In-Hospital Mortality in a Cohort of Hospitalized Pregnant and Nonpregnant Patients With COVID-19
Authors: Federico Prefumo
Journal: Annals of Internal Medicine (2021)

LettersDecember 2021In-Hospital Mortality in a Cohort of Hospitalized Pregnant and Nonpregnant Patients With COVID-19FREEFederico Prefumo, MD, PhDFederico Prefumo, MD, PhDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L21-0632 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: Pineles and colleagues' (1) interesting brief research report contradicts previous reports suggesting a higher risk for adverse outcomes in pregnant women with COVID-19 when matched to nonpregnant women with COVID-19 (2) or pregnant women without COVID-19 (3). However, their report suffers from 2 fundamental biases: It is based on administrative data on women admitted to the hospital for COVID-19 and pneumonia, and the analysis does not take into account the clinical severity of the disease. Lower thresholds for hospital and intensive care unit admission and mechanical ventilation were probably applied to the pregnant population because of concerns for fetal well-being, as well as society's appreciation of pregnant women as a group deserving priority in health care resource allocation. For example, most guidelines, expert opinions, and protocols recommend higher target Spo2 values in pregnant women than in other adult patients. It is therefore highly possible that a less severe spectrum of disease and prioritization of interventions in pregnant women may explain the better outcomes observed in pregnant women in Pineles and colleagues' report.References1. Pineles BL, Goodman KE, Pineles L, et al. In-hospital mortality in a cohort of hospitalized pregnant and nonpregnant patients with COVID-19. Ann Intern Med. 2021;174:1186-8. [PMID: 33971101] doi:10.7326/M21-0974 LinkGoogle Scholar2. Martinez-Portilla RJ, Sotiriadis A, Chatzakis C, et al. Pregnant women with SARS-CoV-2 infection are at higher risk of death and pneumonia: propensity score matched analysis of a nationwide prospective cohort (COV19Mx). Ultrasound Obstet Gynecol. 2021;57:224-31. [PMID: 33320401] doi:10.1002/uog.23575 CrossrefMedlineGoogle Scholar3. Villar J, Ariff S, Gunier RB, et al. Maternal and neonatal morbidity and mortality among pregnant women with and without COVID-19 infection: the INTERCOVID multinational cohort study. JAMA Pediatr. 2021;175:817-26. [PMID: 33885740] doi:10.1001/jamapediatrics.2021.1050 CrossrefMedlineGoogle Scholar Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: Disclosures: The author has reported no disclosures of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L21-0632. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoIn-Hospital Mortality in a Cohort of Hospitalized Pregnant and Nonpregnant Patients With COVID-19 Beth L. Pineles , Katherine E. Goodman , Lisa Pineles , Lyndsay M. O’Hara , Gita Nadimpalli , Laurence S. Magder , Jonathan D. Baghdadi , Jacqueline G. Parchem , and Anthony D. Harris In-Hospital Mortality in a Cohort of Hospitalized Pregnant and Nonpregnant Patients With COVID-19 José H. Pagliery In-Hospital Mortality in a Cohort of Hospitalized Pregnant and Nonpregnant Patients With COVID-19 Beth L. Pineles and Anthony D. Harris Metrics December 2021Volume 174, Issue 12Page: 1779KeywordsCOVID-19Cohort studiesEpidemiologyIntensive care unitsInterquartile rangeMortalityPatientsPregnancyPrevention, policy, and public healthViral pneumonia ePublished: 21 December 2021 Issue Published: December 2021 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...