COVID-19 impact in pregnancy ‘severe’ in cohort of HIV-positive South African women
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The impact of COVID-19 in pregnancy was “severe” among a cohort of HIV-positive women in South Africa, researchers reported at the Conference on Retroviruses and Opportunistic Infections.
However, no clinical differences were attributed to HIV infection, “likely because they were mostly virologically suppressed,” Liesl de Waard, MB ChB, an obstetrician and gynecologist at Stellenbosch University in South Africa, told Healio.
De Waard and colleagues analyzed data from pregnant women with COVID-19 at a hospital in Cape Town from May 1 through July 31, 2020, and documented pregnancy and birth outcomes through Oct. 30.
In her presentation, de Waard noted that about 20% of all women delivering babies at the Cape Town hospital were living with HIV. However, she reported that less than 1% of the pregnancies led to vertical transmission.
Among 100 pregnant women, 28 had HIV. All 100 women had laboratory-confirmed cases of COVID-19. Frequently observed comorbidities were obesity, hypertension disorders and gestational diabetes, the authors reported.
Among the 28 pregnant women living with HIV, 27 received ART. Nineteen women were virologically suppressed.
Of the 100 women, 81 cases of COVID-19 were diagnosed in the third trimester, and half of the women delivered within 2 weeks of infection onset.
While infected, 40 women developed pneumonia and 13 developed adult respiratory distress syndrome, whereas six required invasive ventilation. Eight deaths were reported — seven from adult respiratory distress syndrome, and one from advanced HIV disease with bacteremia.
“COVID-19 can lead to severe morbidity and mortality in women with certain high-risk conditions in pregnancy,” de Waard told Healio. “However, women living with HIV who are on treatment and virally suppressed are not at higher risk for mortality or severe disease.”
In all, 91 live births were reported, five stillbirths, four miscarriages, two mothers died with the fetus in fetu, and there was one medical termination of a pregnancy. Of the 91 live births, 90 neonates were fine, but one died from complications related to perinatal asphyxia.