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Comparative Study
. 2024;33(5):441-451.
doi: 10.1159/000539004. Epub 2024 Apr 20.

Retrospective Cohort Study Comparing the Clinical Profile and Outcomes of Critically Ill Pregnant Patients in Kuwait during the COVID-19 Pandemic Waves

Eman Alazmi  1 , Zahraa Akbar  1 , Mariam Aldarweesh  1 , Khalid Almuzayen  1 , Eelaf Husain  1 , Jehad Alharmi  2
Affiliations
Comparative Study

Retrospective Cohort Study Comparing the Clinical Profile and Outcomes of Critically Ill Pregnant Patients in Kuwait during the COVID-19 Pandemic Waves

Eman Alazmi et al. Med Princ Pract. 2024.

Abstract

Objectives: COVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2 virus). This virus evolved into several variants, each with different severity. There are surges in the number of infected patients, commonly described as "waves." In Kuwait, three waves occurred. Our study describes and compares the clinical presentation and outcomes of critically ill pregnant patients infected with different variants.

Methods: This was a retrospective cohort study in two intensive care units (ICU) dedicated to patients with COVID-19. The wave periods were retrieved from the Kuwait Ministry of Health.

Results: The total number of ICU admissions during the study period was 74 patients. Most cases occurred during the third wave (n = 47/74, 63.5%). Most patients did not have comorbidities. The most common presenting symptoms were fever 62.2%, dyspnea 71.6%, and dry cough 74.3%. Low oxygen saturation 35.1% and maternal tachycardia 75.7% were observed in most patients. Cesarean section was the most common route of delivery, with maternal indication accounting for most cases 78.84%. Eight patients (13.69%) underwent dialysis, and thirty-one (41.9%) needed extracorporeal membrane oxygenation. Most patients required ventilatory support 66.21%. Almost all patients were unvaccinated 97.01%. Maternal mortality was mainly noted in the third wave (13.23%).

Conclusions: In Kuwait, the number of admissions and the rate of maternal complications, morbidity, and mortality increased with successive waves.

Keywords: COVID-19; Dialysis; Extracorporeal membrane oxygenation; Mortality; Pregnancy.

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Figures

Fig. 1.
Fig. 1.
Active COVID-19 cases in Kuwait from February 2020 to October 2023 [5].
Fig. 2.
Fig. 2.
Prevalence of SARS-CoV-2 clades in Kuwait between February 2020 and June 2021 [6].
Fig. 3.
Fig. 3.
The proportion (%) of patients who required dialysis, mechanical ventilation, or ECMO across the three different waves.
Fig. 4.
Fig. 4.
Maternal outcomes after ICU admission in the three waves in Kuwait. The Y-axis in the graph and the table below the graph indicate (n) number of cases.
See this image and copyright information in PMC

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