COVID-19 When Pregnant and Living with a Rheumatic Disease

COVID-19 When Pregnant and Living with a Rheumatic Disease 

In this small study, people with systemic rheumatic diseases who were pregnant at the time of COVID-19 infection had relatively favorable outcomes. The co-existence of a chronic rheumatologic disease and pregnancy did not suggest worse outcomes from COVID-19 infection than what has been observed in the general population of people that are pregnant. This provides cautious optimism, given the increased risk of poor outcomes that have been reported in other studies of people that are pregnant with COVID-19. 

The study is from the COVID-19 Global Rheumatology Alliance’s (GRA) physician registry (March 24, 2020-January 14, 2021) that contained 39 rheumatology patients that were pregnant at the time of their COVID-19 infection. Rheumatic disease diagnosis included people living with rheumatoid arthritis, lupus, psoriatic arthritis or other inflammatory arthritis, and antiphospholipid antibody syndrome. 

Researchers compared the results to other women of childbearing age that were not pregnant who are part of the same GRA physician registry of rheumatology patients. 

Pregnant N=39 Non-Pregnant N=1878
Not Hospitalized 29 (74%) 1584 (84%)
Hospitalized 10 (26) 126 (7%)
      Hospitalized with Supplemental  Oxygen 2 (5%) 127 (7%)
Death 0 (0%) 41 (2%)

Researchers reviewed data on race, age, comorbidities (such as diabetes or obesity), and medications. The people in this registry were young, had few comorbidities, and were on low glucocorticoid doses, all of which may have contributed to a more benign course. Information regarding pregnancy including previous pregnancy and outcomes were available for 22 people. 

Pregnancy Status Number Gestation
Termination 1 9 weeks
Miscarriage 1 <20 weeks
Ongoing 1 19 weeks
Preterm Birth (<37/40) 3 32, 35, and 36 weeks
Term Birth 16 Median = 39 weeks

The data from this registry cannot address the individual risk of infection, morbidity, or pregnancy outcome. Further details are in the published study in the Journal of Rheumatology COVID-19 In Women With Rheumatic Disease Who Are Pregnant: Data from the COVID-19 Global Rheumatology Alliance [Open Access Paper]

This lay summary was written/reviewed by: 

Richard Howard, John Wallace, Jean W. Liew, MD, Philip C Robinson