Study details risk factors for maternal COVID-19 death in Latin America
An observational study using a multinational database of 447 maternal COVID-19 deaths in Latin America reveals that over 90% were attributed to acute respiratory failure after severe infection and that 35% of the women who died were never admitted to an intensive care unit (ICU), possibly due to lack of capacity.
The analysis, led by researchers at the Universidad de Cartagena in Colombia, involved 447 maternal deaths attributed to COVID-19 in eight Latin American countries from Mar 1, 2020, to Nov 29, 2021.
The investigators obtained data on COVID-related maternal deaths in Costa Rica (11 deaths), Ecuador (55), Honduras (126), Paraguay (86), the Dominican Republic (30), Colombia (84), Bolivia (21), and Peru (34).
At maternal death, median age was 31 years and median gestational age was 31 weeks. A total of 86.4% of the women tested positive for COVID-19 before delivery, with 60.3% of cases identified in the third trimester.
The most common symptoms at hospitalization were shortness of breath (73.0%), fever (69.0%), and cough (59.0%). Of the women who died, 90.4% had organ dysfunction at admission, nearly half were obese, 9.2% had a history of diabetes, 8.4% had a history of high blood pressure, and 25.3% were older than 35 years. Overall, 64.8% of women were admitted to an ICU for a median of 8 days. Eight deaths occurred among healthcare workers.
Median time from symptom onset to death was 14 days, Most deaths occurred in the first 6 weeks after delivery, with a median of 7 days between childbirth and death. The most common perinatal complication was preterm delivery (76.9%), and 59.9% of infants were of low birth weight.
The researchers called for increasing ICU capacity for severely ill pregnant women in Latin America by defining protocols and adding beds.
"Efforts should be directed to increase awareness for early detection of the COVID-19 severity in the pregnant population throughout the region," they wrote. "Decision-makers should strengthen severity awareness, and referral strategies to avoid potential delays."
May 6 Lancet Reg Health Am study
Pandemic caused global increase in loneliness, meta-analysis reveals
Two years into the COVID-19 pandemic, research published yesterday by the American Psychological Association (APA) in American Psychologist shows a small but significant worldwide increase in loneliness.
While lockdown measures and school closures led to dramatic headlines about increased rates of loneliness and subsequent mental health problems—including depression—researchers from Johannes Gutenberg-University Mainz in Germany said some reports may have been overblown, but even small increases in loneliness constitute a risk for premature death and mental and physical health.
The meta-analysis sought to separate loneliness—a feeling of despair—from the inevitable social isolation of the pandemic, and the investigators looked at 34 longitudinal studies from four continents involving more than 200,000 total participants, which tracked loneliness scores before and during the pandemic. Most of the studies used a 20-item University of California, Los Angeles (UCLA) loneliness scale.
Based on the pooled effect sizes of 19 studies, the authors found about a 5% overall increase in loneliness since the start of the pandemic (standardized mean differences, 0.27; 95% confidence interval, 0.14 to 0.40). In all studies, loneliness was more pronounced in young adults and the elderly.
"Other variables associated with changes in loneliness included participants' living situation or relationship status, gender, and mental health. Women were more likely to report increases in loneliness than men," the authors wrote.
In an APA press release on the study, first study author Mareike Ernst, PhD said, "We think that loneliness should be made a priority in large-scale research projects aimed at investigating the health outcomes of the pandemic."
May 9 Am Psychol study
May 9 APA press release
