During delivery hospitalizations, COVID-19 was independently associated with increased risks of cardiovascular complications, including preeclampsia (aOR 1.33; 95% CI 1.29-1.37).
Cohort (n=3,458,691)
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Does COVID-19 infection increase the risk of acute peripartum cardiovascular complications in pregnant individuals during delivery hospitalizations?
COVID-19 infection during delivery hospitalizations is associated with a substantially increased risk of severe acute cardiovascular complications, including a nearly 13-fold higher risk of acute coronary syndrome.
Odds Ratio: 1.33 (95% CI 1.29–1.37)
Persons with COVID-19 infection have an increased risk of pregnancy-related complications. However, data on acute cardiovascular (CV) complications during delivery admissions remain limited. The purpose of this study was to determine whether pregnant individuals with COVID-19 have an increased risk of acute peripartum CV complications during their delivery admission. This population-based retrospective cohort study used the 2020 National Inpatient Sample database. The International Classification of Diseases, 10th Revision codes were used to identify delivery admissions with a diagnosis of COVID-19. A multivariable logistic regression model was performed to determine the association between COVID-19 and acute peripartum CV complications at delivery. A total of 3, 458, 691 weighted delivery admissions were identified, of which 1. 3% were among persons with COVID-19 (n = 46, 375). Persons with COVID-19 were younger (median 28 vs 29 years, P < 0. 01) and had a higher prevalence of gestational diabetes mellitus, preterm births, and Cesarean delivery (P < 0. 01). After adjustment for age, race/ethnicity, comorbidities, insurance, and income, COVID-19 remained independently associated with peripartum CV complications including preeclampsia (adjusted odds ratio aOR: 1. 33 95% CI, 1. 29-1. 37), peripartum cardiomyopathy (aOR: 2. 09 1. 54-2. 84), acute coronary syndrome (aOR: 12. 94 8. 85-18. 90), and arrhythmias (aOR: 1. 55 1. 45-1. 67), compared with no COVID-19. Likewise, the risks of in-hospital mortality, acute kidney injury, stroke, pulmonary edema, and venous thromboembolism were higher with COVID-19. For resource utilization, the cost of hospitalization (5, 374 vs 4, 837, P < 0. 01) was higher for deliveries among persons with COVID-19. In the year 2020, pregnant persons with COVID-19 had a higher risk of preeclampsia, in-hospital mortality, and other serious CV complication during delivery hospitalizations compared to pregnant individuals without COVID-19.
Zahid et al. (Thu,) conducted a cohort in Pregnancy with COVID-19 (n=3,458,691). COVID-19 vs. No COVID-19 was evaluated on Preeclampsia (aOR 1.33, 95% CI 1.29-1.37). During delivery hospitalizations, COVID-19 was independently associated with increased risks of cardiovascular complications, including preeclampsia (aOR 1.33; 95% CI 1.29-1.37).