Outcome predictors and patient progress following delivery in pregnant and postpartum patients with severe COVID-19 pneumonitis in intensive care units in Israel (OB-COVICU): a nationwide cohort study
An erratum to this article was published (Lancet Respir Med, Apr 2023 ↗)
Authors' conclusion
In patients who underwent delivery during their ICU stay, maternal outcome deteriorated following delivery among those defined as critical compared with non-critical patients, who improved following delivery.
Study context
- Population
- Pregnant women (13th week of gestation to 1st week postpartum) admitted to an intensive care unit (ICU) in Israel with severe COVID-19 pneumonitis, Feb 2020–Jan 2022analysed
- Participants
- 84 women
- Exposure
- Delivery-critical vs delivery-non-critical vs postpartum vs no-delivery
- No-deliveryn = 34
- Postpartumn = 4
- Delivery-criticaln = 32
- Delivery-non-criticaln = 14
- Outcome
- Maternal outcome (worst of: no invasive positive pressure ventilation [IPPV], IPPV, ECMO, or death); primary longitudinal outcome SOFA score
Methodological detailsmulticentre, nationwide
- Multicentre
- Nationwide
Main finding
As reported in the abstract
Maternal outcome: IPPV (events), ECMO and death (measures)
| Group | Value | ECMO | Death |
|---|---|---|---|
| Delivery-critical | 81% | 12 (38%) | 1 (3%) |
| Postpartum | 100% | 3 (75%) | 2 (50%) |
| No-delivery | 18% | 0 | 0 |
| Delivery-non-critical | 14% | 0 | 0 |
Value
Delivery-critical81%
Postpartum100%
No-delivery18%
Delivery-non-critical14%
ECMO
Delivery-critical12 (38%)
Postpartum3 (75%)
No-delivery0
Delivery-non-critical0
Death
Delivery-critical1 (3%)
Postpartum2 (50%)
No-delivery0
Delivery-non-critical0
Observational data: associations, not effects.
Further findings
Predictors of adverse maternal outcome (SpO2, S/F ratio, P/F ratio, ROX index, Sequential Organ Failure Assessment (SOFA) and PORCH scores)
- All highly predictive for adverse maternal outcome
- P < 0.0001
ICU course and duration
- Delivery-critical group deteriorated on day of delivery, continued to deteriorate and took longer to recover (ICU duration, Mantel-Cox)
- P < 0.0001
- Delivery-non-critical group improved rapidly following delivery
Day of delivery as covariate for longitudinal scores
- Significant covariate for PORCH score
- P < 0.0001
- Not significant for SOFA score
- P = 0.09
Original publication
Outcome predictors and patient progress following delivery in pregnant and postpartum patients with severe COVID-19 pneumonitis in intensive care units in Israel (OB-COVICU): a nationwide cohort study. Lancet Respir Med. Published 3 February 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →