Omicron prompted spike in COVID cases in pregnant women, but fewer hospitalizations

Date:
April 25, 2022
Source:
UT Southwestern Medical Center
Summary:
Women who were pregnant during the recent Omicron surge were
diagnosed with COVID-19 at a much higher rate than during previous
phases of the pandemic, but were less likely to develop severe
illness, a study has found.



FULL STORY ========================================================================== Women who were pregnant during the recent Omicron surge were diagnosed
with COVID-19 at a much higher rate than during previous phases of the pandemic, but were less likely to develop severe illness, a study by
UT Southwestern and Parkland Health scientists found. The research,
reported in JAMA, is the first published evidence documenting how the
boom in COVID-19 cases late last year and early this year impacted the
health of pregnant women.


========================================================================== "Obstetrics never stopped during the pandemic. Women are still having
babies and coming in for their prenatal care," said study leader
Emily Adhikari, M.D., Assistant Professor and Maternal-Fetal Medicine specialist at UTSW and Medical Director of Perinatal Infectious Diseases
at Parkland Health. "It's important to understand how this virus behaves
in the population we serve." Dr. Adhikari explained that respiratory infections, including COVID-19, are as infectious to pregnant women as
they are in the general population. However, their effects can be far
more severe due to the physiologic changes that occur in pregnancy: While
a woman's lung capacity decreases about 20-30% during later pregnancy,
oxygen consumption increases significantly as the fetus grows.

Although previous research, including a study at UTSW, had shown that hospitalizations of pregnant women increased during the Delta wave of
COVID-19, no research had yet quantified severity of the Omicron variant
in this population.

Toward this end, Dr. Adhikari, along with colleagues in Women and
Infants Specialty Health at Parkland and in the Departments of Pathology
and Pediatrics at UT Southwestern, gathered data from patients who
received prenatal care at Parkland Health, the Dallas County system encompassing a centralized acute care hospital and 10 community-based
prenatal clinics. The researchers collected information on positive cases
and whether their illness was severe -- meaning the patient required supplemental oxygen or higher-level support such as high- flow nasal
cannula, mechanical ventilation, or extracorporeal membrane oxygenation
(a type of life support that temporarily replaces heart and lung function)
-- spanning May 17, 2020 to Jan. 29, 2022.

Dr. Adhikari and her colleagues found that 2,641 positive cases were
diagnosed during this time period, which covered a pre-Delta phase, the
Delta surge, and the Omicron surge. Their analysis showed that during
the Delta surge, the case rate was three times higher than during the
pre-Delta period. The case rate during the Omicron surge was 10 times
higher than the pre-Delta period.

However, while Delta cases were about three times more severe than
pre-Delta cases, Omicron cases were about 80% less severe, Dr. Adhikari
said.

She noted that although vaccination might have played a role in decreasing
the severity of illness, this variable was accounted for, suggesting
that differences may be due to other factors, such as the behavior of the particular SARS-CoV-2 variant or immunity from prior infection. Because
the future of the pandemic remains uncertain, Dr. Adhikari added,
vaccination will be key to helping pregnant women stay healthy if the
next variant causes more severe illness.

"We're very lucky that although Omicron caused more cases than Delta,
it was a less severe variant. If the same portion of positive patients
had ended up on oxygen or ventilators, we would have been overwhelmed,"
Dr. Adhikari said. "We have no control over the nature of the next
variant, but pregnant women do have control over whether to receive the COVID-19 vaccine, which has been proven to help prevent severe illness
and spread." Other researchers who contributed to this study include
Jeffrey A. SoRelle, Jessica Morse, Jessica Pruszynski, and Catherine
Y. Spong, all of UT Southwestern; and Lorre MacDonald of Parkland Health.

Dr. SoRelle is the inventor of the genotyping PCR tests for variants
and is entitled to income from their use.


========================================================================== Story Source: Materials provided by UT_Southwestern_Medical_Center. Note: Content may be edited for style and length.


========================================================================== Journal References:
1. Emily H. Adhikari, Lorre MacDonald, Jeffrey A. SoRelle, Jessica
Morse,
Jessica Pruszynski, Catherine Y. Spong. COVID-19 Cases and Disease
Severity in Pregnancy and Neonatal Positivity Associated With Delta
(B.1.617.2) and Omicron (B.1.1.529) Variant Predominance. JAMA,
2022; 327 (15): 1500 DOI: 10.1001/jama.2022.4356
2. Emily H. Adhikari, Jeffrey A. SoRelle, Donald D. McIntire,
Catherine Y.

Spong. Increasing severity of COVID-19 in pregnancy with Delta
(B.1.617.2) variant surge. American Journal of Obstetrics and
Gynecology, 2022; 226 (1): 149 DOI: 10.1016/j.ajog.2021.09.008 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/04/220425121046.htm

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