Is it possible to reduce the rate of vertical transmission and improve perinatal outcomes by inclusion of remdesivir in treatment regimen of pregnant women with COVID–19?

Abstract Background Coronavirus disease 2019 (COVID–19) is currently one of the world's most critical health issues so far. Given the importance of appropriate treatment in pregnancy and the controversies about Remdesivir effectiveness and complications, the present study aimed to evaluate the...

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Main Authors: Nader Tavakoli, Shahla Chaichian, Jamileh Sadat Sadraei, Saeedeh Sarhadi, Sepideh Arbabi Bidgoli, Elnaz Rokhsat, Katayoon Anoushirvani, Banafsheh Nikfar, Abolfazl Mehdizadehkashi
Format: Article
Language:English
Published: BMC 2023-02-01
Series:BMC Pregnancy and Childbirth
Subjects:
Online Access:https://doi.org/10.1186/s12884-023-05405-y
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author Nader Tavakoli
Shahla Chaichian
Jamileh Sadat Sadraei
Saeedeh Sarhadi
Sepideh Arbabi Bidgoli
Elnaz Rokhsat
Katayoon Anoushirvani
Banafsheh Nikfar
Abolfazl Mehdizadehkashi
author_facet Nader Tavakoli
Shahla Chaichian
Jamileh Sadat Sadraei
Saeedeh Sarhadi
Sepideh Arbabi Bidgoli
Elnaz Rokhsat
Katayoon Anoushirvani
Banafsheh Nikfar
Abolfazl Mehdizadehkashi
author_sort Nader Tavakoli
collection DOAJ
description Abstract Background Coronavirus disease 2019 (COVID–19) is currently one of the world's most critical health issues so far. Given the importance of appropriate treatment in pregnancy and the controversies about Remdesivir effectiveness and complications, the present study aimed to evaluate the impact of Remdesivir on maternal, fetal, and perinatal outcomes in pregnant women with COVID–19 diseases. Methods A total of 189 pregnant women with positive polymerase chain reaction (PCR) results for SARS–COV–2, and oxygen saturation [SpO2] of < 95%) were admitted to 12 hospitals affiliated with the Iran University of Medical Sciences from March 1st, 2020 to June 7th, 2021, namely the first four COVID-19 Picks in Iran. They were enrolled in this retrospective cohort study by census method and categorized into case and control groups, based on the inclusion of Remdesivir in their treatment protocol. Demographics, clinical outcomes, and pregnancy-related complications of the mothers and the neonates were compared between the two study groups. Results A comparison of 54 mothers in the case and 135 in the control group showed no demographic and clinical characteristics difference. Neonates whose mothers did not receive Remdesivir had a higher rate of positive PCR (10.2%), compared to the Remdesivir group (1.9%) with a relative risk of 0.91 reported for Remdesivir (95% CI: 0.85–0.98, P = 0.04); besides, Remdesivir resulted in fewer neonatal intensive care unit admission rates in mild/moderate COVID–19 group (RR = 0.32, 95% CI: 0.105–1.02, P = 0.03). Although neonatal death between the two groups was not statistically significant, from the clinical point seems important; 1(1.9%) in the case vs. 9(7.2%) in the control group. Interestingly LOS (Length of Stay) in the hospital was longer in the case group (median of 7 vs. 3 days; P < 0.0001). Conclusion The inclusion of Remdesivir in the treatment protocol of pregnant women with COVID–19 may reduce vertical transmission and improve perinatal outcomes, thus being suggested to be considered.
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spelling doaj.art-088927ab53db4da9aff173fe138c65992023-03-22T12:38:53ZengBMCBMC Pregnancy and Childbirth1471-23932023-02-012311810.1186/s12884-023-05405-yIs it possible to reduce the rate of vertical transmission and improve perinatal outcomes by inclusion of remdesivir in treatment regimen of pregnant women with COVID–19?Nader Tavakoli0Shahla Chaichian1Jamileh Sadat Sadraei2Saeedeh Sarhadi3Sepideh Arbabi Bidgoli4Elnaz Rokhsat5Katayoon Anoushirvani6Banafsheh Nikfar7Abolfazl Mehdizadehkashi8Trauma and Injury Research Center, Iran University of Medical SciencesEndometriosis Research Center, Iran University of Medical SciencesTrauma and Injury Research Center, Iran University of Medical SciencesHealth Promotion Research Center, Zahedan University of Medical SciencesDepartment of Toxicology and Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, Islamic Azad University, Tehran Medical Sciences UniversityPars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical SciencesPars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical SciencesPars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical SciencesEndometriosis Research Center, Iran University of Medical SciencesAbstract Background Coronavirus disease 2019 (COVID–19) is currently one of the world's most critical health issues so far. Given the importance of appropriate treatment in pregnancy and the controversies about Remdesivir effectiveness and complications, the present study aimed to evaluate the impact of Remdesivir on maternal, fetal, and perinatal outcomes in pregnant women with COVID–19 diseases. Methods A total of 189 pregnant women with positive polymerase chain reaction (PCR) results for SARS–COV–2, and oxygen saturation [SpO2] of < 95%) were admitted to 12 hospitals affiliated with the Iran University of Medical Sciences from March 1st, 2020 to June 7th, 2021, namely the first four COVID-19 Picks in Iran. They were enrolled in this retrospective cohort study by census method and categorized into case and control groups, based on the inclusion of Remdesivir in their treatment protocol. Demographics, clinical outcomes, and pregnancy-related complications of the mothers and the neonates were compared between the two study groups. Results A comparison of 54 mothers in the case and 135 in the control group showed no demographic and clinical characteristics difference. Neonates whose mothers did not receive Remdesivir had a higher rate of positive PCR (10.2%), compared to the Remdesivir group (1.9%) with a relative risk of 0.91 reported for Remdesivir (95% CI: 0.85–0.98, P = 0.04); besides, Remdesivir resulted in fewer neonatal intensive care unit admission rates in mild/moderate COVID–19 group (RR = 0.32, 95% CI: 0.105–1.02, P = 0.03). Although neonatal death between the two groups was not statistically significant, from the clinical point seems important; 1(1.9%) in the case vs. 9(7.2%) in the control group. Interestingly LOS (Length of Stay) in the hospital was longer in the case group (median of 7 vs. 3 days; P < 0.0001). Conclusion The inclusion of Remdesivir in the treatment protocol of pregnant women with COVID–19 may reduce vertical transmission and improve perinatal outcomes, thus being suggested to be considered.https://doi.org/10.1186/s12884-023-05405-yCOVID–19Pregnant womenRemdesivirNeonatalVertical transmissionPregnancy outcome
spellingShingle Nader Tavakoli
Shahla Chaichian
Jamileh Sadat Sadraei
Saeedeh Sarhadi
Sepideh Arbabi Bidgoli
Elnaz Rokhsat
Katayoon Anoushirvani
Banafsheh Nikfar
Abolfazl Mehdizadehkashi
Is it possible to reduce the rate of vertical transmission and improve perinatal outcomes by inclusion of remdesivir in treatment regimen of pregnant women with COVID–19?
BMC Pregnancy and Childbirth
COVID–19
Pregnant women
Remdesivir
Neonatal
Vertical transmission
Pregnancy outcome
title Is it possible to reduce the rate of vertical transmission and improve perinatal outcomes by inclusion of remdesivir in treatment regimen of pregnant women with COVID–19?
title_full Is it possible to reduce the rate of vertical transmission and improve perinatal outcomes by inclusion of remdesivir in treatment regimen of pregnant women with COVID–19?
title_fullStr Is it possible to reduce the rate of vertical transmission and improve perinatal outcomes by inclusion of remdesivir in treatment regimen of pregnant women with COVID–19?
title_full_unstemmed Is it possible to reduce the rate of vertical transmission and improve perinatal outcomes by inclusion of remdesivir in treatment regimen of pregnant women with COVID–19?
title_short Is it possible to reduce the rate of vertical transmission and improve perinatal outcomes by inclusion of remdesivir in treatment regimen of pregnant women with COVID–19?
title_sort is it possible to reduce the rate of vertical transmission and improve perinatal outcomes by inclusion of remdesivir in treatment regimen of pregnant women with covid 19
topic COVID–19
Pregnant women
Remdesivir
Neonatal
Vertical transmission
Pregnancy outcome
url https://doi.org/10.1186/s12884-023-05405-y
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