Comorbidity, poverty and social vulnerability as risk factors for mortality in pregnant women with confirmed <scp>SARS‐CoV</scp>‐2 infection: analysis of 13 062 positive pregnancies including 176 maternal deaths in Mexico

Torres-Torres, Johnatan; Martínez-Portilla, Raigam Jafet; Sosa, Salvador Espino Y; Estrada-Gutiérrez, Guadalupe; Solis-Paredes, Juan Mario; Villafán-Bernal, José Rafael; Medina-Jimenez, V.; Rodríguez‐Morales, Alfonso J.; Rojas-Zepeda, Lourdes; Poon, Liona C.

doi:10.1002/uog.24797

Cited by 29 publications

(34 citation statements)

References 22 publications

(29 reference statements)

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“…This finding shows that young people feel empathy for others, something that has been denied by criminalizing them in the media. In addition, in Mexico the population has a high comorbidity [ 42 ] having several diseases, so the Mexican population is more vulnerable at the time of being infected by COVID-19 and this can raise the levels of psychological symptomatology.…”

Section: Discussionmentioning

confidence: 99%

Emotional State of Mexican University Students in the COVID-19 Pandemic

Santamaría

Ozamiz-Etxebarria

Mondragón

et al. 2022

IJERPH

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Background: Since the WHO declared the COVID-19 crisis a pandemic in March 2020, the young population is suffering from a range of psychological symptoms. The present study measured symptoms of stress, anxiety and depression in university students of Saltillo, Mexico, using the Depression and Anxiety Stress Scale-21 (DASS-21). Methods. The DASS-21 scale and an ad hoc questionnaire were used to collect sociodemographic information. Results: The results show that the students who participated in this study suffer from high levels of stress, anxiety and depression. In terms of sociodemographic variables, women, people suffering from a chronic disease and people living with a chronic disease had the highest levels of stress, anxiety and depression, and people who live with a chronically ill person, people who have had the COVID-19 disease and those who have had someone close to them fall sick have had more stress, anxiety and depression than the rest. Another finding of the present study is that university students who believe that others comply with COVID-19 safety measures have significantly lower anxiety and depression than those who believe that others do not comply. Conclusions: It is concluded that university students are a psychologically vulnerable group in the face of the pandemic.

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Section: Discussionmentioning

confidence: 99%

Emotional State of Mexican University Students in the COVID-19 Pandemic

Santamaría

Ozamiz-Etxebarria

Mondragón

et al. 2022

IJERPH

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“…Conversely, higher admission rates to ICU and a higher risk for more severe COVID-19 cases was reported among pregnant compared with non-pregnant patients (238)(239)(240). Advanced maternal age, comorbidities such as diabetes mellitus, hypertension, low socioeconomic status as well as obesity have all been identified as possible risk factors for maternal death from COVID-19 (241).…”

Section: Covid-19 and Pregnancymentioning

confidence: 99%

Molecular and Physiological Aspects of SARS-CoV-2 Infection in Women and Pregnancy

Liu

xavier

Singh

et al. 2022

Front. Glob. Womens Health

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Whilst scientific knowledge about SARS-CoV-2 and COVID-19 is rapidly increasing, much of the effects on pregnant women is still unknown. To accommodate pregnancy, the human endometrium must undergo a physiological transformation called decidualization. These changes encompass the remodeling of endometrial immune cells leading to immunotolerance of the semi-allogenic conceptus as well as defense against pathogens. The angiotensin converting enzyme 2 (ACE2) plays an important regulatory role in the renin-angiotensin-system (RAS) and has been shown to be protective against comorbidities known to worsen COVID-19 outcomes. Furthermore, ACE2 is also crucial for decidualization and thus for early gestation. An astounding gender difference has been found in COVID-19 with male patients presenting with more severe cases and higher mortality rates. This could be attributed to differences in sex chromosomes, hormone levels and behavior patterns. Despite profound changes in the female body during pregnancy, expectant mothers do not face worse outcomes compared with non-pregnant women. Whereas mother-to-child transmission through respiratory droplets during labor or in the postnatal period is known, another question of in utero transmission remains unanswered. Evidence of placental SARS-CoV-2 infection and expression of viral entry receptors at the maternal-fetal interface suggests the possibility of in utero transmission. SARS-CoV-2 can cause further harm through placental damage, maternal systemic inflammation, and hindered access to health care during the pandemic. More research on the effects of COVID-19 during early pregnancy as well as vaccination and treatment options for gravid patients is urgently needed.

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“…Coronavirus disease-2019 (COVID-19) was associated with a substantial increase in maternal morbidity and mortality ( 5 ) . The maternal mortality rates varied widely from 1.35% to 12.3% ( 6 , 7 , 8 ) . Variants of concern have begun to be reported by the World Health Organization (WHO) ( 9 ) and the pace of the pandemic has increased.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 related maternal mortality cases in associated with Delta and Omicron waves and the role of lung ultrasound

Tekin¹,

Yassa²,

İlter³

et al. 2022

tjod

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Objective: To present coronavirus disease-2019 (COVID-19) related maternal mortality in relation to Delta and Omicron waves and to investigate the role of lung ultrasound (LUS) in estimating mortality. Materials and Methods: This retrospective cohort study was conducted in the obstetrics and gynecology clinic of a tertiary pandemic hospital between March 2020 and January 2022. The hospitalized pregnant women with COVID-19 diagnosis and maternal deaths were studied in relation with Delta and Omicron waves. The relationship between LUS scores of hospitalized patients and maternal mortality was explored. Results: Thousand and sixty-five pregnant women were hospitalized because of COVID-19 infection. Fifty-one (4.79%) of these patients had critical sickness, 96 (9.01%) of them had severe illness, 62 (5.82%) of them were admitted to the intensive care unit and 28 (2.63%) of all hospitalized pregnant women had died. Of the 1.065 patients, 783 (73.5%) were hospitalized before the Delta wave and the maternal mortality rate was 1.28% (10/783), 243 (22.8%) were hospitalized during the Delta wave and the maternal mortality rate was 7% (17/243) [relative risk (RR)=5.478, 95% confidence interval (CI) (2.54-11.8), z=4.342, p<0.001]. During the Omicron wave 39 (3.66%) patients were hospitalized and the maternal mortality rate was 2.56% (1/39). Maternal mortality rates, according to LUS scores, were 0.37% (1/273) for LUS 0, 0.72% (2/277) for LUS 1, 2.58% (10/387) for LUS 2 and 11.72% (15/128) for LUS 3 respectively (LUS 3 vs. others; maternal mortality: RR=8.447, 95% CI (4.11-17.34), z=5.814, p<0.0001). There were no vaccinated patients in the study cohort. Conclusion: The maternal mortality rate was relatively high, particularly during the Delta wave at our referral center. The Delta wave, delayed vaccination and vaccine hesitancy of pregnant women might have important roles in maternal mortality. Higher LUS scores should warn clinicians of an increased risk of maternal death.

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Comorbidity, poverty and social vulnerability as risk factors for mortality in pregnant women with confirmed SARS‐CoV‐2 infection: analysis of 13 062 positive pregnancies including 176 maternal deaths in Mexico

Cited by 29 publications

References 22 publications

Emotional State of Mexican University Students in the COVID-19 Pandemic

Emotional State of Mexican University Students in the COVID-19 Pandemic

Molecular and Physiological Aspects of SARS-CoV-2 Infection in Women and Pregnancy

COVID-19 related maternal mortality cases in associated with Delta and Omicron waves and the role of lung ultrasound

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