Evidence map›Paper›PMID 38096234›Full record

ArticlePloS one2023

Severe Covid-19 in pregnant and postpartum women admitted to an intensive care unit: A retrospective cohort study.

Isabel Cristina Melo Mendes, Ana Luiza Martins de Oliveira, Priscila Martins Pinheiro Trindade, Wallace Mendes da Silva, Patricia Pontes Frankel, Carolina Carvalho Mocarzel, Marta de Alencar Rosa, Ana Paula Santos Nascimento, Glaucia de Melo Rodrigues, Clarisse Pimentel and 4 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 3 institutions in 1 country.

Isabel Cristina Melo MendesInfectious Diseases Post-Graduation Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.ORCID 0000-0002-3654-8436
Ana Luiza Martins de OliveiraInstituto Estadual de Infectologia São Sebastião, Rio de Janeiro, Brazil.
Priscila Martins Pinheiro TrindadeFaculty of Pharmacy, Fluminense Federal University, Niteroi, Brazil.
Wallace Mendes da SilvaHospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil.ORCID 0000-0002-5195-4061
Patricia Pontes FrankelHospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil.
Carolina Carvalho MocarzelHospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil.
Marta de Alencar RosaHospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil.ORCID 0009-0003-6852-5022
Ana Paula Santos NascimentoInstituto Estadual de Infectologia São Sebastião, Rio de Janeiro, Brazil.
Glaucia de Melo RodriguesInstituto Estadual de Infectologia São Sebastião, Rio de Janeiro, Brazil.
Clarisse PimentelInstituto Estadual de Infectologia São Sebastião, Rio de Janeiro, Brazil.
Raissa de Moraes PerlingeiroInstituto Estadual de Infectologia São Sebastião, Rio de Janeiro, Brazil.ORCID 0000-0003-1671-2398
Alessandra Gonçalves Lisbôa PereiraHospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil.
Claudia Caminha EscosteguyHospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil.
Rafael Mello GalliezInstituto Estadual de Infectologia São Sebastião, Rio de Janeiro, Brazil.
Hospital Federal dos Servidores do Estado · BRUniversidade Federal do Rio de Janeiro · BRUniversidade Federal Fluminense · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSARS-CoV-2 infection is associated with worse maternal and fetal outcomes. This study aims to describe the characteristics of pregnant and postpartum women with severe Covid-19 admitted to ICU. METHODS AND

findingsIt's a retrospective cohort study evaluating pregnant and postpartum women referenced to a specialized ICU between May 2020 and June 2022. Covid-19 was confirmed with RT-PCR or rapid antigen test on a nasopharyngeal swab. Variables were described by median and IQR when numerical, and by frequency and percentage when categorical. OR with 95% CI were calculated for the evaluation of factors related to death. P-values were calculated using Pearson's ꭓ2-test, Fisher's exact test, Wilcoxon rank sum test, and Kruskall-Wallis test, and statistical significance was established as < 0·05. Missing data were excluded. All statistical analysis were performed using R software version 4.2.2. Of the 101 admissions, 85 (84·2%) were of pregnant women. Obesity (23·0%) and systemic arterial hypertension (13·0%) were the most prevalent medical conditions. Sixty-six (65·3%) were admitted using some type of oxygen support. Forty-seven (46·5%) evolved to mechanical ventilation. There were 61 events considered obstetric complications, with 8 stillbirths/fetal losses. The overall lethality was 15·8%. Pregnancy interruption, need for non-invasive mechanical ventilation, level of oxygen support at admission, prone maneuver, hemodialysis, and healthcare-related infections were factors associated with death. Evaluating the WHO 7-category ordinary scale, there was a trend of increase in the risk of death with higher punctuation, with a statistically significant difference of women with 5 (OR = 7·27; 95% IC = 1·17-194; p = 0·031) or 6 points (OR = 12·0; 95% IC = 1·15-391; p = 0·038) when compared to the ones with 3 points, i.e., of women admitted with a high-flow non-rebreathing mask or invasive mechanical ventilation, compared with the ones admitted at room air, respectively. The main limitations of this study are the relatively small number of participants, and the use of data derived of medical records-which are susceptible to misclassification and variable amounts of missing data.

conclusionsPregnant and postpartum women with severe Covid-19 have high lethality and a high incidence of clinical and obstetric complications. These findings support that this population should be prioritized in public health strategies that address Covid-19.

Indexed as

COVID-19FemaleHumansIntensive Care UnitsOxygenPostpartum PeriodPregnancyPregnant PeopleRetrospective StudiesSARS-CoV-2Oxygen

Identifiers

PMID38096234
PMCPMC10721012
OpenAlexW4389725925

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.