Management and outcomes of pregnant women admitted to intensive care unit for severe pneumonia related to SARS-CoV-2 infection : the multicenter and international COVIDPREG study
© 2022. Springer-Verlag GmbH Germany, part of Springer Nature..
PURPOSE: Management and outcomes of pregnant women with coronavirus disease 2019 (COVID-19) admitted to intensive care unit (ICU) remain to be investigated.
METHODS: A retrospective multicenter study conducted in 32 ICUs in France, Belgium and Switzerland. Maternal management as well as maternal and neonatal outcomes were reported.
RESULTS: Among the 187 pregnant women with COVID-19 (33 ± 6 years old and 28 ± 7 weeks' gestation), 76 (41%) were obese, 12 (6%) had diabetes mellitus and 66 (35%) had pregnancy-related complications. Standard oxygenation, high-flow nasal oxygen therapy (HFNO) and non-invasive ventilation (NIV) were used as the only oxygenation technique in 41 (22%), 55 (29%) and 18 (10%) patients, respectively, and 73 (39%) were intubated. Overall, 72 (39%) patients required several oxygenation techniques and 15 (8%) required venovenous extracorporeal membrane oxygenation. Corticosteroids and tocilizumab were administered in 157 (84%) and 25 (13%) patients, respectively. Awake prone positioning or prone positioning was performed in 49 (26%) patients. In multivariate analysis, risk factors for intubation were obesity (cause-specific hazard ratio (CSH) 2.00, 95% CI (1.05-3.80), p = 0.03), term of pregnancy (CSH 1.07, 95% CI (1.02-1.10), per + 1 week gestation, p = 0.01), extent of computed tomography (CT) scan abnormalities > 50% (CSH 2.69, 95% CI (1.30-5.60), p < 0.01) and NIV use (CSH 2.06, 95% CI (1.09-3.90), p = 0.03). Delivery was required during ICU stay in 70 (37%) patients, mainly due to maternal respiratory worsening, and improved the driving pressure and oxygenation. Maternal and fetal/neonatal mortality rates were 1% and 4%, respectively. The rate of maternal and/or neonatal complications increased with the invasiveness of maternal respiratory support.
CONCLUSION: In ICU, corticosteroids, tocilizumab and prone positioning were used in few pregnant women with COVID-19. Over a third of patients were intubated and delivery improved the driving pressure.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:48 |
|---|---|
| Enthalten in: |
Intensive care medicine - 48(2022), 9 vom: 17. Sept., Seite 1185-1196 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Péju, Edwige [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Acute respiratory distress syndrome |
|---|
| Anmerkungen: |
Date Completed 13.09.2022 Date Revised 21.11.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00134-022-06833-8 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM344967514 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM344967514 | ||
| 003 | DE-627 | ||
| 005 | 20231226024002.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00134-022-06833-8 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1149.xml |
| 035 | |a (DE-627)NLM344967514 | ||
| 035 | |a (NLM)35978137 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Péju, Edwige |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Management and outcomes of pregnant women admitted to intensive care unit for severe pneumonia related to SARS-CoV-2 infection |b the multicenter and international COVIDPREG study |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 13.09.2022 | ||
| 500 | |a Date Revised 21.11.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022. Springer-Verlag GmbH Germany, part of Springer Nature. | ||
| 520 | |a PURPOSE: Management and outcomes of pregnant women with coronavirus disease 2019 (COVID-19) admitted to intensive care unit (ICU) remain to be investigated | ||
| 520 | |a METHODS: A retrospective multicenter study conducted in 32 ICUs in France, Belgium and Switzerland. Maternal management as well as maternal and neonatal outcomes were reported | ||
| 520 | |a RESULTS: Among the 187 pregnant women with COVID-19 (33 ± 6 years old and 28 ± 7 weeks' gestation), 76 (41%) were obese, 12 (6%) had diabetes mellitus and 66 (35%) had pregnancy-related complications. Standard oxygenation, high-flow nasal oxygen therapy (HFNO) and non-invasive ventilation (NIV) were used as the only oxygenation technique in 41 (22%), 55 (29%) and 18 (10%) patients, respectively, and 73 (39%) were intubated. Overall, 72 (39%) patients required several oxygenation techniques and 15 (8%) required venovenous extracorporeal membrane oxygenation. Corticosteroids and tocilizumab were administered in 157 (84%) and 25 (13%) patients, respectively. Awake prone positioning or prone positioning was performed in 49 (26%) patients. In multivariate analysis, risk factors for intubation were obesity (cause-specific hazard ratio (CSH) 2.00, 95% CI (1.05-3.80), p = 0.03), term of pregnancy (CSH 1.07, 95% CI (1.02-1.10), per + 1 week gestation, p = 0.01), extent of computed tomography (CT) scan abnormalities > 50% (CSH 2.69, 95% CI (1.30-5.60), p < 0.01) and NIV use (CSH 2.06, 95% CI (1.09-3.90), p = 0.03). Delivery was required during ICU stay in 70 (37%) patients, mainly due to maternal respiratory worsening, and improved the driving pressure and oxygenation. Maternal and fetal/neonatal mortality rates were 1% and 4%, respectively. The rate of maternal and/or neonatal complications increased with the invasiveness of maternal respiratory support | ||
| 520 | |a CONCLUSION: In ICU, corticosteroids, tocilizumab and prone positioning were used in few pregnant women with COVID-19. Over a third of patients were intubated and delivery improved the driving pressure | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Acute respiratory distress syndrome | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Mechanical ventilation | |
| 650 | 4 | |a Neonates | |
| 650 | 4 | |a Oxygenation | |
| 650 | 4 | |a Pregnancy | |
| 650 | 4 | |a Prognosis | |
| 650 | 4 | |a Prone positioning | |
| 700 | 1 | |a Belicard, Félicie |e verfasserin |4 aut | |
| 700 | 1 | |a Silva, Stein |e verfasserin |4 aut | |
| 700 | 1 | |a Hraiech, Sami |e verfasserin |4 aut | |
| 700 | 1 | |a Painvin, Benoît |e verfasserin |4 aut | |
| 700 | 1 | |a Kamel, Toufik |e verfasserin |4 aut | |
| 700 | 1 | |a Thille, Arnaud W |e verfasserin |4 aut | |
| 700 | 1 | |a Goury, Antoine |e verfasserin |4 aut | |
| 700 | 1 | |a Grimaldi, David |e verfasserin |4 aut | |
| 700 | 1 | |a Jung, Boris |e verfasserin |4 aut | |
| 700 | 1 | |a Piagnerelli, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Winiszewski, Hadrien |e verfasserin |4 aut | |
| 700 | 1 | |a Jourdain, Merce |e verfasserin |4 aut | |
| 700 | 1 | |a Jozwiak, Mathieu |e verfasserin |4 aut | |
| 700 | 0 | |a COVIDPREG Study Group |e verfasserin |4 aut | |
| 700 | 1 | |a Argaud, Laurent |e investigator |4 oth | |
| 700 | 1 | |a Aubron, Cécile |e investigator |4 oth | |
| 700 | 1 | |a Bèle, Nicolas |e investigator |4 oth | |
| 700 | 1 | |a Beloncle, François |e investigator |4 oth | |
| 700 | 1 | |a Bertrand, Pierre-Marie |e investigator |4 oth | |
| 700 | 1 | |a Bodenes, Laetitia |e investigator |4 oth | |
| 700 | 1 | |a Boroli, Filippo |e investigator |4 oth | |
| 700 | 1 | |a Bouhemad, Belaid |e investigator |4 oth | |
| 700 | 1 | |a Braconnier, Lucie |e investigator |4 oth | |
| 700 | 1 | |a Buffieres, William |e investigator |4 oth | |
| 700 | 1 | |a Darreau, Cédric |e investigator |4 oth | |
| 700 | 1 | |a Dellamonica, Jean |e investigator |4 oth | |
| 700 | 1 | |a Ehrmann, Stephan |e investigator |4 oth | |
| 700 | 1 | |a Faure, Mélanie |e investigator |4 oth | |
| 700 | 1 | |a Gibot, Sébastien |e investigator |4 oth | |
| 700 | 1 | |a Gniadek, Claudine |e investigator |4 oth | |
| 700 | 1 | |a Goudelin, Marine |e investigator |4 oth | |
| 700 | 1 | |a Guenier, Pierre-Alban |e investigator |4 oth | |
| 700 | 1 | |a Guitton, Christophe |e investigator |4 oth | |
| 700 | 1 | |a Haussaire, Etienne |e investigator |4 oth | |
| 700 | 1 | |a Helms, Julie |e investigator |4 oth | |
| 700 | 1 | |a Jamme, Matthieu |e investigator |4 oth | |
| 700 | 1 | |a Kaidomar, Michel |e investigator |4 oth | |
| 700 | 1 | |a Lascarrou, Jean-Baptiste |e investigator |4 oth | |
| 700 | 1 | |a Le Terrier, Christophe |e investigator |4 oth | |
| 700 | 1 | |a Maizel, Julien |e investigator |4 oth | |
| 700 | 1 | |a Meziani, Ferhat |e investigator |4 oth | |
| 700 | 1 | |a Mira, Jean-Paul |e investigator |4 oth | |
| 700 | 1 | |a Morand, Lucas |e investigator |4 oth | |
| 700 | 1 | |a Muller, Grégoire |e investigator |4 oth | |
| 700 | 1 | |a Pequignot, Benjamin |e investigator |4 oth | |
| 700 | 1 | |a Piton, Gaël |e investigator |4 oth | |
| 700 | 1 | |a Pugin, Jérôme |e investigator |4 oth | |
| 700 | 1 | |a Robert, Alexandre |e investigator |4 oth | |
| 700 | 1 | |a Siino, Michael |e investigator |4 oth | |
| 700 | 1 | |a Souweine, Bertrand |e investigator |4 oth | |
| 700 | 1 | |a Stanowski, Mattieu |e investigator |4 oth | |
| 700 | 1 | |a Tamion, Fabienne |e investigator |4 oth | |
| 700 | 1 | |a Terzi, Nicolas |e investigator |4 oth | |
| 700 | 1 | |a Thiery, Guillaume |e investigator |4 oth | |
| 773 | 0 | 8 | |i Enthalten in |t Intensive care medicine |d 1993 |g 48(2022), 9 vom: 17. Sept., Seite 1185-1196 |w (DE-627)NLM000234818 |x 1432-1238 |7 nnns |
| 773 | 1 | 8 | |g volume:48 |g year:2022 |g number:9 |g day:17 |g month:09 |g pages:1185-1196 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00134-022-06833-8 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 48 |j 2022 |e 9 |b 17 |c 09 |h 1185-1196 | ||