Study Investigates COVID-19 in Pregnant Patients with Rheumatologic Disease
A new study has found that among patients with rheumatologic disease, pregnancy is not associated with increased self-reported COVID-19, but is associated with a shorter duration of COVID-19 symptoms and a higher prevalence of loss of smell or taste. The study, by researchers from Hospital for Special Surgery (HSS), in New York City, appears online first in the journal Arthritis Care & Research.
“The results may provide some reassurance to physicians who are taking care of women with rheumatic diseases who become pregnant or who are contemplating pregnancy during the pandemic, because there does not seem to be an increased risk of COVID-19, but the findings need to be interpreted with caution given that in other national datasets including the Centers for Disease Control and Prevention data, pregnant patients who get COVID-19 have been shown to have potentially more severe outcomes,” said lead study author Medha Barbhaiya, MD, MPH, rheumatologist at HSS and assistant professor of medicine and healthcare policy & research, Weill Cornell Medicine.
For their study, Dr. Barbhaiya and her colleagues emailed an online COVID-19 survey to 26,045 patients in the Division of Rheumatology at HSS. 7,094 responded with 1,547 in the targeted population of women age 18 to 50. 4% reported pregnancy.
The prevalence of self-reported COVID-19 was similar in pregnant and non-pregnant women (8% vs. 9% respectively; P=0.76). Among women with COVID-19, pregnant women had a shorter duration of symptoms (P<0.01) and were more likely to experience loss of smell or taste (P=0.02) than non-pregnant women. A systemic rheumatic disease was present in approximately three-fourths of women, with no differences when stratified by pregnancy or COVID-19 status. While 67% of pregnant women reported changes to prenatal care during the pandemic, 23% of postpartum women stated the pandemic affected delivery.
“These findings are novel and should be investigated in other cohorts. Future studies will hopefully assess the long-term outcomes of rheumatology patients and their offspring who were exposed to COVID-19 during pregnancy, which our cross-sectional study could not address,” said Dr. Barbhaiya.
“Why pregnant patients are more likely to present with these symptoms warrants further study. This unique finding may help us better understand the immunology of both conditions,” said senior study author Lisa A. Mandl, MD, MPH, rheumatologist at HSS and assistant professor of medicine and healthcare policy & research, Weill Cornell Medicine. “These data also suggest that testing for COVID-19 in otherwise well pregnant women who lose their sense of taste or smell may help in the timely identification of COVID-19 in these vulnerable patients.”
HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 11th consecutive year), No. 4 in rheumatology by U.S. News & World Report (2020-2021), and named a leader in pediatric orthopedics by U.S. News & World Report “Best Children’s Hospitals” list (2020-2021). HSS is ranked world #1 in orthopedics by Newsweek (2020-2021). Founded in 1863, the Hospital has the lowest complication and readmission rates in the nation for orthopedics, and among the lowest infection rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center five consecutive times. The global standard total knee replacement was developed at HSS in 1969. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Global Innovation Institute was formed in 2016 to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 130 countries. The institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu.