COVID-19 related medicine utilization study in pregnancy - the COVI-PREG cohort.

Abstract

OBJECTIVE

The aim was to describe the use of COVID-19 related medicines during pregnancy and their evolution between the early/late periods of the pandemic.

METHODS

Pregnant women tested positive for SARS-CoV-2 from March 2020, to July 2021, were included using the COVI-PREG registry. Exposure to the following COVID-19 related medicine were recorded: antibiotics, antivirals, hydroxychloroquine, corticosteroids, anti-interleukin-6 and immunoglobulins. We described the prevalence of medicines used, by trimester of pregnancy, maternal COVID-19 severity level and early/late period of the pandemic (before and after July 1 2020).

FINDINGS

We included 1,964 pregnant patients, tested positive for SARS-CoV-2. Overall, 10.4% (205/1964) received at least one COVID-19 related medicine including antibiotics (8.6%; 169/1694), corticosteroids (3.2%; 62/1964), antivirals (2.0%; 39/1964), hydroxychloroquine (1.4%; 27/1964), and anti-interleukin-6 (0.3%; 5/1964). The use of at least one COVID-19 related medicine was 3.1% (12/381) in asymptomatic, 4.2% (52/1233) in outpatients, 19.7% (46/233) in inpatients without oxygen, 72.1% (44/61) in requiring standard oxygen, 95.7% (22/23) in requiring high flow oxygen, 96.2% (25/26) in intubated and 57.1% (4/7) among patients who died. The proportion who received medicines to treat COVID-19 was higher before than after July 2020 (16.7% vs. 7.7%). Antibiotics, antivirals, and hydroxychloroquine had lower rates of use lately.

INTERPRETATION

Medicine use in pregnancy was increasing with disease severity. The trend toward increased corticosteroids use seems to be aligned with changing guidelines. Evidence is still needed regarding the effectiveness and safety of COVID-19 related medicines in pregnancy.

FUNDING

Research funded by the Swiss Federal Office of Public Health.