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Long COVID after SARS-CoV-2 during pregnancy in the United States

Zang, Chengxi
Guth, Daniel
Bruno, Ann M
Xu, Zhenxing
Li, Haoyang
Ammar, Nariman
Chew, Robert
Guthe, Nick
Hadley, Emily
Kaushal, Rainu
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Abstract

Pregnancy alters immune responses and clinical manifestations of COVID-19, but its impact on Long COVID remains uncertain. This study investigated Long COVID risk in individuals with SARS-CoV-2 infection during pregnancy compared to reproductive-age females infected outside of pregnancy. A retrospective analysis of two U.S. databases, the National Patient-Centered Clinical Research Network (PCORnet) and the National COVID Cohort Collaborative (N3C), identified 29,975 pregnant individuals (aged 18-50) with SARS-CoV-2 infection in pregnancy from PCORnet and 42,176 from N3C between March 2020 and June 2023. At 180 days after infection, estimated Long COVID risks for those infected during pregnancy were 16.47 per 100 persons (95% CI, 16.00-16.95) in PCORnet using the PCORnet computational phenotype (CP) model and 4.37 per 100 persons (95% CI, 4.18-4.57) in N3C using the N3C CP model. Compared to matched non-pregnant individuals, the adjusted hazard ratios for Long COVID were 0.86 (95% CI, 0.83-0.90) in PCORnet and 0.70 (95% CI, 0.66-0.74) in N3C. The observed risk factors for Long COVID included Black race/ethnicity, advanced maternal age, first- and second-trimester infection, obesity, and comorbid conditions. While the findings suggest a high incidence of Long COVID among pregnant individuals, their risk was lower than that of matched non-pregnant females.

Source

Zang C, Guth D, Bruno AM, Xu Z, Li H, Ammar N, Chew R, Guthe N, Hadley E, Kaushal R, Love T, McGrath BM, Patel RC, Seibert EC, Senathirajah Y, Singh SK, Wang F, Weiner MG, Wilkins KJ, Zhang Y, Metz TD, Hill E, Carton TW; RECOVER PCORnet EHR Consortia; RECOVER N3C EHR Consortia; RECOVER Pregnancy Consortia. Long COVID after SARS-CoV-2 during pregnancy in the United States. Nat Commun. 2025 Apr 1;16(1):3005. doi: 10.1038/s41467-025-57849-9. PMID: 40169569; PMCID: PMC11961632.

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DOI
10.1038/s41467-025-57849-9
PubMed ID
40169569
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Funding and Acknowledgements
The UMass Center for Clinical and Translational Science (UMCCTS), UL1TR001453, helped fund this study.
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Open Access: This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creativecommons.org/licenses/by-nc-nd/4.0/. © The Author(s) 2025Attribution-NonCommercial-NoDerivatives 4.0 International