Long Covid has been a confounding subject for researchers since the coronavirus began spreading more than four years ago. The syndrome is blamed for a range of persistent symptoms that sometimes vary between patient groups, and the virus may pose a particular threat to pregnant people, an already vulnerable population.
Still, medical experts say the study is a stark reminder of the effects of pregnancy on the immune system and the impact it has on the body, underscoring the need for more research. The study was funded as part of the National Institutes of Health Researching COVID to Enhance Recovery Initiative, better known as RECOVER.
“I was initially surprised by the prevalence of long COVID in this population,” said Torri Metz, a lead author of the study and a maternal-fetal medicine specialist at the University of Utah Health. “It really caught my attention and I had to have this on my radar when I see patients.”
As part of the 1,500-person study, researchers analyzed individuals who were infected with the coronavirus during pregnancy; half of the participants, who were mostly in their 30s, were fully vaccinated when they enrolled. They evaluated study participants for long-term COVID symptoms 10 months after the initial infection.
The most common symptoms were malaise, fatigue and gastrointestinal complaints. Some of these complaints can also be characteristic of pregnancy.
The researchers wanted to make sure that the reported symptoms were related to COVID rather than due to pregnancy or the postpartum period. They found that the effects persisted and were still visible when they were evaluated 10 months after the initial infection. That indicated to the researchers that the study participants’ symptoms, such as fatigue and pain, were not due to pregnancy but instead were the hallmark of long-term COVID.
“This is another opportunity to really draw attention to the importance of patients receiving ongoing care after pregnancy [if they have] “Chronic conditions that require specialist care and that should be transferred to people who can really deal with them,” Metz said.
Cynthia Abraham, an associate professor at the Icahn School of Medicine at Mount Sinai in New York, who was not involved in the study, said the research highlights the threat of respiratory illness during pregnancy, with the potential for worse outcomes.
“A lot of the data we have come from nonpregnant populations … so this paper focuses on an important population that has been understudied,” said Abraham, who is also a fellow of the American College of Obstetricians and Gynecologists.
This year, more federal dollars were allocated to studying the impact of long COVID. The Biden administration announced it would invest an additional $515 million over the next four years to research the condition. It is not yet clear how much will be spent on pregnancy and covid research. So far, RECOVER has recruited over 30,000 people, including children and pregnant women.
Monica Longo, a gynecology and obstetrics researcher on the NIH RECOVER team and an expert in maternal-fetal medicine, stressed the importance of understanding how the disease affects pregnancy and the potential consequences for a fetus.
“Those nine months are critical for the developing fetus, and any change in their environment can significantly impact their development,” Longo said. “So it’s critical to study the effects of COVID exposure on the fetus.”
Longo suggested that future research could examine the effects of the virus on the fetus and investigate the consequences for the baby after birth, particularly with regard to developmental outcomes.