Long COVID following SARS‐CoV‐2 infection during pregnancy: An observational study in a large Italian hospital during the COVID‐19 pandemic

INTRODUCTION Despite mounting evidence on Long COVID, data regarding its impact on women infected during pregnancy remains scarce. This study aimed to assess the development of Long COVID in women who had been infected with SARS-CoV-2 during pregnancy, focusing on possible risk factors and potential protective elements associated with its development.

MATERIAL AND METHODS We analyzed a cohort of 348 pregnant women with laboratory-confirmed SARS-CoV-2 infection admitted to ASST-Spedali Civili (Brescia, Italy) between March 2020 and May 2022. Data collection included demographics, comorbidities, COVID-19 severity markers, and vaccination status. To assess the possible association between the analyzed risk factors and Long Covid, beyond standard multivariable models, we employed inverse probability weighting techniques (IPTW) and calculated e-values to assess unmeasured confounding.

RESULTS Among study participants, 27.0% (94/348) developed Long COVID. Risk factors included preexisting respiratory comorbidities (adjusted OR = 3.171, 95% CI 0.99-10.1), pneumonia at admission (adjusted OR = 4.48, 95% CI 2.16-9.28), and earlier pregnancy stage at infection (adjusted OR = 0.96 per week, 95% CI 0.93-0.99). COVID-19 vaccination was associated with a significantly lower risk of Long COVID (15.5% in vaccinated vs. 31.8% in unvaccinated women; IPTW-adjusted OR = 0.38, 95% CI: 0.20-0.71, p-value: 0.003). The most common symptoms were fatigue (46.8%) and memory impairment (38.3%), with unvaccinated patients exhibiting a higher prevalence of neuropsychiatric symptoms.

CONCLUSIONS Our data suggest that one in four pregnant women hospitalized with COVID-19 develop persistent symptoms. The most frequently affected women had preexisting respiratory disease, pneumonia at admission, and infection earlier in pregnancy. COVID-19 vaccination appears to reduce risk and alter symptom presentation. These findings underscore the importance of vaccination throughout pregnancy and highlight the need for targeted surveillance in high-risk subgroups.