Rheumatic disease in pregnancy not linked to worse COVID-19 outcomes: C19-GRA

Thursday, 9 Sep 2021

Pregnant women who have systemic rheumatic disease do not seem to be at greater risk of worse outcomes from COVID-19 infection than the general population of pregnant women, a small study suggests.

Using data from the global COVID-19 Global Rheumatology Alliance (C19-GRA) registry, researchers looked at data on 39 pregnant women (mean age of 33 years) with rheumatic diseases who developed COVID-19.

The rheumatic diseases diagnosed included rheumatoid arthritis (n=9), systemic lupus erythematosus (9), psoriatic/other inflammatory arthritides (8) and anti-phospholipid antibody syndrome (6).

The data, published in the Journal of Rheumatology, showed that a quarter (10) of the women were hospitalised, but only two required supplemental oxygen and none died.

Three reported no symptoms, and in those who did the most common (reported by five or more patients) included cough (24), fever (21), headache (12), anosmia (11), myalgia (11), shortness of breath (11), vomiting or nausea (8), arthralgia (8), altered taste (6) and sore throat (6).

The majority (82%) did not receive specific medication for their COVID-19 infection, and seven patients received a combination of anti-malarials, colchicine, anti-IL-1beta, azithromycin, glucocorticoids and lopinavir/ritonavir.

Current evidence suggests that pregnant women with COVID-19 infection are more likely to be hospitalised and require mechanical ventilation and may have a higher likelihood of death compared to non-pregnant women. These results indicate that having a rheumatic disease did not further worsen outcomes.

While the study had limitations due to its small size and methodology, the findings “provide cautious optimism for pregnancy outcomes for women with rheumatic disease given the increased risk of poor outcomes that have been reported in other series of pregnant women with COVID-19,” the authors noted.

“Pregnancy and COVID-19 outcomes in pregnant patients with systemic rheumatic disease were relatively benign in this patient series. However, data on all pregnancy outcomes and whether there were any cases of vertical transmission to infants is not available,” they said.

“Additional cases with greater granularity of data regarding pregnancy and fetal outcomes in the rheumatic disease population will greatly enhance our knowledge in this area.”

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