COVID-19 in pregnancy means 10 times higher risk of ICU admission, Canadian data shows

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When Alex Carnio tested positive for the coronavirus in early August while pregnant with twins, she hadn’t predicted how quickly her disease would progress.

The 28-year-old Kelowna, BC resident was not yet vaccinated, but in addition to having experienced a higher risk pregnancy, she was generally in good health with no underlying medical issues .

Despite this, her initially mild symptoms worsened within a few days.

“I started to have pain in my chest, unable to really breathe easily, I started not being able to hold any liquid,” recalls Carnio. “It was then that I knew, around the sixth day, that I had to go to the hospital.”

She was briefly hospitalized, returned home for a day, and then began to struggle to get up. After returning to her local emergency department, she was admitted to a COVID-19 isolation ward.

“I was woken up by a nurse in the middle of the night who said my oxygen was getting a little too low, so they put me on oxygen for two days – and it was something shocking to me,” Carnio said.

But her experience is not surprising to Canadian researchers who have tracked the impact of COVID-19 during pregnancy, with data suggesting that pregnant people face significantly higher risks of serious illness requiring hospitalization, admission to intensive care or life support.

“We know that infection impacts both the health and well-being of the mother and the outcome of the pregnancy,” said Dr. Wendy Whittle, maternal-fetal medicine specialist at the Toronto’s Mount Sinai Hospital.

When Alex Carnio, 28, tested positive for the coronavirus in early August while pregnant with twins, she hadn’t predicted how quickly her disease would progress. Data suggests that pregnant people who contract COVID-19 are at higher risk of serious illness requiring hospitalization, intensive care admission, or life support. (Dillon Hodgin / CBC)

Higher risk of hospitalization during pregnancy

Whittle co-wrote a new backgrounder from Ontario’s COVID-19 Science Advisory Table, which notes that the risks of contracting COVID-19 during pregnancy include a higher likelihood of needing a cesarean or having a premature delivery, preliminary evidence shows.

The latest available Canadian data compiled by the Canadian Pregnancy COVID-19 Surveillance Team (CANCOVID) also suggests that pregnant people are nearly five times more likely to be admitted to hospital for COVID-19 than their non-pregnant peers – and 10 times more likely to be admitted to an intensive care unit.

“Seven to 15% of pregnant people with COVID-19 will suffer from moderate to severe illness requiring hospitalization,” the backgrounder said.

The advisory team noted that the increased risk of hospitalization could be explained in part by “a lower threshold” for providing care during pregnancy, which means that pregnant people can be admitted to hospital while they are pregnant. ‘a non-pregnant person with the same symptoms would not be. But, they pointed out that pregnant people were also at a higher risk of needing mechanical ventilation in various studies, which is “indicative of clinically serious illness.”

While Canadian and international research suggests that the bulk of infections during pregnancy are either asymptomatic or mild, Whittle said the higher risks of serious health problems are of concern, especially since pregnant women typically have lower vaccination rates, as shown by data from Ontario and United States

“It makes me absolutely petrified,” she said.

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6 pregnant Albertans sent to intensive care units in August

In Alberta, which has the highest number of active COVID-19 cases across the country, those fears are already coming true.

An unvaccinated pregnant woman from Alberta recently died of a COVID-related infection after being admitted to an intensive care unit, as her baby delivered and survived, sources told CBC News.

Provincial authorities also announced last week that six pregnant Albertans, all unvaccinated, had been admitted to intensive care units with COVID-19 in August – a peak in admissions in one month that almost matched the seven seen during throughout the first year of the pandemic.

“Not only has COVID had serious impacts on the health of parents, but also that of the child,” Alberta Chief Medical Officer of Health Dr. Deena Hinshaw said at a press conference last Thursday.

“Five premature deliveries took place as early as 29 weeks. If you are pregnant, trying to become pregnant, or have recently given birth, please receive both doses of the COVID-19 vaccine as soon as possible. “

Speaking to CBC News by phone, Calgary-area mom-to-be Meggi Mah said she had already fully immunized to protect herself and her baby, and that she was taking precautions in her life. everyday, but she feared that was not enough. skyrocketing infection rates.

“It’s been an increasingly scary time to be pregnant in Alberta,” she said.

Mah added that she had heard reports of the death of a pregnant woman.

“You hope it won’t be you,” she said. “There isn’t much we can do to keep ourselves safe.”

A pregnant woman receives a Pfizer vaccine against COVID-19 at a library converted into a vaccination center in Mexico City on May 13, 2021. (Fernando Llano / The Associated Press)

Safe and effective vaccines during pregnancy

Women’s health experts say that aside from basic precautions, getting the vaccine is the best way to prevent serious COVID-19 infection. But deciding whether or not to get vaccinated has been a difficult process for many Canadian women.

“Even though we have real data, and it is very good quality data, that first message that COVID-19 vaccines have not been tested during pregnancy is on people’s minds,” the report said. CANCOVID collaborator Dr. Eliana Castillo, Clinical Associate Professor in the Departments of Obstetrics and Gynecology and Medicine at the University of Calgary.

“And if you add all of the inherent fears and uncertainties that are normal in any pregnancy, and the sheer amount of misinformation that is in social media, we just have the combination that is very damaging to moms and babies.”

Yet vaccines approved in Canada and the United States have been shown to be both safe and effective during pregnancy, according to scientists and researchers on both sides of the border.

Carnio is staying at a Ronald McDonald House in Vancouver with her husband and daughter to be near a major hospital in case his twins are born prematurely. (Dillon Hodgin / CBC)

There are several large-scale analytical studies showing vaccine efficacy as well as “no safety signals of concern reported in pregnant vaccine recipients,” reads the recent Scientific Advisory Table briefing note. Ontario’s COVID-19.

An analysis of available data from the United States Centers for Disease Control and Prevention (CDC) assessed vaccination in early pregnancy and found no increased risk of miscarriage in nearly 2,500 pregnant women who received a vaccine. mRNA-based before the 20 week mark.

Previous data from three security monitoring systems also found no safety concerns either for pregnant women who were vaccinated in late pregnancy, or for their babies, according to the CDC.

“We have a vaccine that works during pregnancy, which is safe,” Castillo said. “And very importantly, it will not only protect you, but in fact, we have good evidence that the protection you get will be passed on to your baby.”

Concerned about COVID-19 vaccines and pregnancy? Click here for a CBC News Q&A featuring the latest research and expert advice on immunization during pregnancy.

“I just kept worrying”

After contracting COVID-19 last month, Carnio ended up getting the vaccine and wishes he had received his shots sooner.

But she said making that decision is often difficult for pregnant women, who have long heard mixed messages about what is safe to put in their bodies. And in her case, she had complications early in her pregnancy that caused her to wait.

“I looked at my own experience, and the alternative of not getting the shot and ending up in an intensive care unit in a hospital was a million times worse,” she told CBC News during from an interview on Tuesday.

Carnio is now staying at a Ronald McDonald House in Vancouver with her family, so she can be near a large hospital that can handle a higher risk childbirth if her twins – who are due in December – are born early.

As she sat at a picnic table near the building she calls home until her twins were at least 30 weeks old, Carnio said she wanted to tell her story to help others. pregnant women to avoid their heartbreaking COVID-19 experience.

“Being in this situation is not something I wish on anyone, especially if you are pregnant,” she said. “I kept worrying: are the children in me okay? “


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