COVID-19 Among Pregnant Women in Assiut
COVID-19 Among Pregnant Women in Assiut
COVID-19 is a new disease , little is known about COVID-19 during pregnancy and to the best
 of our knowledge no published studies in Assiut .

 Aims of the Research :

 1. To describe COVID-19 among pregnant women attending isolation and women hospitals in
 Assiut .

 2. To identify comorbidities that may affect both maternal , fetal and neonatal outcomes .

 3. To correlate between COVID-19 infection and maternal, fetal and neonatal outcomes .
COVID-19 is the disease caused by a new corona virus on December 2019 in Wuhan, China . On
 February 2020, the International Committee of Taxonomy of Viruses recognized the etiology of
 this infection and named it "SARS-CoV-2". World Health Organization (WHO) named the disease
 COVID-19 , and declared it a pandemic on March 11th 2020 .

 Pregnant women are at an increased risk for severe illness from COVID-19 compared to
 non-pregnant women . Additionally, pregnancy represents a vulnerable period, and this
 pandemic can negatively impact its outcomes . Therefore, pregnant women may be a group
 requiring special care in relation to the transmission of SARS-CoV-2 .

 The modulations of the maternal immune system in pregnancy may have consequences for the
 clinical course of COVID-19 , for the treatment and prevention of COVID-19 in pregnancy . In
 addition to the systemic immunological changes, the reduction in total lung capacity and
 inability to clear secretions occurring during pregnancy can make pregnant more susceptible
 to severe respiratory infections .

 There are higher levels of circulating coagulation and fibrinolytic factors during pregnancy
 which may be implicated in the pathogenesis of SARS-CoV-2 infection.

 COVID-19 disease has a similar spectrum of symptoms in pregnant woman as in non-pregnant
 woman . Although most of the symptoms are less frequent during pregnancy but pregnant women
 are more likely to need admission to an ICU and require invasive ventilation .

 Pre-existing maternal comorbidities such as increased maternal age, high body mass index,
 chronic hypertension and pre-existing diabetes are risk factors for the severity of
 infection.

 The overall data from cohort studies by Allotey et al. , showed 73 deaths (0.63%) in COVID-19
 positive pregnant women. The severe form of COVID-19 manifested in 13% of pregnant women,
 admission to an intensive care unit was required for 4% , 3% required invasive ventilation
 and 0.4% required extracorporeal membrane oxygenation .

 Hsu et al. study on COVID-19 symptom progression during pregnancy compared to non pregnant
 women showed that 8.3% of the COVID-19 pregnant women had severe disease of whom 86%
 progressed to a critical stage and were admitted to the ICU , another study by Blitz et al.
 showed no significant difference between the rates of ICU admission in hospitalized COVID-19
 pregnant and non-pregnant COVID-19 positive patients .

 Vertical transmission happens if an infected pregnant woman transmits the infection to her
 fetus / infant during the fetal , intra-partum or post-partum period . Kotlyar et al. in
 their systematic review and meta-analysis showed a pooled proportion of 3.2% for vertical
 transmission of COVID-19 infection .

 Other studies as Penfield et al. have shown a linkage of vertical transmission with maternal
 disease severity .
Inclusion Criteria:

 -  Pregnant women with confirmed COVID-19 in Isolation hospitals in Assiut recorded and
 diagnosed by PCR swab from 1/3/2020 until the end of October 2021.

 Exclusion Criteria:

 -  Pregnant women who are probably or suspected to be infected with COVID-19.