COVID-19 medicine use in pregnancy increases with disease severity

Use of medicines for COVID-19 during pregnancy is higher in patients with more severe disease, according to a study. In addition, a trend towards increased corticosteroids use has been observed and appears to be consistent with changing guidelines.

This study used the COVI-PREG registry to identify pregnant women who tested positive for SARS-CoV-2 from March 2020 to July 2021. The investigators recorded the exposure to the following COVID-19‒related medications: antibiotics, antivirals, hydroxychloroquine, corticosteroids, anti-interleukin-6, and immunoglobulins. They then 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 1 July 2020).

A total of 1,964 pregnant patients with a positive diagnosis of COVID-19 were included in the analysis. Of these, 205 (10.4 percent) received at least one COVID-19‒related medicine, including antibiotics (n=169, 8.6 percent), corticosteroids (n=62, 3.2 percent), antivirals (n=39, 2.0 percent), hydroxychloroquine (n=27, 1.4 percent), and anti-interleukin-6 (n=62, 3.2 percent).

Using at least one medicine for COVID-19 increased with disease severity: 3.1 percent (12/381) in asymptomatic individuals, 4.2 percent (52/1,233) in outpatients, 19.7 percent (46/233) in inpatients without oxygen, 72.1 percent (44/61) in those requiring standard oxygen, 95.7 percent (22/23) in those requiring high flow oxygen, 96.2 percent (25/26) in patients who required intubation, and 57.1 percent (4/7) in those who succumbed to the disease.

In addition, the number of patients treated with medicines for COVID-19 was greater before than after July 2020 (16.7 percent vs 7.7 percent). The use of antibiotics, antivirals, and hydroxychloroquine was lower during the late period.