Background/Purpose: The impact of COVID-19 on pregnancy in patients with rheumatic disease is unknown.  We describe COVID-19 outcomes in pregnant women with rheumatic disease who self-reported to the COVID-19 Global Rheumatology Alliance (C19-GRA) Patient Experience Survey.

Methods: The C19-GRA launched the Patient Experience Survey for adults and parents of children with rheumatic disease, with or without COVID-19 infection. This patient-reported survey was distributed online through patient support organizations and on social media. The survey was available to an international audience and collected data on rheumatic disease diagnosis, medications, COVID-19 outcomes, and pregnancy status. The survey launched on April 3, and we report data until May 26, 2020. The study was approved by the IRB at Boston Children’s Hospital.

Results: Out of more than 10,000 patients who answered the survey, six patients self-reported with COVID-19 infection and pregnancy. Four were white, one pacific islander, and one pacific islander/south Asian. The mean age was 36 years, range 26-45 years. Four were pregnant at the time of COVID-19 infection, one was within six weeks of delivery, and one became pregnant within six weeks of infection. Two were current smokers, four were non-smokers. Their rheumatic diagnoses were rheumatoid arthritis & Sjögren syndrome (n=1), undifferentiated connective tissue disease (n=1), SLE & Sjögren syndrome (n=1), anti-phospholipid antibody syndrome (n=1), Bechet’s disease (n=1) and psoriatic arthritis, Sjögren syndrome, and scleritis/uveitis (n=1).  The patients reported taking the following medications:  TNF inhibitor (n=1), glucocorticoid monotherapy (prednisone 10mg, n=1), antimalarial monotherapy (n=1), antimalarial & glucocorticoid (prednisone 40mg, n=1) and cyclosporine (n=1) and none (n=1). Symptoms of COVID-19 included cough (n=6), malaise/fatigue (n=5), muscle aches (n=5), sore throat (n=5), myalgia (n=5), fever (n=4), shortness of breath (n=4) and loss of taste (n=2). The diagnosis was made by a doctor based on a positive test (n=1), by a doctor based on symptoms (n=3), and self-diagnosis by the patient (n=2). The one patient who had a positive test received colchicine and azithromycin for treatment of COVID-19 and another patient reported receiving steroids. Three cases had work-related exposures: two healthcare employees and a patient that was exposed to an ill co-worker in her office; three others reported potential exposures in healthcare facilities. No patient was hospitalized, two patients reported no difficulties performing activities of daily living (ADLs), and four did report difficulties performing ADLs.

Conclusion: In this small series of patients with rheumatic disease and COVID-19, patient-reported outcomes were favorable. Although patient-reported outcomes have limitations especially with regard to the accuracy of self-diagnosis, they may add to the knowledge on the course of COVID-19 in pregnant patients. Future studies should follow the long-term effects of COVID-19 on the pregnancy, mother, and child.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/patient-reported-covid-19-infection-in-pregnant-women-with-rheumatic-disease-data-from-the-covid-19-global-rheumatology-alliance-patient-experience-survey/