Chief Scientific Officer Cambridge, Massachusetts, United States
Background: Evidence suggests that pregnant women with COVID-19 are at increased risk for severe illness compared with nonpregnant women.
Objectives: To examine characteristics and COVID-related symptoms among women of reproductive age enrolled in the COVID-19 Active Research Experience (CARE) registry by pregnancy status
Methods: The CARE registry launched in April 2020 in the US. CARE is an online respondent-driven sampling of adults (>=18 years) recruited through social media who provide consent at www.helpstopCOVID19.com. Participants self-report demographics, COVID-19 test results and symptoms using a 4-point scale, concomitant illness, medication and supplement use, and selected high-risk occupational settings (e.g., healthcare workers). There have been 2 waves of recruitment: Wave 1 (April 2020) targeting COVID-exposed and Wave 2 (Jan 2021) targeting COVID-positive. This study used Wave 2 recruitment data, restricted to women aged 18 – 44 years old who reported a positive COVID-19 test result prior to enrollment.
Results: 27 pregnant women and 1,296 nonpregnant women in Wave 2 were included in the analysis. The largest racial/ethnic group of women identified as White (n=997; 75.4%); n=291 (22.0%) identified as Hispanic/Latino ethnicity. The median [IQR] time from test result to enrollment was 6 [3; 12] days and did not differ by group. The average age was 30.3 (SD=4.9) years among pregnant women and 33.5 (SD=7.0) among nonpregnant women. The median [IQR] count of symptoms reported was 7 [4, 11] among pregnant women and 8 [4,11] among nonpregnant women; 11% (n=3) and 7% (n=93), respectively, reported no symptoms. The overall most prevalent symptoms were fatigue (70.3%; n=930), headache (63.3%; n=837) and nasal congestion (62.7%; n=830), with 55% (n=15) of pregnant and 41% (n=531) of nonpregnant women reporting all 3. Pregnant women were more likely to report chills than were nonpregnant women (37.0% vs 28.9%) and expectedly were more likely to report nausea than nonpregnant women (33.3% vs 26.3%).
Conclusions: Direct-to-community online surveys such as the CARE registry can show meaningful insights into disease presentation in a broader range of individuals (eg, milder illness, reduced access to healthcare). The prevalence of symptoms did not differ much by pregnancy status; however, the prevalence of each symptom tended to be higher compared to what was reported by the CDC. Elevated rates of fatigue, depression and anxiety observed in both pregnant and nonpregnant women may be mental health concerns requiring further investigation. Ongoing data collection and data linkages inclusive of more pregnant participants will provide more comparative evidence to nonpregnant women.