People Expecting Experience Lower Risks of Long COVID

Summary: A large study of over 72,000 pregnant women found that those infected with SARS-CoV-2 during pregnancy were less likely to develop Long COVID than non-pregnant peers. Using data from two national databases, researchers found consistent results: about 16% of pregnant women developed Long COVID symptoms versus 19% of matched non-pregnant women.

While pregnancy appears to offer some protection, certain subgroups—such as women with obesity, older maternal age, or who identify as Black—were at higher risk. The findings point to a potential protective role of immune changes during and after pregnancy and highlight the need for more focused Long COVID research in pregnant populations.

Key Facts:

  • Reduced Risk: Pregnant women had a lower rate of Long COVID than non-pregnant peers.
  • Higher-Risk Groups: Black women, those 35+, and those with metabolic conditions faced higher risk.
  • Consistent Results: Findings held across two national health data networks and different definitions.

Source: Weill Cornell University

Pregnancy may offer some protection from developing Long COVID, found a new study led by Weill Cornell Medicine, University of Rochester Medical Center, University of Utah Health and Louisiana Public Health Institute.

Previous research has mostly focused on non-pregnant adults affected by Long COVID— a condition lasting for months after a person recovers from SARS-CoV-2 infection.

The study, published April 1 in Nature Communications, helps fill a critical gap about Long COVID in women infected with SARS-CoV-2 during pregnancy.

Among the pregnant women, the researchers found that certain groups had higher Long COVID risks than others. Credit: Neuroscience News

“This population is so important and vulnerable, but we had no evidence about their Long COVID risk to guide their care,” said Dr. Chengxi Zang, an instructor in population health sciences at Weill Cornell Medicine, who co-led the research.

“We hope this new data will help clinicians develop better Long COVID prevention and treatment strategies for pregnant women and help those most at risk.”

Digging into Data

The researchers tapped into real-world data collected in two large electronic health record-based studies, the National Patient-Centered Clinical Research Network (PCORnet) and the National COVID Cohort Collaborative (N3C), under the National Institutes of Health RECOVER initiative.

They analyzed data on approximately 72,000 women who were infected with SARS-CoV-2 during pregnancy between March 2020 and June 2023 and about 208,000 age and demographically matched controls who were not pregnant but developed the infection during this period. They looked for signs of Long COVID 180 days after the women recovered from infections.

The team found that the rates of long-term complications related to COVID-19 are lower among pregnant women than comparably matched women who were not pregnant during their infection.

The findings were consistent across both large databases and held true even when the researchers used different methods to define Long COVID. This consistency adds confidence to the results.

In the PCORnet cohortDr. Zang and his colleagues found that about 16 out of 100 pregnant women developed Long COVID compared with about 19 out of 100 non-pregnant women.

Long COVID is defined as having any of the following symptoms: cognitive problems, encephalopathy, sleep disorders, acute pharyngitis, shortness of breath, pulmonary fibrosis, chest pain, diabetes, edema, malnutrition, joint pain, fever, malaise and fatigue. Similar findings were replicated in the N3C cohort.

“Though we observed that pregnant women have a significant risk of Long COVID, it was surprisingly lower than those who were not pregnant when they had SARS-CoV-2 infection,” Dr. Zang said.

“However, some subgroups seemed especially vulnerable.”

Groups at Higher Risk

Among the pregnant women, the researchers found that certain groups had higher Long COVID risks than others. For example, pregnant women who identified as Black, or were of advanced maternal age (age 35 or older at delivery), or had obesity or other metabolic conditions were more likely to develop Long COVID than pregnant women who weren’t part of these groups. However, this risk was still lower than their matched non-pregnant controls.

“Further research on factors such as inequitable healthcare access, socioeconomic factors and structural racism may help us understand the elevated Long COVID risk in these groups and find ways to protect them,” said Dr. Zang.

“We hypothesize that the altered immune and inflammatory environment lasting about six weeks after giving birth might contribute to lowering the risk of Long COVID,” Dr. Zang said.

“The observed risk differences in this analysis suggest future dedicated studies of Long COVID in pregnant individuals are needed.” For instance, differences in COVID infection by trimester may be informative for patient counseling.

Dr. Zang and his colleagues at Weill Cornell Medicine are also using electronic health records to study how existing medications may be repurposed to protect pregnant women from Long COVID.               

This study was co-led by Dr. Elaine Hill and Dr. Daniel Guth, at the University of Rochester Medical Center; Dr. Torri D. Metz and Dr. Ann Bruno at the University of Utah Health; and Thomas Carton at Louisiana Public Health Institute.

About this long COVID and neurology research news

Author: Barbara Prempeh
Source: Weill Cornell University
Contact: Barbara Prempeh – Weill Cornell University
Image: The image is credited to Neuroscience News

Original Research: Open access.
Long COVID after SARS-CoV-2 During Pregnancy in the United States” by Chengxi Zang, et al. Nature Communications


Abstract

Long COVID after SARS-CoV-2 During Pregnancy in the United States

Pregnancy alters immune responses and clinical manifestations of COVID-19, but its impact on Long COVID remains uncertain.

This study investigated Long COVID risk in individuals with SARS-CoV-2 infection during pregnancy compared to reproductive-age females infected outside of pregnancy.

A retrospective analysis of two U.S. databases, the National Patient-Centered Clinical Research Network (PCORnet) and the National COVID Cohort Collaborative (N3C), identified 29,975 pregnant individuals (aged 18–50) with SARS-CoV-2 infection in pregnancy from PCORnet and 42,176 from N3C between March 2020 and June 2023.

At 180 days after infection, estimated Long COVID risks for those infected during pregnancy were 16.47 per 100 persons (95% CI, 16.00–16.95) in PCORnet using the PCORnet computational phenotype (CP) model and 4.37 per 100 persons (95% CI, 4.18–4.57) in N3C using the N3C CP model.

Compared to matched non-pregnant individuals, the adjusted hazard ratios for Long COVID were 0.86 (95% CI, 0.83–0.90) in PCORnet and 0.70 (95% CI, 0.66–0.74) in N3C. The observed risk factors for Long COVID included Black race/ethnicity, advanced maternal age, first- and second-trimester infection, obesity, and comorbid conditions.

While the findings suggest a high incidence of Long COVID among pregnant individuals, their risk was lower than that of matched non-pregnant females.

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