Long COVID after SARS-CoV-2 during pregnancy in the United States

Abstract Pregnancy alters immune responses and clinical manifestations of COVID-19, but its impact on Long COVID remains uncertain. This study investigated Long COVID risk in individuals with SARS-CoV-2 infection during pregnancy compared to reproductive-age females infected outside of pregnancy. A...

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Main Authors: Chengxi Zang, Daniel Guth, Ann M. Bruno, Zhenxing Xu, Haoyang Li, Nariman Ammar, Robert Chew, Nick Guthe, Emily Hadley, Rainu Kaushal, Tanzy Love, Brenda M. McGrath, Rena C. Patel, Elizabeth C. Seibert, Yalini Senathirajah, Sharad Kumar Singh, Fei Wang, Mark G. Weiner, Kenneth J. Wilkins, Yiye Zhang, Torri D. Metz, Elaine Hill, Thomas W. Carton, On behalf of the RECOVER PCORnet EHR Consortia, the RECOVER N3C EHR Consortia, RECOVER Pregnancy Consortia
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-57849-9
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author Chengxi Zang
Daniel Guth
Ann M. Bruno
Zhenxing Xu
Haoyang Li
Nariman Ammar
Robert Chew
Nick Guthe
Emily Hadley
Rainu Kaushal
Tanzy Love
Brenda M. McGrath
Rena C. Patel
Elizabeth C. Seibert
Yalini Senathirajah
Sharad Kumar Singh
Fei Wang
Mark G. Weiner
Kenneth J. Wilkins
Yiye Zhang
Torri D. Metz
Elaine Hill
Thomas W. Carton
On behalf of the RECOVER PCORnet EHR Consortia
the RECOVER N3C EHR Consortia
RECOVER Pregnancy Consortia
author_facet Chengxi Zang
Daniel Guth
Ann M. Bruno
Zhenxing Xu
Haoyang Li
Nariman Ammar
Robert Chew
Nick Guthe
Emily Hadley
Rainu Kaushal
Tanzy Love
Brenda M. McGrath
Rena C. Patel
Elizabeth C. Seibert
Yalini Senathirajah
Sharad Kumar Singh
Fei Wang
Mark G. Weiner
Kenneth J. Wilkins
Yiye Zhang
Torri D. Metz
Elaine Hill
Thomas W. Carton
On behalf of the RECOVER PCORnet EHR Consortia
the RECOVER N3C EHR Consortia
RECOVER Pregnancy Consortia
author_sort Chengxi Zang
collection DOAJ
description Abstract Pregnancy alters immune responses and clinical manifestations of COVID-19, but its impact on Long COVID remains uncertain. This study investigated Long COVID risk in individuals with SARS-CoV-2 infection during pregnancy compared to reproductive-age females infected outside of pregnancy. A retrospective analysis of two U.S. databases, the National Patient-Centered Clinical Research Network (PCORnet) and the National COVID Cohort Collaborative (N3C), identified 29,975 pregnant individuals (aged 18–50) with SARS-CoV-2 infection in pregnancy from PCORnet and 42,176 from N3C between March 2020 and June 2023. At 180 days after infection, estimated Long COVID risks for those infected during pregnancy were 16.47 per 100 persons (95% CI, 16.00–16.95) in PCORnet using the PCORnet computational phenotype (CP) model and 4.37 per 100 persons (95% CI, 4.18–4.57) in N3C using the N3C CP model. Compared to matched non-pregnant individuals, the adjusted hazard ratios for Long COVID were 0.86 (95% CI, 0.83–0.90) in PCORnet and 0.70 (95% CI, 0.66–0.74) in N3C. The observed risk factors for Long COVID included Black race/ethnicity, advanced maternal age, first- and second-trimester infection, obesity, and comorbid conditions. While the findings suggest a high incidence of Long COVID among pregnant individuals, their risk was lower than that of matched non-pregnant females.
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spelling doaj-art-3aece74c54b94fa8a68798f49a3bee3c2025-08-20T01:54:25ZengNature PortfolioNature Communications2041-17232025-04-0116111410.1038/s41467-025-57849-9Long COVID after SARS-CoV-2 during pregnancy in the United StatesChengxi Zang0Daniel Guth1Ann M. Bruno2Zhenxing Xu3Haoyang Li4Nariman Ammar5Robert Chew6Nick Guthe7Emily Hadley8Rainu Kaushal9Tanzy Love10Brenda M. McGrath11Rena C. Patel12Elizabeth C. Seibert13Yalini Senathirajah14Sharad Kumar Singh15Fei Wang16Mark G. Weiner17Kenneth J. Wilkins18Yiye Zhang19Torri D. Metz20Elaine Hill21Thomas W. Carton22On behalf of the RECOVER PCORnet EHR Consortiathe RECOVER N3C EHR ConsortiaRECOVER Pregnancy ConsortiaDepartment of Population Health Sciences, Weill Cornell MedicineDepartment of Public Health Sciences, University of Rochester Medical CenterDepartment of Obstetrics & Gynecology, University of Utah HealthDepartment of Population Health Sciences, Weill Cornell MedicineDepartment of Population Health Sciences, Weill Cornell MedicineSchool of Information Technology, Illinois State UniversityCenter for Data Science and AI, RTI InternationalPopulation Health, NYU Grossman School of MedicineCenter for Data Science and AI, RTI InternationalDepartment of Population Health Sciences, Weill Cornell MedicineDepartment of Biostatistics and Computational Biology, University of Rochester Medical Center, RochesterResearch Department, OCHIN Inc.School of Medicine, The University of Alabama at BirminghamRECOVER Patient, Caregiver, or Community Advocate RepresentativeDepartment of Biomedical Informatics, University of PittsburghDepartment of Public Health Sciences, University of Rochester Medical CenterDepartment of Population Health Sciences, Weill Cornell MedicineDepartment of Population Health Sciences, Weill Cornell MedicineBiostatistics Program, Office of the Director, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of HealthDepartment of Population Health Sciences, Weill Cornell MedicineDepartment of Obstetrics & Gynecology, University of Utah HealthDepartment of Public Health Sciences, University of Rochester Medical CenterLouisiana Public Health InstituteAbstract Pregnancy alters immune responses and clinical manifestations of COVID-19, but its impact on Long COVID remains uncertain. This study investigated Long COVID risk in individuals with SARS-CoV-2 infection during pregnancy compared to reproductive-age females infected outside of pregnancy. A retrospective analysis of two U.S. databases, the National Patient-Centered Clinical Research Network (PCORnet) and the National COVID Cohort Collaborative (N3C), identified 29,975 pregnant individuals (aged 18–50) with SARS-CoV-2 infection in pregnancy from PCORnet and 42,176 from N3C between March 2020 and June 2023. At 180 days after infection, estimated Long COVID risks for those infected during pregnancy were 16.47 per 100 persons (95% CI, 16.00–16.95) in PCORnet using the PCORnet computational phenotype (CP) model and 4.37 per 100 persons (95% CI, 4.18–4.57) in N3C using the N3C CP model. Compared to matched non-pregnant individuals, the adjusted hazard ratios for Long COVID were 0.86 (95% CI, 0.83–0.90) in PCORnet and 0.70 (95% CI, 0.66–0.74) in N3C. The observed risk factors for Long COVID included Black race/ethnicity, advanced maternal age, first- and second-trimester infection, obesity, and comorbid conditions. While the findings suggest a high incidence of Long COVID among pregnant individuals, their risk was lower than that of matched non-pregnant females.https://doi.org/10.1038/s41467-025-57849-9
spellingShingle Chengxi Zang
Daniel Guth
Ann M. Bruno
Zhenxing Xu
Haoyang Li
Nariman Ammar
Robert Chew
Nick Guthe
Emily Hadley
Rainu Kaushal
Tanzy Love
Brenda M. McGrath
Rena C. Patel
Elizabeth C. Seibert
Yalini Senathirajah
Sharad Kumar Singh
Fei Wang
Mark G. Weiner
Kenneth J. Wilkins
Yiye Zhang
Torri D. Metz
Elaine Hill
Thomas W. Carton
On behalf of the RECOVER PCORnet EHR Consortia
the RECOVER N3C EHR Consortia
RECOVER Pregnancy Consortia
Long COVID after SARS-CoV-2 during pregnancy in the United States
Nature Communications
title Long COVID after SARS-CoV-2 during pregnancy in the United States
title_full Long COVID after SARS-CoV-2 during pregnancy in the United States
title_fullStr Long COVID after SARS-CoV-2 during pregnancy in the United States
title_full_unstemmed Long COVID after SARS-CoV-2 during pregnancy in the United States
title_short Long COVID after SARS-CoV-2 during pregnancy in the United States
title_sort long covid after sars cov 2 during pregnancy in the united states
url https://doi.org/10.1038/s41467-025-57849-9
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