COVID-Severity and Diabetes in Pregnancy

Diabetes and pregnancy are independently associated with increased risk of severe COVID-infection. However, little is known about the relationship between severe COVID-and diabetes in pregnancy. We sought to determine whether diabetes in pregnancy was associated with increased risk of COVID-infection and severity. We conducted a case-control study of all delivering patients at a tertiary hospital from June 2020-September 2021 and accepted universal COVID-testing. Patients with no COVID-test results were excluded. The proportion of patients with any COVID-infection and severe COVID-infection during pregnancy were compared between patients with and without diabetes using chi-square. Severe COVID-was defined as meeting any WHOOSCI or NCPERET criteria (dyspnea, respiratory rate ≥30 breaths per minute, blood oxygen saturation of ≤93%, PaO2/FiO2 <300, lung infiltrates involving >50% on imaging, non-invasive ventilation or high flow oxygen use, intubation and mechanical ventilation, or ventilation with additional organ support) . Of 4,253 patients in our analysis, 292 (6.9%) had COVID-during pregnancy. Demographic characteristics were similar between patients with a COVID-infection in pregnancy and those that were negative;71 (24.3%) had a severe infection, and 451 (10.6%) had diabetes. There was no difference between patients with and without diabetes in incidence of COVID-infection (9.6% vs. 10.7%, p=0.56) or severe COVID-infection (11.3% vs. 9%, p=0.58) . Diabetes in pregnancy was not associated with increased risk of COVID-infection or severe infection. Future research in larger samples may further elucidate the association between diabetes and COVID-infection in pregnancy.

False-negative testing for severe acute respiratory syndrome coronavirus 2: consideration in obstetrical care.

Because the obstetrical population seems to have a high proportion of asymptomatic patients who are carriers of severe acute respiratory syndrome coronavirus 2, universal testing has been proposed as a strategy to risk-stratify all obstetrical admissions and guide infection prevention protocols. Here, we describe a case of a critically ill obstetrical patient with all the clinical symptoms of coronavirus disease 2019 and 3 false-negative results of nasopharyngeal swabs for molecular testing. We review and discuss the uncertain clinical characteristics of current severe acute respiratory syndrome coronavirus 2 molecular testing and the implications of false-negative results in the obstetrical population.