POS0104 POST-COVID SYNDROME IN THE ANTENATAL PERIOD IN WOMEN WITH AUTOIMMUNE DISEASES: AN ANALYSIS FROM THE COVAD DATA SET
Authors: A. Bobirca, C. Alexandru, L. Andreoli, T. Velikova, A. E. Gracia-Ramos, P. Yaadav, S. S. Shaharir, K. Schreiber, A. L. Tan, C. Vinicio Caballero, R. Aggarwal, V. Agarwal, L. Gupta
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Patients with autoimmune diseases (AD) are often at risk of severe COVID manifestations and post COVID syndrome (PCS). Pregnant and breastfeeding (PB) women with AD are an even more vulnerable population, though little is known about the prevalence and characteristics of PCS. <h3>Objectives:</h3> We explored the frequency and characteristics of PCS in the antenatal period in women with AD using the COVAD 2 dataset. <h3>Methods:</h3> The COVAD 2 is a global initiative with responses from 106 countries gathered as a patient -reported electronic survey translated into 18 languages and vetted by a team of experts. PCS was defined as symptoms persisting for more than 3 months after COVID infection, in accordance with the WHO definition. Sex other than female and incomplete responses were excluded. Frequency of PCS in pregnant/breastfeeding (PB) women with AD was compared to controls without AD. <h3>Results:</h3> A total of 15832 responses were gathered, of which 7150 were women (46.2%), 2338 (32.7%) reported at least one positive COVID test, and 1417 (60.6%) submitting a complete COVAD survey at least 3 months after a positive test. Females diagnosed with AD were found in 63.3% of the responses. The frequency of PCS in women with AD was higher compared with women without AD (11.8% vs. 7.9%, respectively). Out of the entire cohort analyzed, 45 women (3.2%) had a positive test during pregnancy or during breastfeeding period, 44.4% women being diagnosed with AD (Table 1). The frequency of PCS among PB women was 6.7% (3/45 cases), compared with 10.5% among non-pregnant, non-breastfeeding females. Considering the presence of ADs, the frequency of PCS in PB women with AD was 15%, while no reports of PCS were documented in PB controls. All three women with PCS in PB group had persistent symptomatology for more than 100 days (135, 114, 121 days, respectively) and had a positive COVID test during pregnancy, neither during breastfeeding period. The three cases were diagnosed with myositis, overlap syndrome and connective tissue disease, respectively. Two out of three women had a disease flare during COVID-19 infection. In two cases oxygen supplementation and special advanced treatment for COVID was administered. <h3>Conclusion:</h3> One in fifteen pregnant women with AD seem to be at risk of PCS, that's higher than in controls, this risk being slightly higher than the background risk identified in individuals with ADs. All cases of PCS in pregnant/breastfeeding women had a positive COVID during pregnancy, therefore it seems plausible that antenatal period may predispose to a more severe condition and longer resolution of the symptomatology. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> The authors are grateful to all COVAD Study Group collaborators. <h3>Disclosure of Interests:</h3> <b>None declared.</b>