Objective
Risk factors for COVID-19 disease severity are established in the nonpregnant population, but are lacking in the pregnant population. The purpose of this study is to determine if risk factors for COVID-19 disease severity in the nonpregnant population apply in pregnancy.
Study Design
This retrospective cohort study included all pregnant patients who tested positive for COVID-19 from January 1 to June 30, 2020 at our institution, an urban, safety net hospital. Disease severity was classified according to National Institutes of Health criteria. Patients were then further stratified into two groups: low severity (asymptomatic, mild, and moderate) and high severity (severe and critical). Patient age, BMI, race, education level, and gestational age at the time of COVID-19 testing were collected. Additionally, a pregnancy comorbidity index was calculated for each patient (Bateman, 2014). Differences between groups for continuous variables were analyzed using the Student’s two-sample t-test, and differences between groups for categorical variables were analyzed with chi-square and Fisher’s exact test.
Results
131 patients tested positive for COVID-19 (Table). 21 patients were asymptomatic. Mild disease severity was seen in 94 patients, moderate in 2, severe in 10, and critical in 4. The mean ± standard deviation of BMI and age for asymptomatic, mild, and moderate patients was 31.9 ± 6.54 kg/m2 and 29.9 ± 6.32 years, and 33.4 ± 9.21 kg/m2 and 31.6 ± 5.6 years for severe and critical patients. There was no statistical difference in mean BMI and age between the two groups. There was no statistically significant difference between patient racial groups, education level, gestational age, and comorbidity index based on disease severity.
Conclusion
Maternal BMI, age, race, education level, gestational age and comorbidity index at the time of COVID-19 infection were not associated with an increased risk of severe disease. Larger studies are needed to confirm these findings.
