Abstract
AIM: The objective of this study was to describe the use of COVID-19-related medicines during pregnancy and their evolution between the early/late periods of the pandemic.
METHODS: Pregnant women who tested positive for SARS-CoV-2 from March 2020 to July 2021 were included using the COVI-PREG registry. Exposure to the following COVID-19-related medicines was recorded: antibiotics, antivirals, hydroxychloroquine, corticosteroids, anti-interleukin-6 and immunoglobulins. We described the prevalence of medicines used, by trimester of pregnancy, maternal COVID-19 severity level and early/late period of the pandemic (before and after 1 July 2020).
FINDINGS: We included 1964 pregnant patients who tested positive for SARS-CoV-2. Overall, 10.4% (205/1964) received at least one COVID-19-related medicine including antibiotics (8.6%; 169/1694), corticosteroids (3.2%; 62/1964), antivirals (2.0%; 39/1964), hydroxychloroquine (1.4%; 27/1964) and anti-interleukin-6 (0.3%; 5/1964). The use of at least one COVID-19-related medicine was 3.1% (12/381) in asymptomatic individuals, 4.2% (52/1233) in outpatients, 19.7% (46/233) in inpatients without oxygen, 72.1% (44/61) in those requiring standard oxygen, 95.7% (22/23) in those requiring high flow oxygen, 96.2% (25/26) in patients who required intubation and 57.1% (4/7) among patients who died. The proportion who received medicines to treat COVID-19 was higher before than after July 2020 (16.7% vs. 7.7%). Antibiotics, antivirals and hydroxychloroquine had lower rates of use during the late period.
CONCLUSION: Medicine use in pregnancy increased with disease severity. The trend towards increased use of corticosteroids seems to be aligned with changing guidelines. Evidence is still needed regarding the effectiveness and safety of COVID-19-related medicines in pregnancy.
Original language | English |
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Pages (from-to) | 1560-1574 |
Number of pages | 15 |
Journal | British Journal of Clinical Pharmacology |
Volume | 89 |
Issue number | 5 |
Early online date | 23 Nov 2022 |
DOIs | |
Publication status | Published - May 2023 |
Bibliographical note
Funding Information:We greatly thank Dr. Hilde Engjom from the Department of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway, for her contribution in the discussions within the CONSIGN group. We thank every patient who agreed to participate in this study.
Funding Information:
This research was funded by a grant from the Swiss Federal Office of Public Health. The research leading to these results was conducted as part of the activities of the EU PE&PV (Pharmacoepidemiology and Pharmacovigilance) Research Network which is a public academic partnership coordinated by the Utrecht University, The Netherlands. The project named CONSIGN has received support from the European Medicines Agency under the Framework service contract No. EMA/2018/28/PE. The content of this paper expresses the opinion of the authors and may not be understood or quoted as being made on behalf of or reflecting the position of the European Medicines Agency or one of its committees or working parties.
Publisher Copyright:
© 2022 British Pharmacological Society.
Keywords
- COVID-19
- COVID-19-related medicine
- SARS-CoV-2
- drug use
- medicine use
- pharmaco-epidemiology
- pregnancy