Gamma SARS-CoV-2 variant of concern infection repercussions on pregnancy outcomes: A translational cohort study

This study conduct viral genome sequencing among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pregnant and postpartum individuals, and investigates disease severity and maternal and perinatal outcomes considering variant of concern (VOC) and non-VOC groups.

The study was designed as a prospective cohort study of unvaccinated pregnant and postpartum women with SARS-CoV-2 infection diagnosed by quantitative reverse transcription polymerase chain reaction between May 2020 and April 2021 at a maternal referral center. Initially, 111 participants were identified, and 50 presented with conditions for genome sequencing and further analysis. The SARS-CoV-2 genome was subjected to next-generation sequencing in eligible cases. Sociodemographic characteristics, background, and clinical and obstetric outcomes were compared according to the SARS-CoV-2 genomic data (VOC vs. non-VOC).

Among the sequenced cases, 18 were classified as VOC, among which 14 were Gamma cases and four Alpha. Oxygen desaturation, hospitalization, intensive care unit admission, invasive ventilation, and maternal death were significantly higher in SARS-CoV-2 VOC-infected than in non-VOC-infected cases. All three cases of maternal death were classified as VOC, including two Gamma and one Alpha.

Pregnant and postpartum people presented with an increased morbidity and mortality due to COVID-19 caused by SARS-CoV-2 VOC, especially Gamma. The increased risk of clinical severity in the unvaccinated obstetric population underscores the importance of addressing the repercussions of the SARS-CoV-2 genomic evolution.