Long COVID after SARS-CoV-2 during pregnancy in the United States

Chengxi Zang (), Daniel Guth, Ann M. Bruno, Zhenxing Xu, Haoyang Li, Nariman Ammar, Robert Chew, Nick Guthe, Emily Hadley, Rainu Kaushal, Tanzy Love, Brenda M. McGrath, Rena C. Patel, Elizabeth C. Seibert, Yalini Senathirajah, Sharad Kumar Singh, Fei Wang, Mark G. Weiner, Kenneth J. Wilkins, Yiye Zhang, Torri D. Metz, Elaine Hill and Thomas W. Carton
Additional contact information
Chengxi Zang: Weill Cornell Medicine
Daniel Guth: University of Rochester Medical Center
Ann M. Bruno: University of Utah Health
Zhenxing Xu: Weill Cornell Medicine
Haoyang Li: Weill Cornell Medicine
Nariman Ammar: Illinois State University
Robert Chew: RTI International
Nick Guthe: NYU Grossman School of Medicine
Emily Hadley: RTI International
Rainu Kaushal: Weill Cornell Medicine
Tanzy Love: Rochester
Brenda M. McGrath: OCHIN Inc.
Rena C. Patel: The University of Alabama at Birmingham
Elizabeth C. Seibert: or Community Advocate Representative
Yalini Senathirajah: University of Pittsburgh
Sharad Kumar Singh: University of Rochester Medical Center
Fei Wang: Weill Cornell Medicine
Mark G. Weiner: Weill Cornell Medicine
Kenneth J. Wilkins: National Institutes of Health
Yiye Zhang: Weill Cornell Medicine
Torri D. Metz: University of Utah Health
Elaine Hill: University of Rochester Medical Center
Thomas W. Carton: Louisiana Public Health Institute

Nature Communications, 2025, vol. 16, issue 1, 1-14

Abstract: Abstract Pregnancy alters immune responses and clinical manifestations of COVID-19, but its impact on Long COVID remains uncertain. This study investigated Long COVID risk in individuals with SARS-CoV-2 infection during pregnancy compared to reproductive-age females infected outside of pregnancy. A retrospective analysis of two U.S. databases, the National Patient-Centered Clinical Research Network (PCORnet) and the National COVID Cohort Collaborative (N3C), identified 29,975 pregnant individuals (aged 18–50) with SARS-CoV-2 infection in pregnancy from PCORnet and 42,176 from N3C between March 2020 and June 2023. At 180 days after infection, estimated Long COVID risks for those infected during pregnancy were 16.47 per 100 persons (95% CI, 16.00–16.95) in PCORnet using the PCORnet computational phenotype (CP) model and 4.37 per 100 persons (95% CI, 4.18–4.57) in N3C using the N3C CP model. Compared to matched non-pregnant individuals, the adjusted hazard ratios for Long COVID were 0.86 (95% CI, 0.83–0.90) in PCORnet and 0.70 (95% CI, 0.66–0.74) in N3C. The observed risk factors for Long COVID included Black race/ethnicity, advanced maternal age, first- and second-trimester infection, obesity, and comorbid conditions. While the findings suggest a high incidence of Long COVID among pregnant individuals, their risk was lower than that of matched non-pregnant females.

Date: 2025
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DOI: 10.1038/s41467-025-57849-9

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