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Background: Multiple studies have described increased risk of severe coronavirus disease (COVID‐19) among pregnant women compared to nonpregnant women. The risk in middle‐income countries where the distributions of age groups and preexisting conditions may differ is less known. Objectives: To determine whether pregnant women with SARS‐CoV‐2 infection are at increased risk for severe COVID‐19 compared to nonpregnant women in Colombia. Methods: We analysed national surveillance data from Colombia, of women aged 15–44 years with laboratory‐confirmed infection with SARS‐CoV‐2 by molecular or antigen testing, from 6 March 2020 to 12 December 2020. An enhanced follow‐up of pregnant women with COVID‐19 was established to monitor pregnancy and birth outcomes. Results: Of 371,363 women aged 15–44 years with laboratory‐confirmed SARS‐CoV‐2 infection, 1.5% (n = 5614) were reported as pregnant; among those, 2610 (46.5%) were considered a complete pregnancy for reporting purposes at the time of analysis. Hospitalisation (23.9%) and death (1.3%) occurred more frequently among pregnant symptomatic women compared to nonpregnant symptomatic women (2.9% and 0.3%, respectively). Compared to nonpregnant symptomatic women, pregnant symptomatic women were at increased risk of hospitalisation (adjusted risk ratio [RR] 2.19, 95% confidence interval [CI] 2.07, 2.32) and death (RR 1.82, 95% CI 1.60, 2.07), after adjusting for age, type of health insurance and presence of certain underlying medical conditions. Among complete pregnancies, 55 (2.1%) were pregnancy losses, 72 (2.8%) resulted in term low birthweight infants and 375 (14.4%) were preterm deliveries. Conclusions: Although pregnant women were infrequently reported with laboratory‐confirmed SARS‐CoV‐2 infection, pregnant symptomatic women with COVID‐19 were at increased risk for hospitalisation and death compared to nonpregnant symptomatic women. Almost all infections we reported on were third‐trimester infections; ongoing follow‐up is needed to determine pregnancy outcomes among women infected earlier in pregnancy. Healthcare providers should counsel pregnant women about preventive measures to protect from SARS‐CoV‐2 infection and when to seek care. [ABSTRACT FROM AUTHOR]

We characterized common exposures reported by a convenience sample of 202 US patients with coronavirus disease during January-April 2020 and identified factors associated with presumed household transmission. The most commonly reported settings of known exposure were households and healthcare facilities; among case-patients who had known contact with a confirmed case-patient compared with those who did not, healthcare occupations were more common. Among case-patients without known contact, use of public transportation was more common. Within the household, presumed transmission was highest from older (>65 years) index case-patients and from children to parents, independent of index case-patient age. These findings may inform guidance for limiting transmission and emphasize the value of testing to identify community-acquired infections. [ABSTRACT FROM AUTHOR]

Background Pregnant women with coronavirus disease 2019 (COVID-19) are at increased risk for severe illness compared with nonpregnant women. Data to assess risk factors for illness severity among pregnant women with COVID-19 are limited. This study aimed to determine risk factors associated with COVID-19 illness severity among pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods Pregnant women with SARS-CoV-2 infection confirmed by molecular testing were reported during 29 March 2020–5 March 2021 through the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET). Criteria for illness severity (asymptomatic, mild, moderate-to-severe, or critical) were adapted from National Institutes of Health and World Health Organization criteria. Crude and adjusted risk ratios for moderate-to-severe or critical COVID-19 illness were calculated for selected demographic and clinical characteristics. Results Among 7950 pregnant women with SARS-CoV-2 infection, moderate-to-severe or critical COVID-19 illness was associated with age 25 years and older, healthcare occupation, prepregnancy obesity, chronic lung disease, chronic hypertension, and pregestational diabetes mellitus. Risk of moderate-to-severe or critical illness increased with the number of underlying medical or pregnancy-related conditions. Conclusions Older age and having underlying medical conditions were associated with increased risk of moderate-to-severe or critical COVID-19 illness among pregnant women. This information might help pregnant women understand their risk for moderate-to-severe or critical COVID-19 illness and can inform targeted public health messaging. [ABSTRACT FROM AUTHOR]