Placental pathology, neonatal birth weight, and Apgar score in acute and distant SARS-CoV-2 infection

Background:: Most research on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy has been on acute infections with limited data on the effect of distant infection. Aim:: We examined placental pathology and neonatal outcomes in distant SARS-CoV-2 infection earlier in pregnancy compared to acute infections late in pregnancy/at birth and to non-SARS-CoV-2 infected patients with other placental pathologies/clinical presentations. Methods:: Placentas birthed to unvaccinated patients with SARS-CoV-2 reverse transcription–polymerase chain reaction (RT-PCR) testing and serology testing results from time of delivery were included in this study. A total of 514 singleton placentas between April 18, 2020, and July 26, 2021, were included: 77 acute SARS-CoV-2 infection (RT-PCR positive and serology negative);222 distant SARS-CoV-2 infection (RT-PCR negative but serology IgG-positive);and 215 non-SARS-Cov-2 infected (RT-PCR negative, serology negative, and history negative) with other placental pathologies: preeclampsia/hypertension, intrauterine growth restriction (IUGR), diabetes, chorioamnionitis, and meconium. Placental pathology findings, Apgar scores, and neonatal birth weights were compared. Results:: Placentas from the acute group had significantly more villous agglutination (10.4%, P = 0.015) and eosinophilic T-cell vasculitis (5.2%, P = 0.004) compared to placentas from the distant group (2.7% and 0%) and non-SARS-CoV-2 placentas (1.9% and 0.9%). One acute case showed SARS-CoV-2 placentitis and resulted in preterm delivery at 25 weeks. Both the preeclampsia/hypertension and the IUGR groups showed significantly more maternal vascular malperfusion findings compared to the acute (6.5%, 6.5% and 1.3%) and distant (7.7%, 7.7%, and 3.2%) groups. Fetal vascular malperfusion findings such as thrombosis of fetal vessels (17.4% P = 0.042) and intramural fibrin deposition (21.7% P = 0.026) were significantly higher in the IUGR group compared to acute (7.8%;2.6%) and distant (3.6%;8.1%) infection. Many neonates born to patients infected with SARS-CoV-2 had birth weights outside of 95% confidence range of observed birth weights. There was no association of Apgar scores with infection status or placental pathology. Conclusion:: Acute and distant SARS-CoV-2 infections present differing placental pathology. Relevance for Patients:: SARS-CoV-2 infection during pregnancy has demonstrable effects on the placenta with potential significant impacts for maternal and fetal health. Prevention of maternal SARS-CoV-2 infection, primarily through vaccination, remains the best mitigation strategy to prevent sequelae of maternal SARS-CoV-2 infection.

Investigation and analysis of work situation of professional and technical personnel in Beijing Centers for Disease Prevention and Control during the COVID-19 epidemic

Objective To analyze the work situation of the personnel in Beijing Centers for Disease Prevention and Control during the novel coronavirns disease 2019 (C0VID-19) epidemic，and to provide references for improving the construction of the capital5 s disease control and prevention system. Methods Cross-sectional survey and cluster sanpling methods were used. A total of 422 municipal-level and 664 district-level professional technicians from CDCs who were mainly involved in epidemic prevention and control in Beijing were included in the study. Self-designed questionnaires were used to collect the basic information, work intensity and satisfaction and other data. The statistical description and test analysis were carried out. Results Among professionals, 64. 36% had nornal workload, and 76. 89% had overload during the epidemic prevention and control period. The proportion of disease control personnel expressing dissatisfaction "with the usual salary level "was 54. 51%, and the satisfaction with the professional title promotion w-as mostly at the average level (45. 58%). The proportions of satisfaction with the prevention and control work arrangements and logistical support during the COVID-19 epidemic were 49. 08% and 54. 42%, respectively. Only 21. 73% professionals were satisfied with the temporar w-ork subsidy. From the perspective of population distribution, staffs at the municipal and district levels and in different job positions were mainly dissatisfied with the salar level (all P<0. 05). Most of staffs who undertook different prevention and control responsibilities were satisfied with the work arrangements and logistics support (all P<0. 05), but they w-ere dissatisfied with the temporar work subsidies (H = 27. 076, P = 0. 012). Among the survey respondents, 44.48% had thoughts of resigning. Regardless of the municipal and district levels, different professional titles or positions, the wdllingness to resign was generally high (all P>0. 05). The primar reason for wanting to leave was the low salary level, followed by difficulty in promotion of professional titles and poor development prospects which were also major considerations. Conclusion It is suggested to improve the stability of CDCs staffs and promote the high-quality and sustainable development of the disease control and prevention system by improving the personnel allocation, strengthening the interdisciplinary talent reserve, improving the salary system and optimizing the professional title appointment mechanism.

Pregnancy and postpartum outcomes in a universally tested population for SARS-CoV-2 in New York City: a prospective cohort study.

OBJECTIVE: To describe differences in outcomes between pregnant women with and without coronavirus dsease 2019 (COVID-19). DESIGN: Prospective cohort study of pregnant women consecutively admitted for delivery, and universally tested via nasopharyngeal (NP) swab for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using reverse transcription-polymerase chain reaction. All infants of mothers with COVID-19 underwent SARS-CoV-2 testing. SETTING: Three New York City hospitals. POPULATION: Pregnant women >20 weeks of gestation admitted for delivery. METHODS: Data were stratified by SARS-CoV-2 result and symptomatic status, and were summarised using parametric and nonparametric tests. MAIN OUTCOME MEASURES: Prevalence and outcomes of maternal COVID-19, obstetric outcomes, neonatal SARS-CoV-2, placental pathology. RESULTS: Of 675 women admitted for delivery, 10.4% were positive for SARS-CoV-2, of whom 78.6% were asymptomatic. We observed differences in sociodemographics and comorbidities among women with symptomatic COVID-10 versus asymptomatic COVID-19 versus no COVID-19. Caesarean delivery rates were 46.7% in symptomatic COVID-19, 45.5% in asymptomatic COVID-19 and 30.9% in women without COVID-19 (P = 0.044). Postpartum complications (fever, hypoxia, readmission) occurred in 12.9% of women with COVID-19 versus 4.5% of women without COVID-19 (P < 0.001). No woman required mechanical ventilation, and no maternal deaths occurred. Among 71 infants tested, none were positive for SARS-CoV-2. Placental pathology demonstrated increased frequency of fetal vascular malperfusion, indicative of thrombi in fetal vessels, in women with COVID-19 versus women without COVID-19 (48.3% versus 11.3%, P < 0.001). CONCLUSION: Among pregnant women with COVID-19 at delivery, we observed increased caesarean delivery rates and increased frequency of maternal complications in the postpartum period. Additionally, intraplacental thrombi may have maternal and fetal implications for COVID-19 remote from delivery. TWEETABLE ABSTRACT: COVID-19 at delivery: more caesarean deliveries, postpartum complications and intraplacental thrombi.

Consideration of traditional Chinese medicine in treatment of highly pathogenic human coronaviruses SARS-CoV-2 and SARS-CoV

Recently, the coronavirus disease 2019 (COVID-19) has broken out in China, similar with the sever acute respiratory syndrome (SARS) outbroke in 2003, this pestilence has wide epidemic, strong infectivity and high pathogenicity, which led a great impact on the production, life and people's health in China, and brought huge losses to the economy as well. These two kinds of pestilence were caused by human highly pathogenic coronavirus SARS-CoV-2 and SARS-CoV, respectively. Traditional Chinese medicine, as a unique medical way from China, plays an indelible role in ensuring people’s health. By comparing the epidemiology, clinical manifestations, therapeutic principles and methods of traditional Chinese medicine, this paper puts forward the similarities and differences of traditional Chinese medicine in the prevention, treatment and recovery periods in COVID-19 and SARS, and gives corresponding suggestions.