TABLE 4.

Pregnancy related complications of SARS-CoV-2 (Goldshtein et al., 2021, 2022; Shimabukuro et al., 2021; Morgan et al., 2022).

	SARS-CoV-2 findings
General symptoms COVID-19 overlap with symptoms of normal pregnancy*	Pregnant people are more likely to be asymptomatic Common symptoms: • Cough • Fever • Myalgias • Headache • Dyspnoea* • Sore throat • Diarrhoea • Nausea/vomiting* • Anosmia or other smell abnormalities • Ageusia or other taste abnormalities • Rhinorrhoea and/or nasal congestion* • Chills/rigors • Fatigue*	Pregnancy can worsen the clinical course of SARS-CoV-2, especially in women of older age (especially >35 years), obesity, preexisting medical comorbidities (particularly hypertension, diabetes, or >1 comorbidity), and being unvaccinated. Consider other viral and bacterial respiratory infections depending on local prevalence.
	Laboratory findings: • Thrombocytopenia • Elevated liver enzymes • Autoimmune hemolysis • Prolonged prothrombin time • Elevated D-dimer • Elevated procalcitonin • Elevated C-reactive protein (CRP) levels • Positive lupus anticoagulant screen • Low fibrinogen levels • Acute kidney injury
Overlap with pregnancy specific conditions	Thrombocytopenia elevated liver enzymes	Consider preeclampsia, HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome. Symptoms also overlap: Headache, acute cerebrovascular disease, and seizures. Hypertension is a feature of preeclampsia but not usually of SARS-CoV-2.
	Acute kidney injury	Can also be a severe complication of obstetric disorders, such as pre-eclampsia with severe features, abruptio placentae, or hemorrhagic shock. Uterine bleeding is a prominent feature of the last two disorders but not for SARS- CoV-2 or preeclampsia.
Effects on pregnancy	No effect on miscarriage risk • No effect on risk of congenital anomalies • Increased in severe disease: ° Preterm birth ° Caesarean section ° Stillbirths • Increased risk of pre-eclampsia and HELLP syndrome
Vertical transmission	Extent of vertical transmission (in utero, intrapartum, early postnatal period) remains unclear, but may occur via hematogenous or ascending route.

The symbol * indicates symptoms that overlap with normal pregnancy changes.