(175) Effect of Respiratory and Anticoagulation Medications on Long Covid in the Postpartum Period

Long Covid (LC) is a collective term referring to the persistence of symptoms and complications related to those acquiring an acute SARS-CoV-2 infection. This study sought to evaluate the potential benefits of certain medications often employed empirically in the management of LC for pregnant patients in the 3^rd trimester and postpartum periods.

Study Design:

We conducted a multi-center, prospective observational study from 7/2021 to 7/2022 comparing all pregnant women diagnosed with SARS-CoV-2 infection (CoV-2) in the 3^rd trimester through 6 weeks postpartum. The primary outcomes included the development of LC and improvement following treatment. Patients with preexisting respiratory, hematological, or neurological disorders or preterm delivery < 37 weeks-gestation, were excluded. Medications including any CoV-2 antiviral treatment, enoxaparin, aspirin, inhaled corticosteroids with or without a long-acting beta blocker, theophylline, leukotriene receptor antagonists, and 1^st generation antihistamines were included as covariates. Primary outcomes were determined by patient-reported symptoms and provider interpretation in the immediate postpartum, 1-week postpartum (1P), and 6-week postpartum (6P) periods.

Results:

The study included 444 patients diagnosed with LC. 291 (65.6%) patients received enoxaparin at time of diagnosis continued weekly until 6 weeks postpartum. Patients who received enoxaparin were less likely to report LC at the 1P and 6P visits (39.2% v. 54.9%, p = 0.02). LC was not significantly different when comparing patients who received antiviral therapies to those who did not. Patients with LC were more likely to report improvement when taking aspirin 325mg (19.8% v. 11.3%, p = 0.003) or when taking theophylline (22.9% v. 14.2%, p = 0.01). After adjusting for confounding factors these differences remained significant.

Conclusion:

These findings suggest that treatments targeting the circulatory system may prove more useful for LC in the 3rd trimester and postpartum period than other types of medications.