapeutic escape, and the ability to evade the host immune response. Studies have shown that certain mutations increase the infectivity and pathogenicity of the virus as demonstrated in the case of SARS-CoV-2, the Omicron variant. It is reported that the Omicron variant has >60 mutations with at least 30 mutations in the Spike protein (“S” protein) and 15 mutations in the receptor-binding domain (RBD), resulting in rapid attachment to target cells and immune evasion. The spread of VBM and VOCs has affected the actual protective efficacy of the first-generation vaccines (ChAdOx1, Ad26.COV2.S, NVX-CoV2373, BNT162b2). Currently, the data on the effectiveness of existing vaccines against newer variants of SARS-CoV-2 are very scanty; hence additional studies are immediately warranted. To this end, recent studies have initiated investigations to elucidate the structural features of crucial proteins of SARS-CoV-2 variants and their involvement in pathogenesis. In addition, intense research is in progress to develop better preventive and therapeutic strategies to halt the spread of COVID-19 caused by variants. This review summarizes the structure and life cycle of SARS-CoV-2, provides background information on several variants of SARS-CoV-2 and mutations associated with these variants, and reviews recent studies on the safety and efficacy of major vaccines/vaccine candidates approved against SARS-CoV-2, and its variants.