Abstract

Abstract Background Comparing outcomes of both symptomatic and asymptomatic hospitalized pregnant women with COVID-19 can inform both the prognosis during hospitalization for pregnant women with COVID-19 and the relationship of COVID-19 to pregnancy outcomes. Methods Using population-based surveillance data from COVID-19 Associated Hospitalization Surveillance Network (COVID-NET), chart reviews were conducted for SARS-CoV-2 positive pregnant patients, age 15 to 49 years, residing in Alameda, Contra Costa, and San Francisco Counties in California who delivered in a hospital between March 1st 2020 and February 28th 2021. Cases were defined as SARS-CoV-2 positive if they had a positive test during hospitalization or within 14 days prior to admission. Multivariate analysis was used to describe demographic characteristics, underlying medical conditions, vaccination status, and pregnancy outcomes by presence or absence of symptoms upon hospitalization. Chi-square tests assessed significance with p-values < 0.05 considered statistically significant. Results Among the 330 SARS-CoV-2 positive women that delivered in a hospital, 60.3% were Hispanic or Latino, 4.9% were White (Non-Hispanic), 6.4% were Black (Non-Hispanic), 6.7% were Asian or Pacific Islander, 0.9% were multiracial, and 20.9% were unknown race or ethnicity. Symptomatic cases spent a median of 3 days in the hospital while asymptomatic cases spent a median of 2 days in the hospital. Symptomatic women were more likely to have a Caesarian-section (OR 2.49, 95% CI: 1.45, 4.28), have preeclampsia (OR 2.19, 95% CI: 1.17, 4.10), and be admitted to the ICU (OR 3.78, 95% CI: 1.08, 13.29) than asymptomatic women. Invasive mechanical ventilation was required for 3 of the 109 symptomatic women and none of the 221 asymptomatic women (P=0.03). Conclusion Among hospitalized SARS-CoV-2 positive patients in three California countries from March 1st 2020 to February 28th 2021, symptomatic pregnant women were more likely to have a Caesarian-section, have preeclampsia, and be admitted to the ICU compared to asymptomatic pregnant women. As COVID-19 continues to be prevalent, future studies should examine the associations and potential confounders between COVID-19 symptoms and pregnancy outcomes. Disclosures All Authors: No reported disclosures.

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