Journal
BRAZILIAN JOURNAL OF INFECTIOUS DISEASES
Volume 25, Issue 5, Pages -Publisher
ELSEVIER BRAZIL
DOI: 10.1016/j.bjid.2021.101620
Keywords
Pregnancy; Maternal mortality; Severe acute respiratory infections; SARS-CoV-2; Brazil; SIVEP-Gripe
Categories
Funding
- CIHR Foundation Scheme Grant [FDN-143297 LFL]
- CIHR Drug Safety and Effectiveness Cross-Disciplinary Training Program (DSECT)
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In Brazil, pregnant and recently pregnant women with SARI, especially COVID-19, have higher mortality rates, particularly in regions with already high maternal mortality rates.
Background: Knowledge about COVID-19 in pregnancy is limited, and evidence on the impact of the infection during pregnancy and postpartum is still emerging. Aim: To analyze maternal morbidity and mortality due to severe acute respiratory infections (SARI), including COVID-19, in Brazil. Methods: National surveillance data from the SIVEP-Gripe (Sistema de Informa , cao de Vigilancia Epidemiologica da Gripe) was used to describe currently and recently pregnant women aged 10-49 years hospitalized for SARI from January through November, 2020. SARI cases were grouped into: COVID-19; influenza or other detected agent SARI; and SARI of unknown etiology. Characteristics, symptoms and outcomes were presented by SARI type and region. Binomial proportion and 95% confidence intervals (95% CI) for outcomes were obtained using the Clopper-Pearson method. Results: Of 945,460 SARI cases in the SIVEP-Gripe, we selected 11,074 women aged 10-49 who were pregnant (7964) or recently pregnant (3110). COVID-19 was confirmed in 49.4% cases; 1.7% had influenza or another etiological agent; and 48.9% had SARI of unknown etiology. The pardo race/ethnic group accounted for 50% of SARI cases. Hypertension/Other cardiovascular diseases, chronic respiratory diseases, diabetes, and obesity were the most common comorbidities. A total of 362 women with COVID-19 (6.6%; 95%CI 6.0-7.3) died. Mortality was 4.7% (2.2-8.8) among influenza patients, and 3.3% (2.9-3.8) among those with SARI of unknown etiology. The South-East, Northeast and North regions recorded the highest frequencies of mortality among COVID-19 patients. Conclusion: Mortality among pregnant and recently pregnant women with SARIs was elevated among those with COVID-19, particularly in regions where maternal mortality is already high. (C) 2021 Sociedade Brasileira de Infectologia. Published by Elsevier Espana, S.L.U.
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