Demographic and epidemiological characteristics of pregnant and postpartum women who died from severe acute respiratory syndrome in Brazil: A retrospective cohort study comparing COVID-19 and nonspecific etiologic causes

Abstract

The objective of this study is to compare the demographic characteristics and symptoms in pregnant and postpartum women who died from Severe Acute Respiratory Syndrome (SARS) caused by COVID-19 or by nonspecific cause in different states of Brazil. This is a retrospective cohort study and the analysis was conducted on SARS death records between 02/16/2020 and 04/17/2021, obtained from the Information System for the Epidemiological Surveillance of Influenza (Sistema de Informação da Vigilância Epidemiológica da Gripe, SIVEP-Gripe). Pregnant and postpartum women, aged between 10 and 55 years, who died from SARS, were included and classified into two groups: SARS due to confirmed COVID-19 or SARS due to nonspecific cause. The cases were analyzed according to the women’s demographic and epidemiological characteristics, clinical symptoms, risk factors and disease evolution. As results, 19,333 pregnant and postpartum women were identified. From these, 1,279 died (1,026 deaths from COVID-19 and 253 deaths from SARS with nonspecific cause). The groups showed significant differences in age, education, race, and occurrence of obesity and chronic lung disease. The group of women who died from confirmed COVID-19 presented a significantly higher frequency of symptoms of fever, cough, fatigue, loss of taste, and loss of smell, as well as a higher rate of admission to the intensive care unit (ICU). Data analysis draws attention to the high number of cases of SARS without a causal diagnosis, the low access to ICU and orotracheal intubation (OTI), which might be explained by the demographic and regional inequalities in the access to healthcare.

survInTime - Exploring surveillance methods and data analysis on Brazilian respiratory syndrome dataset and community mobility changes

“…This database contains more than 3 million records but not all cities are represented in it neither the most part of the asymptomatic cases. The epidemiological works [3][4][5][6][7][8][9][10] published about the disease spread and cases simulation and projection clearly demonstrated the discrepancies between the data reported and the real number of cases and deaths across the Brazilian cities. However, few works provided integration and methodological approaches to diagnose and extract useful insights from this data.…”

Nutritional Knowledge about Maternal and Newborn Health among Physiotherapists during the COVID-19 Pandemic in Minas Gerais, Brazil

“…Overweight and obesity are major public health problems [ 10 ]. Their incidence in pregnant women has been associated with newborn prematurity, neonatal infections, and cardiovascular, respiratory, and neurological disorders [ 7 , 9 , 11 , 12 , 13 ], with a high prevalence in low- and middle-income countries [ 14 ].…”

Impacto da infecção pelo SARS-CoV-2 nos resultados gestacionais e neonatais em gestantes acompanhadas no Hospital das Clínicas da Faculdade de Medicina e no Hospital Universitário da USP

“…Em especial, é digno de nota que grande parte deles tenha sido realizado em países de alta renda, em que mudanças no estilo de vida (melhor nutrição, redução de situações de estresse relacionadas ao trabalho e isolamento social eficaz) restringiram consultas de emergência que poderiam culminar em partos prematuros iatrogênicos 196 , ao mesmo tempo em que o pronto acesso ao cuidado levou à tomada de ações de forma mais eficaz, reduzindo a prematuridade consequente a sintomas críticos. Essa realidade não corresponde à da maioria dos países do mundo que, assim como o Brasil, viu crescer a morbimortalidade materna por acesso desigual aos serviços de saúde 52,199 .…”