{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T15:40:00Z","timestamp":1763739600458,"version":"3.45.0"},"reference-count":45,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. bras. epidemiol."],"abstract":"<jats:p>ABSTRACT  Objective: To compare mortality, intensive care unit (ICU) admission, and use of invasive ventilatory support in hospitalized pregnant and nonpregnant women with severe acute respiratory syndrome due to Coronavirus-2 in Brazil.  Methods: It is a cross-sectional study developed with data from the Brazilian Surveillance of Severe Acute Respiratory Syndrome (SARS), Ministry of Health. Three outcomes were investigated: mortality, ICU admission, and use of invasive ventilatory support among COVID-19 cases. Hospitalized pregnant and nonpregnant women were paired according to age group, geographic region, and epidemiological week (33,113 nonpregnant women; 15,567 pregnant women) from March 2020 to March 2022. Associations between pregnancy status and outcomes were analyzed using conditional logistic regression. For 2021 data, an interaction term with vaccination status (no\/yes) was included.  Results: Mortality (17.6 vs 7.9%), ICU admission (30.3 vs 26.1%), and invasive ventilatory support use (46.6 vs 38.5%) were higher among nonpregnant women, respectively. ICU admission was highest in the second trimester of pregnancy (32.6%). Being in the second trimester increased the likelihood of ICU admission (OR=1.26; 95%CI 1.15\u20131.39) compared to nonpregnant women. The odds of ICU admission was lower among vaccinated pregnant women in the first (OR=0.71; 95%CI 0.51\u20130.96), second (OR=0.74; 95%CI 0.62\u20130.88), and third trimesters (OR=0.65; 95%CI 0.57\u20130.74).  Conclusion: All three outcomes were more frequent among hospitalized nonpregnant women, except for ICU admission in the second trimester. COVID-19 vaccination has proven to be an important protective measure, particularly for pregnant women in the second and third trimesters.<\/jats:p>","DOI":"10.1590\/1980-549720250054","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T15:06:24Z","timestamp":1763737584000},"source":"Crossref","is-referenced-by-count":0,"title":["Mortality, intensive care unit admission, and ventilatory support in pregnant and nonpregnant women with COVID-19 in Brazil: a paired observational study"],"prefix":"10.1590","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0154-554X","authenticated-orcid":false,"given":"Ana Elisa Madalena","family":"Rinaldi","sequence":"first","affiliation":[{"name":"Universidade Federal de Uberl\u00e2ndia,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8537-2529","authenticated-orcid":false,"given":"Camila Abadia Rodrigues","family":"Meira","sequence":"additional","affiliation":[{"name":"Universidade Federal de Uberl\u00e2ndia,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3101-3894","authenticated-orcid":false,"given":"Mar\u00edlia Neves","family":"Santos","sequence":"additional","affiliation":[{"name":"Universidade Federal de Uberl\u00e2ndia,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5140-3622","authenticated-orcid":false,"given":"Luciana Bertoldi","family":"Nucci","sequence":"additional","affiliation":[{"name":"Pontif\u00edcia Universidade Cat\u00f3lica de Campinas,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4634-4402","authenticated-orcid":false,"given":"Carla Cristina","family":"Enes","sequence":"additional","affiliation":[{"name":"Pontif\u00edcia Universidade Cat\u00f3lica de Campinas,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0493-134X","authenticated-orcid":false,"given":"Wolney Lisboa","family":"Conde","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2025]]},"reference":[{"issue":"5","key":"ref1","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.ajog.2020.02.017","article-title":"Coronavirus Disease 2019 (COVID-19) and pregnancy: what obstetricians need to know","volume":"222","author":"Rasmussen SA","year":"2020","journal-title":"Am J Obstet Gynecol"},{"issue":"25","key":"ref2","doi-asserted-by":"crossref","first-page":"769","DOI":"10.15585\/mmwr.mm6925a1","article-title":"Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status \u2014 United States, January 22\u2013June 7, 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Secretaria de Vigil\u00e2ncia em Sa\u00fade. Conjunto de dados - SRAG 2021 a 2024 - Banco de dados da S\u00edndrome Respirat\u00f3ria Aguda Grave [Internet]"},{"key":"ref21","article-title":"Pregnancy and COVID-19: management and challenges","volume":"62","author":"Wenling Y","year":"2020","journal-title":"Rev Inst Med Trop S\u00e3o Paulo [Internet]"},{"key":"ref22","series-title":"Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) [Internet]","year":"2020"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.bpobgyn.2021.03.004","article-title":"Effects of the COVID pandemic on pregnancy outcomes","volume":"73","author":"Elsaddig M","year":"2021","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"12","DOI":"10.18332\/ejm\/120973","article-title":"The latest update on the effects of COVID-19 infection in pregnancy","volume":"4","author":"Antonakou A","year":"2020","journal-title":"Eur J Midwifery"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"100118","DOI":"10.1016\/j.ajogmf.2020.100118","article-title":"Coronavirus disease 2019 infection among asymptomatic and symptomatic pregnant women: two weeks of confirmed presentations to an affiliated pair of New York City hospitals","volume":"2","author":"Breslin N","year":"2020","journal-title":"Am J Obstet Gynecol MFM"},{"issue":"13","key":"ref26","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1001\/jama.2020.2648","article-title":"Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China","volume":"323","author":"Wu Z","year":"2020","journal-title":"JAMA"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"6928","DOI":"10.1038\/s41598-021-86452-3","article-title":"Symptoms and syndromes associated with SARS-CoV-2 infection and severity in pregnant women from two community cohorts","volume":"11","author":"Molteni E","year":"2021","journal-title":"Sci Rep"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"384","DOI":"10.11604\/pamj.2021.38.384.28695","article-title":"SARS-CoV-2 infection in pregnant women; epidemiological, clinical, biological and evolutionary profile in 16 cases: the COVID-19 experience in the Moroccan Military Hospital in Benslimane","volume":"38","author":"Benlghazi A","year":"2021","journal-title":"Pan Afr Med J"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"05018","DOI":"10.7189\/jogh.11.05018","article-title":"A systematic review and meta-analysis of data on pregnant women with confirmed COVID-19: Clinical presentation, and pregnancy and perinatal outcomes based on COVID-19 severity","volume":"11","author":"Lassi ZS","year":"2021","journal-title":"J Glob Health"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.ajem.2022.03.060","article-title":"The association between pregnancy and COVID-19: A systematic review and meta-analysis","volume":"56","author":"Wang H","year":"2022","journal-title":"Am J Emerg Med"},{"issue":"2","key":"ref31","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1002\/uog.23575","article-title":"Pregnant women with SARS-CoV-2 infection are at higher risk of death and pneumonia: propensity score matched analysis of a nationwide prospective cohort (COV19Mx)","volume":"57","author":"Martinez-Portilla RJ","year":"2021","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"4","key":"ref32","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1111\/ppe.12808","article-title":"Severity of illness by pregnancy status among laboratory-confirmed SARS-CoV-2 infections occurring in reproductive-aged women in Colombia","volume":"36","author":"Rozo N","year":"2022","journal-title":"Paediatr Perinat Epidemiol"},{"issue":"44","key":"ref33","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.15585\/mmwr.mm6944e3","article-title":"Update: Characteristics of symptomatic women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status - 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