Management and outcomes of pregnant ICU patients with severe COVID-19 pneumonia in Qatar: A retrospective cohort study

Hayat Elfil; Mogahed Ismail Hassan Hussein; Layla J M Kily; Sohel M G Ahmed; Mohammed Janish; Salwa M Abuyaqoub; Huda A Saleh; Marcus D Lance

doi:10.5339/qmj.2023.24

Management and outcomes of pregnant ICU patients with severe COVID-19 pneumonia in Qatar: A retrospective cohort study

Qatar Med J. 2023 Dec 12;2023(3):24. doi: 10.5339/qmj.2023.24. eCollection 2023.

Authors

Hayat Elfil¹, Mogahed Ismail Hassan Hussein², Layla J M Kily², Sohel M G Ahmed², Mohammed Janish³, Salwa M Abuyaqoub⁴, Huda A Saleh⁴, Marcus D Lance⁵

Affiliations

¹ Department of Anesthesiology, ICU and Perioperative Medicine, Women's Wellness and Research Centre, Doha, Qatar.
² Department of Anesthesiology, ICU and Perioperative Medicine, Hamad General Hospital, Doha, Qatar Email: Helfil@hamad.qa ORCID iD: 0000-0002-8210-0640.
³ Department of Anesthesiology, ICU and Perioperative Medicine, Research, Hamad Medical Corporation, Doha, Qatar.
⁴ Department of Obstetrics and Gynaecology, Women's Wellness and Research Centre, Doha, Qatar.
⁵ Department of Anesthesiology, ICU and Perioperative Medicine, Aga Khan University Medical College, Nairobi, Kenya.

Abstract

Introduction: Pregnant women are considered a high-risk group for COVID-19 due to their increased vulnerability to viral infections. The impact of COVID-19 on pregnant women is not well understood, and there is a need for data on managing severe COVID-19 in pregnant patients. This retrospective descriptive cohort study described the characteristics, hospital stay, interventions, and outcomes of pregnant patients admitted to the intensive care units (ICUs) with severe COVID-19 pneumonia in Qatar.

Methods: Data were collected from medical records and chart reviews of pregnant women admitted to Hamad Medical Corporation (HMC) with COVID-19 pneumonia from March 01, 2020, to July 31, 2021. The inclusion criteria encompassed pregnant women with a positive polymerase chain reaction (PCR) antigen test or radiological changes at admission, requiring respiratory support, and hospitalized for more than 24 hours.

Results: A total of 43 pregnant women were included in this study. Most patients were admitted during the first wave of the pandemic, with a median gestational age of 212 days [interquartile range 178-242 days] at presentation. The most common respiratory support methods were high-flow nasal cannula, non-invasive positive pressure ventilation, and invasive positive pressure ventilation. Convalescent plasma therapy was administered to 58% of patients, and tocilizumab was used in 28%. Renal replacement therapy was required by 4.6% of patients and 7% required extracorporeal membrane oxygenation.

Conclusion: This study provides valuable insights into the impact of COVID-19 on pregnant patients admitted to the ICUs in Qatar. The results suggest that pregnant patients with COVID-19 pneumonia require close monitoring and appropriate interventions to minimize adverse outcomes for both mother and fetus. The data may contribute to future guidelines and management strategies for severe COVID-19 in pregnant patients.

Keywords: COVID-19; Qatar; high-flow nasal cannula; intensive care unit; intermittent positive pressure ventilation; non-invasive ventilation; pregnancy.