Clinical Characteristics of Pregnant Women with Coronavirus Disease 2019 in Wuhan, China

Abstract

Background: Coronavirus disease 2019 (COVID-19) has become a pandemic. Despite of the growing number of patients with COVID-19 infection, data on the clinical characteristics of pregnant women is still unknown. Methods: In this retrospective case-control study, we included childbearing-age women patients with laboratory-confirmed COVID-19 at Renmin Hospital of Wuhan University (Wuhan, China) from January 15 to February 23, 2020. Demographic, clinical, radiological, laboratory, and treatment data were reviewed and analyzed. Clinical characteristics and disease severity of pregnant and non-pregnant patients were compared. Findings: 111 childbearing-age women with COVID-19 were included, including severe or critical disease in 16 patients (14.4%). Compared with non-pregnant patients (n = 80), pregnant patients (n = 31) were younger (median age, 29.0 vs 33.0 years), less likely to have dyspnea (16.1%] vs 37.5%), asthenia (3.2% vs 33.8%), and symptoms number ≥ 3 (22.6% vs 45.0%), had significantly higher white blood cell count (6.9 vs 4.6 × 10 9 /L), neutrophil count (5.2 vs 2.5 × 10 9 /L), higher percentage of CD3+ cells (76.7% vs 73.7%) and CD8+ cells (32.3% vs 28.4%), and had dramatically lower percentage of lymphocyte (18.2% vs 31.8%), lower CD4+/CD8+ ratio (1.2 vs 1.4), lower level of IgG (9.8 vs 11.9 g/L). Notably, pregnant patients had significantly lower percentage of severe disease (3.2% vs. 18.8%) and substantially higher level of inflammation markers including neutrophil-to-lymphocyte ratio (4.4 vs 1.9) and systematic inflammatory index (812.8 vs 354.7) than non-pregnant patients. Interpretation: Pregnant patients with COVID-19 had less level of severity together with enhanced inflammatory response and cell immunity when compared with non-pregnant patients. Funding Statement: This work was supported by the Scientific Research Projects from Health and Family Planning Commission in Hubei Province (grant WJ2017M026 to Dr B. Cheng), Wuhan University School of Medicine (grant TFZZ2018018 to Dr B. Cheng), Wuhan University postdoctoral research project (grant 169557 to Dr B. Cheng), Shanghai Pujiang Talent Plan (grant 2019PJD048 to Dr S. Ren), Shanghai Key disciplines of Respiratory (grant 2017ZZ02012 to Dr S. Ren), and Shanghai Major Diseases Multidisciplinary Cooperation Diagnosis and Treatment Construction Project. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: This study was approved by the Research Ethics Committee of Renmin Hospital of Wuhan University (approval number: WDRY2020-K076). Considering the urgent need for public health outbreak investigation, written informed consent was waived. All data were anonymously collected and analyzed.