How Long COVID Affects Pregnant People
New research to help communities plan for the upcoming fall vaccination season.
With updated COVID-19 and flu vaccines around the corner and recommended for everyone 6 months and older, new data sheds key information on why staying up to date with routine vaccinations is imperative, especially for vulnerable populations.
For example, community-based organizations working to provide health services in communities that lack access face challenges reaching pregnant people.
And while previous studies have established that COVID-19 is particularly risky for pregnant individuals, it was unclear how likely they are to develop long COVID.
To better understand new research that may help community health workers plan for the upcoming fall vaccination season, Public Good News spoke with Dr. Torri Metz, associate professor at the University of Utah, maternal fetal medicine physician, and co-author of a study that found that almost one in 10 pregnant people who get sick with COVID go on to develop long COVID.
Here’s what she said.
PGN: Can you tell us more about your study’s findings?
Dr. Torri Metz: This study is part of the National Institutes of Health Researching COVID (RECOVER) initiative which looks to examine long COVID, its risk factors, and, ultimately, treatments. As part of that larger initiative, there’s a smaller pregnancy cohort that I am one of the investigators for.
So, this publication is an initial snapshot aimed to evaluate if people acquire COVID-19 during pregnancy, what percentage of them then go on to develop long COVID.
We know that they’re at higher risk for death and needing things like ICU admission, so we wondered if that’s true, does that then correspond to higher risks of developing long COVID, or are there differences in the immune response to COVID-19 that perhaps actually make them less likely to develop long COVID?
We looked at a median of 10 months after infection. We talked to people about their symptoms and symptom severity. We then applied a research definition of long COVID to identify people that seem very likely to have long COVID based on the reported symptoms that they have.
We estimated that 9 percent of people who had SARS-CoV-2 during pregnancy basically meet the research definition for long COVID at a median of 10 months.
PGN: Are pregnant people more vulnerable to developing long COVID?
T.M: We don’t really know yet if they’re more vulnerable to developing long COVID, and that’s a lot of the work that we’re continuing to do.
But with the initial infection, just like other viruses, we think that it’s really a difference in the immune response to infections during pregnancy that puts pregnant people at higher risk for more severe manifestations of the infection or more severe symptoms of the infection.
Normally, if our body encountered foreign DNA, it would reject that thing. But in pregnancy, the mother has to tolerate having a fetus that has different DNA than they do, and so the immune response is really modulated.
So, when pregnant people get things like SARS-CoV-2, the flu, and other infections, they really can have more severe symptoms.
PGN: What advice do you have for community health workers who work with pregnant people?
T.M.: Pregnant people are particularly vulnerable to more severe infections with SARS-CoV-2. So, I think broadly, we do want to encourage pregnant people to be vaccinated, just on that basis alone.
As an obstetrician, I know that early in the pandemic, we really didn’t have any data about COVID-19 vaccination in pregnant populations. It just hadn’t been studied. So, I know that that really resulted in a lot of early vaccine hesitancy in pregnant people, which is understandable when you’re trying to talk to people about a vaccine that hasn’t been tested previously in pregnant populations. But that’s just not the case anymore.
Now, these vaccines have been administered broadly to pregnant populations. We have a lot of safety data saying that these vaccines are safe, that, in fact, these vaccines prevent adverse pregnancy outcomes like stillbirth and preterm birth. And, probably, it’s not because the vaccine itself is preventing those things—it’s because the vaccine is preventing the COVID-19 infection that then would result in those other complications. So, this is a really important preventative measure.
PGN: What’s next in your research?
T.M.: This study was really just the beginning of more work to ultimately compare this to non-pregnant populations.
There is some CDC data demonstrating that there’s a high proportion of patients who have some symptoms of long COVID, but then it sort of seems to decrease over time. Data shows that people do seem to be getting better over time, not all of them, obviously, but some people do improve. So, we do want to look at the trajectory.
So now, these patients are enrolled in a four-year longitudinal study. We want to see six months from then, or a year from then, what proportions still have those symptoms, and look at if there’s a particular type of patient who gets better versus some patients who may not to then identify who we could really target interventions and treatments towards in the future.
Separately, we are also looking into what the long term effects are on offspring of people who have SARS-CoV-2 during pregnancy.
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This article first appeared on Public Good News and is republished here under a Creative Commons license.