Increasing severity of COVID-19 in pregnancy with Delta (B.1.617.2) variant surge

Adhikari, Emily H.; SoRelle, Jeffrey A.; McIntire, Donald D.; Spong, Catherine Y.

doi:10.1016/j.ajog.2021.09.008

Cited by 85 publications

(82 citation statements)

References 3 publications

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“…3 The overall rates of severe or critical illness in this cohort are consistent with the previously published data from our institution. 4 However, recent trends demonstrate that along with increasing case volume, the proportion of cases requiring hospitalization is rising. The potential pathophysiologic mechanisms for the increased severity of illness with B.1.617.2 in pregnancy are unclear.…”

Section: Discussionmentioning

confidence: 99%

Increasing severity of COVID-19 in pregnancy with Delta (B.1.617.2) variant surge

Adhikari

SoRelle

McIntire

et al. 2022

American Journal of Obstetrics and Gynecology

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Increasing severity of COVID-19 in pregnancy with Delta (B.1.617.2) variant surge OBJECTIVE:The Delta (B.1.617.2) variant of the SARS-CoV-2 virus became the predominant variant circulating in the United States beginning July 2021. 1 We report the trends of illness severity among obstetrical patients with COVID-19, on a background of Delta variant predominance and describe COVID-19 vaccinations in this cohort at Parkland Hospital-a public county hospital. STUDY DESIGN:We prospectively studied pregnant patients diagnosed with SARS-CoV-2 by nasal or nasopharyngeal swab polymerase chain reaction, in a large prenatal system encompassing a centralized acute care hospital and 10 community-based prenatal clinics, all with an integrated electronic health record. Externally tested patients who received care at Parkland were also included. In mid-May

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Section: Discussionmentioning

confidence: 99%

Increasing severity of COVID-19 in pregnancy with Delta (B.1.617.2) variant surge

Adhikari

SoRelle

McIntire

et al. 2022

American Journal of Obstetrics and Gynecology

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“…In the particular case of the Delta variant, hospital systems in different countries report numbers of younger people, even babies, admitted to hospital and a growing prevalence of severe or critical illness [186,212,213]. This could be a consequence of the enormous viral load found in individuals infected with the Delta variant, and the improved capacities for cell entry worsening the disease symptoms, along with the fact that young people are not yet vaccinated in many populations.…”

Section: Covid-19 During Human Developmentmentioning

confidence: 99%

The Development of SARS-CoV-2 Variants: The Gene Makes the Disease

Perez-Gomez

2021

JDB

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A novel coronavirus (SARS-CoV-2) emerged towards the end of 2019 that caused a severe respiratory disease in humans called COVID-19. It led to a pandemic with a high rate of morbidity and mortality that is ongoing and threatening humankind. Most of the mutations occurring in SARS-CoV-2 are synonymous or deleterious, but a few of them produce improved viral functions. The first known mutation associated with higher transmissibility, D614G, was detected in early 2020. Since then, the virus has evolved; new mutations have occurred, and many variants have been described. Depending on the genes affected and the location of the mutations, they could provide altered infectivity, transmissibility, or immune escape. To date, mutations that cause variations in the SARS-CoV-2 spike protein have been among the most studied because of the protein’s role in the initial virus–cell contact and because it is the most variable region in the virus genome. Some concerning mutations associated with an impact on viral fitness have been described in the Spike protein, such as D614G, N501Y, E484K, K417N/T, L452R, and P681R, among others. To understand the impact of the infectivity and antigenicity of the virus, the mutation landscape of SARS-CoV-2 has been under constant global scrutiny. The virus variants are defined according to their origin, their genetic profile (some characteristic mutations prevalent in the lineage), and the severity of the disease they produce, which determines the level of concern. If they increase fitness, new variants can outcompete others in the population. The Alpha variant was more transmissible than previous versions and quickly spread globally. The Beta and Gamma variants accumulated mutations that partially escape the immune defenses and affect the effectiveness of vaccines. Nowadays, the Delta variant, identified around March 2021, has spread and displaced the other variants, becoming the most concerning of all lineages that have emerged. The Delta variant has a particular genetic profile, bearing unique mutations, such as T478K in the spike protein and M203R in the nucleocapsid. This review summarizes the current knowledge of the different mutations that have appeared in SARS-CoV-2, mainly on the spike protein. It analyzes their impact on the protein function and, subsequently, on the level of concern of different variants and their importance in the ongoing pandemic.

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“…None have included pregnant women with COVID-19 ARDS. Compared to the general population, pregnant women with COVID-19 are at increased risk of severe disease including pre-eclampsia, venous thromboembolism, need for intensive care unit (ICU) care and mechanical ventilation [ [12] , [13] , [14] ].…”

Section: Introductionmentioning

confidence: 99%

A center experience with lung transplantation for COVID-19 ARDS

Franco-Palacios

Allenspach

Stagner

et al. 2022

Respiratory Medicine Case Reports

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COVID-19 can cause irreversible lung damage from acute respiratory distress syndrome (ARDS), chronic respiratory failure associated with post COVID-19 de novo fibrosis or worsening of an underlying fibrotic lung disease. Pregnant women are at increased risk for invasive mechanical ventilation, extracorporeal membrane oxygenation, and death. The Centers for Disease Control and Prevention reported more than 22,000 hospitalizations and 161 deaths for COVID-19 in pregnant women. Between August 2020 and September 2021, five patients underwent bilateral lung transplant (LT) for COVID-19 ARDS at the Henry Ford Hospital in Detroit, Michigan. De-identified demographics data, clinical characteristics, perioperative challenges, explanted lung pathology, and post-transplant outcomes are described. In post-hospitalization follow-up (median survival 273 days), we see improving endurance and excellent lung function. One patient did not survive to hospital discharge and succumbed to complications 5 months after LT. We report the first cases of bilateral LT in two postpartum women.

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Increasing severity of COVID-19 in pregnancy with Delta (B.1.617.2) variant surge

Cited by 85 publications

References 3 publications

Increasing severity of COVID-19 in pregnancy with Delta (B.1.617.2) variant surge

Increasing severity of COVID-19 in pregnancy with Delta (B.1.617.2) variant surge

The Development of SARS-CoV-2 Variants: The Gene Makes the Disease

A center experience with lung transplantation for COVID-19 ARDS

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