Symptoms and syndromes associated with SARS-CoV-2 infection and severity in pregnant women from two community cohorts

Erika Molteni*, Christina M. Astley, Wenjie Ma, Carole H. Sudre, Laura A. Magee, Benjamin Murray, Tove Fall, Maria F. Gomez, Neli Tsereteli, Paul W. Franks, John S. Brownstein, Richard Davies, Jonathan Wolf, Tim D. Spector, Sebastien Ourselin, Claire J. Steves, Andrew T. Chan, Marc Modat

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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We tested whether pregnant and non-pregnant women differ in COVID-19 symptom profile and severity, and we extended previous investigations on hospitalized pregnant women to those who did not require hospitalization. Two female community-based cohorts (18–44 years) provided longitudinal (smartphone application, N = 1,170,315, n = 79 pregnant tested positive) and cross-sectional (web-based survey, N = 1,344,966, n = 134 pregnant tested positive) data, prospectively collected through self-participatory citizen surveillance in UK, Sweden and USA. Pregnant and non-pregnant were compared for frequencies of events, including SARS-CoV-2 testing, symptoms and hospitalization rates. Multivariable regression was used to investigate symptoms severity and comorbidity effects. Pregnant and non-pregnant women positive for SARS-CoV-2 infection were not different in syndromic severity, except for gastrointestinal symptoms. Pregnant were more likely to have received testing, despite reporting fewer symptoms. Pre-existing lung disease was most closely associated with syndromic severity in pregnant hospitalized. Heart and kidney diseases and diabetes increased risk. The most frequent symptoms among non-hospitalized women were anosmia [63% pregnant, 92% non-pregnant] and headache [72%, 62%]. Cardiopulmonary symptoms, including persistent cough [80%] and chest pain [73%], were more frequent among pregnant who were hospitalized. Consistent with observations in non-pregnant populations, lung disease and diabetes were associated with increased risk of more severe SARS-CoV-2 infection during pregnancy.

Original languageEnglish
Article number6928
JournalScientific Reports
Issue number1
Early online date25 Mar 2021
Publication statusPublished - Dec 2021


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