Maternal and perinatal outcomes following pre-Delta, Delta, and Omicron SARS-CoV-2 variants infection among unvaccinated pregnant women in France and Switzerland: a prospective cohort study using the COVI-PREG registry

Favre, Guillaume; Maisonneuve, Emeline; Pomar, Léo; Daire, Charlotte; Poncelet, C.; Quibel, Thibaud; Monod, Cécile; Tejada, Begoña Martínez de; Schäffer, Leonhard; Papadia, Andrea; Radan, AP; Todesco-Bernasconi, Monya; Ville, Y.; Voekt, C.; Eggel-Hort, Béatrice; Capoccia-Brugger, Romina; Johann, Silke; Grawe, Claudia; Defert, Sophie; Mottet, Nicolas; Kahlert, Christian R.; Garabédian, Charles; Sentilhes, Loïc; Weber, Brigitte; Leu, Steffi; Bassler, Dirk; Lepigeon, Karine; Winterfeld, Ursula; Panchaud, Alice; Baud, David

doi:10.1016/j.lanepe.2022.100569

Cited by 36 publications

(42 citation statements)

References 33 publications

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“…59 We reviewed 25 studies reporting specific information relating to SARS-CoV-2 variants, including 3667 pregnancies with the wild-type strain, 1740 pregnancies with the Alpha variant, 35,673 pregnancies with the Delta variant, and 11,968 pregnancies with the Omicron variant. [17][18][19][20]51,52,54,57,[59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75] Table 1 shows the clinical characteristics and maternal outcomes of pregnancies with SARS-CoV-2 infection. Maternal deaths arising from COVID-19 infection were rare, irrespective of whether the cases involved the wild-type strain or variants.…”

Section: Maternal Outcomesmentioning

confidence: 99%

“…We reviewed 25 studies reporting specific information relating to SARS-CoV-2 variants, including 3667 pregnancies with the wild-type strain, 1740 pregnancies with the Alpha variant, 35,673 pregnancies with the Delta variant, and 11,968 pregnancies with the Omicron variant 17–20,51,52,54,57,59–75 Table 1. shows the clinical characteristics and maternal outcomes of pregnancies with SARS-CoV-2 infection.…”

Section: Maternal Outcomesmentioning

confidence: 99%

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Maternal and Perinatal Outcomes of SARS-CoV-2 and Variants in Pregnancy

et al. 2023

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Pregnancy is a physiological state that predisposes women to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, a disease that can cause adverse maternal and perinatal outcomes. The severity of coronavirus disease 2019 (COVID-19) disease is known to vary by viral strain; however, evidence for the effects of this virus in pregnant women has yet to be fully elucidated. In this review, we describe maternal and perinatal outcomes, vaccination, and vertical transmission, among pregnant women infected with the different SARS-CoV-2 variants identified to date. We also summarize existing evidence for maternal and perinatal outcomes in pregnant women with specific information relating to SARS-CoV-2 variants. Our analysis showed that Omicron infection was associated with fewer severe maternal and perinatal adverse outcomes while the Delta variant was associated with worse pregnancy outcomes. Maternal deaths arising from COVID-19 were found to be rare (<1.0%), irrespective of whether the virus was a wild-type strain or a variant. Severe maternal morbidity was more frequent for the Delta variant (10.3%), followed by the Alpha (4.7%), wild-type (4.5%), and Omicron (2.9%) variants. The rates of stillbirth were 0.8%, 4.1%, 3.1%, and 2.3%, respectively, in pregnancies infected with the wild-type strain, Alpha, Delta, and Omicron variants, respectively. Preterm birth and admission to neonatal intensive care units were more common for cases with the Delta infection (19.0% and 18.62%, respectively), while risks were similar for those infected with the wild-type (14.7% and 11.2%, respectively), Alpha (14.9% and 13.1%), and Omicron variants (13.2% and 13.8%, respectively). As COVID-19 remains a global pandemic, and new SARS-CoV-2 variants continue to emerge, research relating to the specific impact of new variants on pregnant women needs to be expanded.

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Section: Maternal Outcomesmentioning

confidence: 99%

Section: Maternal Outcomesmentioning

confidence: 99%

Maternal and Perinatal Outcomes of SARS-CoV-2 and Variants in Pregnancy

et al. 2023

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“…3 Recently, ALI/ ARDS have been concerned by high incidence in different variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients. 4,5 ALI/ARDS are characterized mainly by diffuse alveolar damage, pulmonary edema, hypoxemia, and oedema, leading to severe inflammatory processes. 6,7 Currently, treatment of ALI/ARDS is generally supportive care, including nutrition support, infection control combined with ventilatory strategies and appropriate antimicrobial treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Acute lung injury/acute respiratory distress syndrome (ALI/ARDS), first defined by Ashbaugh et al in 1967, are severe pulmonary manifestations highly occurring in severe clinical patients. , Epidemiological investigations indicate that various processes directly or indirectly injure lung tissues, resulting in ALI/ARDS and leading to high mortality . Recently, ALI/ARDS have been concerned by high incidence in different variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients. , ALI/ARDS are characterized mainly by diffuse alveolar damage, pulmonary edema, hypoxemia, and oedema, leading to severe inflammatory processes. , Currently, treatment of ALI/ARDS is generally supportive care, including nutrition support, infection control combined with ventilatory strategies and appropriate antimicrobial treatment . However, they are not specifically therapeutic strategies to mitigate the proinflammatory response in ALI/ARDS .…”

Section: Introductionmentioning

confidence: 99%

Targeting Receptor-Interacting Protein Kinase 1 by Novel Benzothiazole Derivatives: Treatment of Acute Lung Injury through the Necroptosis Pathway

et al. 2023

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Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) are serious and devastating pulmonary manifestations of acute systemic inflammation with high morbidity and mortality worldwide. Currently, there are no specific effective treatments for ALI/ARDS. RIPK1, which contributes to necroptosis and inflammation, is confirmed to be a promising strategy for the treatment of ALI. Herein, 23 benzothiazole derivatives were designed to specifically target RIPK1, and SZM-1209 showed high anti-necroptotic activity (EC50 = 22.4 nM) and kinase selectivity on RIPK1 over RIPK3 (K d,RIPK1 = 85 nM, K d,RIPK3 > 10,000 nM). In a mTNF-α-induced systemic inflammatory response syndrome (SIRS) model, SZM-1209 could completely reverse mouse deaths with significant anti-inflammatory effects. Furthermore, in a NNK short-term intratracheal exposure-induced ALI model, SZM-1209 significantly alleviated ALI by reducing pulmonary edema and pathological damage. Collectively, activities of SZM-1209 against RIPK1, necroptosis, SIRS, and ALI warranted further investigation of optimized benzothiazoles as promising lead structures against ALI-related diseases.

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“…4 Another recent study by Favre et al compared maternal and perinatal outcomes across three variant periods (pre-Delta, Delta, and Omicron) in France and Switzerland and showed that the Delta period is associated with higher risk of adverse maternal outcomes compared to the pre-Delta period and the Omicron period is associated with a lower risk of adverse maternal outcomes when compared to the pre-Delta period. 16 Considering the differential impact of COVID-19 variants, no study has considered the impact of all of the variants of concern thus far. In addition, currently there is no systematic study such as a meta-analysis across geographical regions with confirmed SARS-CoV-2 infections during pregnancy to assess current research and derive conclusions.…”

Section: Introductionmentioning

confidence: 99%

Risk of Adverse Maternal and Fetal Outcomes Associated with COVID-19 Variants of Concern: A Sequential Prospective Meta-Analysis

Farooq

Oakley

Kerchner

et al. 2023

Preprint

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Introduction The main objective of this study is to conduct an individual patient data meta-analysis with collaborators from various countries to identify SARS-CoV-2 variants of concern associated with adverse maternal and neonatal outcomes. Methods Eligible studies included registries and single- or multi-site cohort studies that recruited pregnant and recently postpartum women with confirmed COVID-19. Studies must have enrolled at least 25 women within a defined catchment area. Studies also had to have data that overlapped more than a single COVID-19 variant time period. We invited principal investigators already participating in an ongoing sequential, prospective meta-analysis of perinatal COVID-19. Investigators shared individual patient data (IPD) with the technical team for review and analysis. We examined 31 outcomes related to: i) COVID-19 severity (n=5); ii) maternal morbidities including adverse birth outcomes (n=14); iii) fetal and neonatal morbidity and mortality (n=5) and iv) adverse birth outcomes (n=8). SARS-CoV-2 strains that have been identified as variants of concern (VOC) by the WHO were analyzed using the publicly available strain frequency data by Nextstrain.org and strains were classified as dominant when they were more than half of sequences in a given geographic area. We applied a 2-stage IPD meta-analytic framework to generate pooled relative risks, with 95% CI for each dominant variant and outcome pair when there were one or more studies with available data. Results Our data show that the Delta wave, compared to Omicron, was associated with a higher risk of all adverse COVID-19 severity outcomes in pregnancy including risk of hospitalization [RR 4.02 (95% CI 1.10, 14.69), n=1 study], risk of ICU admissions [RR 2.59 (95% CI 1.26, 5.30, n=3 studies], risk of critical care admission [RR 2.52 (95% CI 1.25, 5.08, n=3 studies], risk of needing ventilation [RR 3.96 (95% CI 1.47, 10.71), n=3 studies] and risk of pneumonia [RR 6.73 (95% CI 2.17, 20.90), n=3 studies]. The majority of maternal morbidity and mortality indicators were not at increased risk during any of the COVID-19 variant waves except hemorrhage, any Cesarean section, intrapartum Cesarean section and maternal composite outcome, although data was limited. Risk of fetal and neonatal morbidity and mortality did not show significant increases in risks during any of the COVID-19 waves except stillbirth and perinatal death during the Delta wave ([RR 4.84 (95% CI 1.37, 17.05, n=3 studies], [RR 6.03 (95%CI 1.63, 22.34), n=3 studies], respectively) when compared to the Pre-alpha wave. Adverse birth outcomes including very low birthweight and very preterm birth also showed increased risks during the Delta wave compared to the Pre-alpha wave. Discussion During periods of Delta strain predominance, all COVID-19 severity outcomes were more severe among pregnant women, compared to periods when other COVID-19 strains predominated. In addition, there are limited data comparing the impact of different variants on pregnancy outcomes. This highlights the importance of ongoing genomic surveillance among special populations.

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Maternal and perinatal outcomes following pre-Delta, Delta, and Omicron SARS-CoV-2 variants infection among unvaccinated pregnant women in France and Switzerland: a prospective cohort study using the COVI-PREG registry

Cited by 36 publications

References 33 publications

Maternal and Perinatal Outcomes of SARS-CoV-2 and Variants in Pregnancy

Maternal and Perinatal Outcomes of SARS-CoV-2 and Variants in Pregnancy

Targeting Receptor-Interacting Protein Kinase 1 by Novel Benzothiazole Derivatives: Treatment of Acute Lung Injury through the Necroptosis Pathway

Risk of Adverse Maternal and Fetal Outcomes Associated with COVID-19 Variants of Concern: A Sequential Prospective Meta-Analysis

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