Background and Objectives: The study aimed at identification and analysis of adverse COVID-19 outcomes (admission to intensive care units due to COVID-19, acute respiratory distress syndrome, mechanical ventilation, and death) among hospitalized pregnant and nonpregnant women, which are critical for informed decision-making in obstetric diagnostics and healthcare. Materials and Methods: This was a retrospective observational study conducted on a series of inpatient pregnant women comparatively followed up with nonpregnant women hospitalized between 15 July 2020 to 20 January 2022 across multidisciplinary hospitals in three cities of Kazakhstan. Following group matching with propensity score for COVID-19 disease severity, residence status, and age, the study ultimately included 156 participants, of whom 50% were pregnant, from an initial sample of 314 female inpatients diagnosed with COVID-19. All findings were considered statistically significant at a p-value < 0.05. Results: Laboratory investigations revealed significantly elevated levels of erythrocyte sedimentation rate, creatinine, neutrophils, platelet count, alanine aminotransferase, aspartate aminotransferase, lymphocyte count, and C-reactive protein in pregnant inpatients compared to nonpregnant inpatients. Furthermore, pregnant women exhibited significantly higher levels of D-dimer (2402.97 ng/mL vs. 793.91 ng/mL) and procalcitonin (0.398 ng/mL vs. 0.134 ng/mL) compared to their nonpregnant counterparts. Overall, 16.88% of the pregnant women were admitted to the intensive care unit, whereas among the nonpregnant women, only 2.6% were hospitalized. The most lethal outcomes (8.3%) occurred among pregnant women, while for nonpregnant women, there were two cases (1.3%). Conclusions: Pregnant women diagnosed with COVID-19 may exhibit more severe clinical symptoms and encounter more adverse outcomes compared to their nonpregnant counterparts. Future research should incorporate larger matched samples to comprehensively explore the association between additional factors and clinical conditions.

Background/Objectives: Long-term real-world evidence on golimumab in axial spondyloarthritis (axSpA) from Central Asia is limited. We evaluated clinical outcomes through week 144, treatment persistence through 36 months, factors associated with discontinuation, and reasons for discontinuation in Kazakhstan. Methods: This prospective observational cohort included 113 adults with axSpA enrolled at two rheumatology centers in Almaty in October 2019. All had received golimumab 50 mg subcutaneously every four weeks for at least 12 weeks before enrollment. Time zero for persistence analyses was the enrollment date. Clinical assessments were performed at baseline and weeks 12, 24, 52, 104, and 144. Treatment persistence was estimated using Kaplan–Meier analysis, and factors associated with confirmed discontinuation were explored using Cox regression. Clinical responses were assessed using non-responder imputation (NRI; N = 113). Results: During 36 months, 24 patients had confirmed permanent discontinuation; two patients lost to follow-up without confirmed discontinuation were censored. Kaplan–Meier estimated persistence was 89.3% (95% CI, 83.8–95.2%) at 12 months, 79.4% (72.2–87.3%) at 24 months, and 78.5% (71.2–86.5%) at 36 months. Among 88 patients with paired baseline and week 144 assessments, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score based on erythrocyte sedimentation rate (ASDAS-ESR), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), and Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) improved significantly (all p < 0.001). With NRI, 64.6% achieved BASDAI50, 59.3% ASDAS inactive disease, and 54.9% ASDAS major improvement at week 144. Higher Rheumatic Disease Comorbidity Index (RDCI) score (adjusted hazard ratio [HR] 1.312, 95% CI, 1.042–1.653) and functional class III–IV versus I–II (adjusted HR 2.412, 95% CI, 1.037–5.611) were associated with higher discontinuation hazards in exploratory analyses. Loss of effectiveness was the most frequent reason for discontinuation (54.2%). Adverse events were recorded only when they led to discontinuation and therefore do not represent overall safety incidence. Conclusions: Golimumab was characterized by substantial 36-month treatment persistence and clinical improvement among patients who remained on treatment and were evaluable at week 144 (n = 88). Full-cohort NRI analyses also demonstrated clinically relevant responses at week 144. Comorbidity burden and poorer functional class were associated with discontinuation in exploratory analyses. These findings add long-term real-world evidence from an under-represented geographic setting.