1032 COVID Disease Severity: Comparing Demographics and Social Vulnerability Indices for Pregnant Patients

Published reports indicate that some groups of COVID patients may have disproportionate rates of morbidity and mortality. The purpose of this study was to assess the relationship between COVID disease severity and demographics and social vulnerability indices among pregnant women. A retrospective analysis was performed of all pregnant patients diagnosed with COVID-19 at two urban tertiary care centers in Houston, TX between March and August 2020. Maternal demographic, COVID, and delivery characteristics were collected. The CDC Social Vulnerability Index (SVI) was obtained based on a patients' census tract of residence (Table 1 summarizes SVI components). Analyses compared women with asymptomatic, mild, or severe disease at diagnosis. Comparisons were made by chi-square test for group data, analysis of variance for normally distributed continuous data, and mixed regression for non-normal data. 317 total women tested positive for COVID (see Table 2 for comparison based on disease severity). Asymptomatic women were more likely to be diagnosed at later gestational ages, but there were no other differences in baseline maternal characteristics. Disease severity was significantly associated with later patient presentation after symptom onset (mild: mean (SD) 5.4+/-0.9d vs severe 4.1+/-0.4d, p<0.0001). Women with more severe disease had greater social vulnerability as shown by the SVI housing and transportation index (mild mean SVI (SE): 0.58 (0.2), severe: 0.72 (0.06), p=0.030). Total SVI, and other themed SVI indices were not significantly different between groups. We did not find racial or ethnic differences by disease severity in this cohort of COVID-infected pregnant patients. An association was shown between severity and increased vulnerability in living conditions and transportation, and longer duration of symptoms at time of presentation. Continued research into underlying vulnerabilities and association with disease severity, as well as disease incidence, could inform preventative measures for the duration of this pandemic.View Large Image Figure ViewerDownload Hi-res image Download (PPT)