• Eman Alazmi, Zahraa Akbar, Mariam Aldarweesh, Khalid Almuzayen, Eelaf Husain, and Jehad Alharmi.
• Department of Obstetrics and Gynecology, Maternity Hospital Kuwait, Ministry of Health Kuwait, Kuwait City, Kuwait.
• Med Princ Pract. 2024 Jan 1; 33 (5): 441451441-451.

ObjectivesCOVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2 virus). This virus evolved into several variants, each with different severity. There are surges in the number of infected patients, commonly described as "waves." In Kuwait, three waves occurred. Our study describes and compares the clinical presentation and outcomes of critically ill pregnant patients infected with different variants.MethodsThis was a retrospective cohort study in two intensive care units (ICU) dedicated to patients with COVID-19. The wave periods were retrieved from the Kuwait Ministry of Health.ResultsThe total number of ICU admissions during the study period was 74 patients. Most cases occurred during the third wave (n = 47/74, 63.5%). Most patients did not have comorbidities. The most common presenting symptoms were fever 62.2%, dyspnea 71.6%, and dry cough 74.3%. Low oxygen saturation 35.1% and maternal tachycardia 75.7% were observed in most patients. Cesarean section was the most common route of delivery, with maternal indication accounting for most cases 78.84%. Eight patients (13.69%) underwent dialysis, and thirty-one (41.9%) needed extracorporeal membrane oxygenation. Most patients required ventilatory support 66.21%. Almost all patients were unvaccinated 97.01%. Maternal mortality was mainly noted in the third wave (13.23%).ConclusionsIn Kuwait, the number of admissions and the rate of maternal complications, morbidity, and mortality increased with successive waves.© 2024 The Author(s). Published by S. Karger AG, Basel.

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