Outcomes of pregnant women with coronavirus disease 2019 (COVID-19) admitted to intensive care unit in Uzbekistan

Aim. The present study aimed to investigate outcomes of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2 or COVID-19) in the intensive care unit (ICU). Methods. A total of 3080 pregnant women infected with COVID-19 during treatment were studied in the maternity ward of the Zangiota-1 Republican Specialized Infectious Diseases Hospital from December 2020 to January, 2022. At the time of admission of patients to the hospital, 28.9% of women were in the first trimester of pregnancy, 34.3% and 36.8% were in the second and third trimester of pregnancy, respectively. 1980 cases (64.3%) showed a moderate course of pneumonia and in 48% (1478 cases), bilateral pneumonia was detected. At the same time, 60.0% of patients had lung damage (up to 50%) according to CT dataset. Results. A total of 677 out of 3080 pregnant women with COVID-19 pneumonia (22.0%) needed treatment at the ICU. 490 cases out of 677 patients showed severe clinical course of COVID-19, while 277 cases (41%) showed multiple organ dysfunction syndrome (MODS). Of 277 MODS cases, 209 (75.4%) were those in the third trimester of pregnancy and 170 (61.4%) had initially severe clinical picture of COVID-19. Mortality rate in ICU was 9.4% (64 cases out of 677) while 56.6% experienced post-traumatic stress disorder (PTSD) at baseline, 26.7% had general anxiety disorders, and 16.7% (113 of 677) of women experienced depression symptoms. In the postpartum period, 46.1% (312 of 677) cases showed combinations of PTSD, anxiety and depression according to the combined Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) assessment, which was typical for women with severe and extremely severe COVID-19, preterm birth, miscarriages and perinatal mortality. Conclusion. The ICU hospitalization rate for COVID-19 pneumonia in pregnant women was 22.0%, among which the vast majority (72.4%) were cases with severe clinical course of COVID-19 and PTSD (56.6%). Women in the third trimester of pregnancy were most susceptible to developing MODS and severe COVID-19 pneumonia. Recommendation. In promoting pregnant women's mental and physical health, understanding the characteristics of psycho-emotional stress disorders during the COVID-19 pandemic and learning how to deal with them is critical.

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