Long COVID After Acquisition of the Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) During Pregnancy Compared With Outside of Pregnancy

Torri D Metz¹, Harrison T Reeder, Rebecca G Clifton, Valerie Flaherman, Leyna V Aragon, Leah Castro Baucom, Carmen J Beamon, Alexis Braverman, Jeanette Brown, Megan Carmilani, Tingyi Cao, Ann Chang, Maged M Costantine, Jodie A Dionne, Kelly S Gibson, Rachel S Gross, Estefania Guerreros, Mounira Habli, Rachel Hess, Leah Hillier, Sally Hodder, M Camille Hoffman, Matthew K Hoffman, Weixing Huang, Brenna L Hughes, Xiaolin Jia, Minal Kale, Stuart D Katz, Victoria Laleau, Hector Mendez-Figueroa, Grace A McComsey, Igho Ofotokun, Megumi J Okumura, Luis D Pacheco, Anna Palatnik, Kristy T S Palomares, Samuel Parry, Christian M Pettker, Beth A Plunkett, Athena Poppas, Patrick Ramsey, Uma M Reddy, Dwight J Rouse, George R Saade, Grecio J Sandoval, Frank Sciurba, Hyagriv N Simhan, Daniel W Skupski, Amber Sowles, John M Thorp Jr, Alan T N Tita, Samantha Wiegand, Steven J Weiner, Lynn M Yee, Leora I Horwitz, Andrea S Foulkes, Vanessa L Jacoby; NIH RECOVER (Researching COVID to Enhance Recovery) Consortium

Affiliations

Affiliation

¹ University of Utah Health, Salt Lake City, Utah; Massachusetts General Hospital, Boston, Massachusetts; George Washington University, Washington, DC; University of California, San Francisco, San Francisco, and Stanford University, Palo Alto, California; Duke University, Durham, University of North Carolina at Chapel Hill, Chapel Hill, and WakeMed Health and Hospitals, Raleigh, North Carolina; University of New Mexico, Albuquerque, New Mexico; RECOVER Patient, Caregiver, or Community Advocate Representative, NYU Grossman School of Medicine, Mount Sinai Medical Center, and Columbia University, New York, and New York Presbyterian Queens, Queens, New York; University of Illinois Chicago and Northwestern University, Chicago, and NorthShore University Health System, Evanston, Illinois; The Ohio State University, Columbus, The MetroHealth System, Case Western Reserve University, and Case Western Reserve University and University Hospitals of Cleveland, Cleveland, TriHealth Good Samaritan Hospital, Cincinnati, and Wright State University Boonshoft School of Medicine, Dayton, Ohio; University of Alabama at Birmingham, Birmingham, Alabama; University of Arizona, Phoenix, Arizona; West Virginia University, Morgantown, West Virginia; University of Colorado School of Medicine, Aurora, Colorado; Christiana Care Health System, Newark, Delaware; University of Texas at Houston, Houston, University of Texas Medical Branch at Galveston, Galveston, and University of Texas Health Sciences Center San Antonio, San Antonio, Texas; Emory University, Atlanta, Georgia; Medical College of Wisconsin, Milwaukee, Wisconsin; Saint Peter's University Hospital, New Brunswick, New Jersey; University of Pennsylvania, Philadelphia, and University of Pittsburgh, Pittsburgh, Pennsylvania; Yale School of Medicine, New Haven, Connecticut; and Brown University, Providence, Rhode Island.

PMID: 41037811
DOI: 10.1097/AOG.0000000000006067

Long COVID After Acquisition of the Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) During Pregnancy Compared With Outside of Pregnancy

Torri D Metz et al. Obstet Gynecol. 2025.

. 2025 Oct 2.

doi: 10.1097/AOG.0000000000006067. Online ahead of print.

Authors

Affiliation

¹ University of Utah Health, Salt Lake City, Utah; Massachusetts General Hospital, Boston, Massachusetts; George Washington University, Washington, DC; University of California, San Francisco, San Francisco, and Stanford University, Palo Alto, California; Duke University, Durham, University of North Carolina at Chapel Hill, Chapel Hill, and WakeMed Health and Hospitals, Raleigh, North Carolina; University of New Mexico, Albuquerque, New Mexico; RECOVER Patient, Caregiver, or Community Advocate Representative, NYU Grossman School of Medicine, Mount Sinai Medical Center, and Columbia University, New York, and New York Presbyterian Queens, Queens, New York; University of Illinois Chicago and Northwestern University, Chicago, and NorthShore University Health System, Evanston, Illinois; The Ohio State University, Columbus, The MetroHealth System, Case Western Reserve University, and Case Western Reserve University and University Hospitals of Cleveland, Cleveland, TriHealth Good Samaritan Hospital, Cincinnati, and Wright State University Boonshoft School of Medicine, Dayton, Ohio; University of Alabama at Birmingham, Birmingham, Alabama; University of Arizona, Phoenix, Arizona; West Virginia University, Morgantown, West Virginia; University of Colorado School of Medicine, Aurora, Colorado; Christiana Care Health System, Newark, Delaware; University of Texas at Houston, Houston, University of Texas Medical Branch at Galveston, Galveston, and University of Texas Health Sciences Center San Antonio, San Antonio, Texas; Emory University, Atlanta, Georgia; Medical College of Wisconsin, Milwaukee, Wisconsin; Saint Peter's University Hospital, New Brunswick, New Jersey; University of Pennsylvania, Philadelphia, and University of Pittsburgh, Pittsburgh, Pennsylvania; Yale School of Medicine, New Haven, Connecticut; and Brown University, Providence, Rhode Island.

PMID: 41037811
DOI: 10.1097/AOG.0000000000006067

Abstract

Objective: To evaluate whether the risk of long COVID among individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy differs from that of individuals who were not pregnant at time of virus acquisition.

Methods: We conducted a multicenter observational cohort study at 79 NIH RECOVER (Researching COVID to Enhance Recovery) sites. Individuals assigned female at birth aged 18-45 years with an index (first) SARS-CoV-2 infection on or after December 1, 2021, were included. The exposure was pregnancy (any gestational age) at the time of index SARS-CoV-2 infection. The primary outcome was long COVID 6 months after index infection, defined as RECOVER-Adult Long COVID Research Index score 11 or higher based on a detailed symptom survey. To account for confounding and differential selection between participants who were pregnant and not pregnant at infection, propensity score-matching methods were used to balance the groups on variables potentially associated with both pregnancy status and long COVID.

Results: Overall 2,423 participants were included; 580 (23.9%) were pregnant at index SARS-CoV-2 infection. The median age at infection was 33 years (interquartile range 28-38 years), and 2,131 of participants (90.0%) with known vaccination status were vaccinated. After propensity score matching, the adjusted long COVID prevalence estimates 6 months after index infection were 10.2% (95% CI, 6.2-14.3%) among those pregnant at infection and 10.6% (95% CI, 8.8-12.4%) among those not pregnant at infection. Pregnancy was not associated with a difference in adjusted risk of long COVID (adjusted risk ratio 0.96, 95% CI, 0.63-1.48).

Conclusion: Acquisition of SARS-CoV-2 during pregnancy was not associated with a differential risk of long COVID at 6 months compared with similar-aged individuals who acquired SARS-CoV-2 outside of pregnancy.

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Conflict of interest statement

Financial Disclosure Torri D. Metz is the site PI for a Pfizer study of Paxlovid in pregnancy, is a site PI for a Moderna study of RSV vaccination in pregnancy, and was the site PI for a Pfizer study of RSV vaccination in pregnancy. She has received UpToDate royalties for two topics on trial of labor after cesarean. Valerie Flaherman reports payment received from the Research Triangle Institute. Carmen Beamon reports payment from Wellcare of North Carolina for participation on the physician advisory board. Jeanette Brown reports payment from Breas Medical for educational seminars and from Baxter for an advisory board not related to this work. Kelly S. Gibson disclosed that her institution received funding from Materna. Rachel Hess received payment from Astellas Pharmaceuticals for Data Safety Monitoring Board service. Sally Hodder has served as an advisor for Gilead Sciences, Viiv Healthcare, and Merck and her institution has received funding from Merck and Gilead for research study conduct. Brenna L. Hughes disclosed receiving payments from UpToDate, Moderna, and John's Hopkins. Grace A. McComsey served as an advisor for Merck, Gilead, and GlaxoSmithkline. Patrick S. Ramsey disclosed receiving payments from UpToDate and payment to his institution from the Texas Collaborative for Health Mothers and Babies (Texas PQC). Daniel W Skupski reports receiving payments from Organon, Inc. and Cooper Surgical. Alan Tita reports payment from Pfizer. M. Camile Hoffman disclosed her institution received payment for her expert testimony for one medicolegal trial from Wheeler, Trigg, and Associates (a defense attorneys firm). Her institution also received payment for a disease state presentation on postpartum depression and zuranolone from SAGE/Biogen. Leora Horwitz reports payment from the National Academy of Medicine. Andrea Foulkes reports payment from RoundTable. The other authors did not report any potential conflicts of interest.

References

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Long COVID After Acquisition of the Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) During Pregnancy Compared With Outside of Pregnancy

Affiliation

Long COVID After Acquisition of the Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) During Pregnancy Compared With Outside of Pregnancy

Authors

Affiliation

Abstract

Conflict of interest statement

References

Grants and funding

LinkOut - more resources

Full Text Sources

Miscellaneous