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

PLoS One. 2022 Oct 3;17(10):e0274797. doi: 10.1371/journal.pone.0274797. eCollection 2022.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Brazil / epidemiology
  • COVID-19* / epidemiology
  • Child
  • Demography
  • Female
  • Humans
  • Middle Aged
  • Postpartum Period
  • Pregnancy
  • Pregnancy Complications, Infectious* / epidemiology
  • Retrospective Studies
  • SARS-CoV-2
  • Young Adult

Grants and funding

This work was supported in whole or in part, by thea Bill & Melinda Gates Foundation (INV-027961). Under the grant conditions of the Foundation, a Creative Commons Attribution 4.0 Generic License has already been assigned to the Author Accepted. Manuscript version that might arise from this submission. This work is also funded bu CNPq (Award Number 445881/2020-8) and FAPES (Award Number: 007/2021). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.