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1.
International Journal of Infectious Diseases ; 95:376-383, 2020.
Article in English | CAB Abstracts | ID: covidwho-1409676

ABSTRACT

Objectives: This study aimed to compare clinical courses and outcomes between pregnant and reproductive-aged non-pregnant women with COVID-19, and to assess the vertical transmission potential of COVID-19 in pregnancy.

2.
J Perinat Med ; 49(2): 237-240, 2021 Feb 23.
Article in English | MEDLINE | ID: covidwho-1038536

ABSTRACT

OBJECTIVES: The coronavirus disease 2019 (COVID-19) had become a worldwide pandemic, however, information is limited on the asymptomatic proportion and thromboembolism risk of pregnant women with infection. METHODS: All 32 pregnant women with COVID-19 who were admitted to the hospital in Wuhan during the outbreak from January 20 to March 18, 2020, were retrospectively reviewed for the clinical records, laboratory tests, chest CT scans, and neonatal outcomes. RESULTS: There were 17 of the 32 patients (53%) with no subjective symptoms before admission, and 13 (41%) remained asymptomatic throughout hospitalization. There were 28 patients (88%) showing typical radiographic evidence of pneumonia on chest CT. The patients with COVID-19 were found in an increased risk of thromboembolism with much higher D-dimer levels than uninfected pregnant women. One neonate with asphyxia and positive immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies was reported. CONCLUSIONS: The considerable asymptomatic proportion of pregnant women with COVID-19 indicates symptom-based screening would miss a number of cases. Chest CT could provide a useful screening resource during the COVID-19epidemic outbreak. Anticoagulation therapy for the postpartum patients may be helpful for good prognosis. The findings provide important information for the hospital isolation, control strategies and clinical therapy.


Subject(s)
Asymptomatic Infections/epidemiology , COVID-19/complications , Pregnancy Complications, Infectious/virology , Thromboembolism/virology , Adult , COVID-19/blood , COVID-19/diagnostic imaging , COVID-19/epidemiology , China/epidemiology , Female , Fibrin Fibrinogen Degradation Products/metabolism , Humans , Infant, Newborn , Pregnancy , Pregnancy Complications, Infectious/blood , Pregnancy Complications, Infectious/diagnostic imaging , Pregnancy Complications, Infectious/epidemiology , Radiography, Thoracic , Retrospective Studies , Tomography, X-Ray Computed , Young Adult
3.
Arch Pathol Lab Med ; 144(10): 1217-1222, 2020 10 01.
Article in English | MEDLINE | ID: covidwho-1016380

ABSTRACT

CONTEXT.­: The pandemic of a novel coronavirus, termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has created an unprecedented global health burden. OBJECTIVE.­: To investigate the effect of the SARS-CoV-2 infection on maternal, fetal, and neonatal morbidity and other poor obstetrical outcomes. DESIGN.­: All suspected cases of pregnant women with coronavirus disease 2019 (COVID-19) admitted into one center in Wuhan from January 20 to March 19, 2020, were included. Detailed clinical data of those pregnancies with COVID-19 were retrospectively collected and analyzed. RESULTS.­: Twenty-seven pregnant women (4 early pregnancies included) with laboratory or clinically confirmed SARS-CoV-2 infection and 24 neonates born to the 23 women in late pregnancy were analyzed. On admission, 46.2% (13 of 27) of the patients had symptoms, including fever (11 of 27), cough (9 of 27), and vomiting (1 of 27). Decreased total lymphocytes count was observed in 81.5% (22 of 27) of patients. Twenty-six patients showed typical viral pneumonia by chest computed tomography scan, whereas 1 patient confirmed with COVID-19 infection showed no abnormality on chest computed tomography. One mother developed severe pneumonia 3 days after her delivery. No maternal or perinatal death occurred. Moreover, 1 early preterm newborn born to a mother with the complication of premature rupture of fetal membranes, highly suspected to have SARS-CoV-2 infection, was SARS-CoV-2 negative after repeated real-time reverse transcriptase polymerase chain reaction testing. Statistical differences were observed between the groups of women in early and late pregnancy with COVID-19 in the occurrence of lymphopenia and thrombocytopenia. CONCLUSIONS.­: No major complications were reported among the studied cohort, though 1 serious case and 1 perinatal infection were observed. Much effort should be made to reduce the pathogenic effect of COVID-19 infection in pregnancies.


Subject(s)
Coronavirus Infections/complications , Pneumonia, Viral/complications , Pregnancy Complications, Infectious/virology , Adult , Betacoronavirus , COVID-19 , China , Coronavirus Infections/pathology , Female , Humans , Infant, Newborn , Pandemics , Pneumonia, Viral/pathology , Pregnancy , Pregnancy Complications, Infectious/pathology , Pregnancy Outcome , Retrospective Studies , SARS-CoV-2 , Young Adult
4.
Int J Gynaecol Obstet ; 150(3): 312-317, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-574780

ABSTRACT

OBJECTIVE: To evaluate the clinical characteristics and laboratory test results in pregnant women with coronavirus disease 2019 (COVID-19). METHODS: A retrospective study to review and compare clinical data including electronic medical records and laboratory tests from pregnant and nonpregnant patients admitted the Central Hospital of Wuhan, China from December 8, 2019 to April 1, 2020. RESULTS: A total of 72 women (30 pregnant and 42 nonpregnant) with COVID-19 were included. No patients developed severe pneumonia during the study. Compared with the nonpregnant group, pregnant patients were admitted to hospital earlier (0.25 vs 11.00 days; P<0.001), presented milder symptoms, had a higher rate of asymptomatic infection (26.7% vs 0%), and shorter length of hospital stay (14.5 vs 17.0 days; P<0.01). Laboratory test results showed that levels of inflammation markers such as white blood cell count, neutrophil count and percentage, C-reactive protein, procalcitonin, and D-dimer were significantly higher in pregnant women, whereas mean lymphocyte percentage was significantly lower compared with nonpregnant women. CONCLUSION: In some respects, the clinical characteristics and laboratory test results of COVID-19 in pregnant patients seems to be distinctive from their nonpregnant counterparts. Appropriate advice and positive treatment might be critical to the prognosis when dealing with these pregnant patients. Pregnant patients with COVID-19 had their own positive clinical characteristics and special laboratory test results. Responsive medical advice and active treatment for those patients are critical to recovery.


Subject(s)
COVID-19 Testing/diagnosis , COVID-19/diagnosis , Pregnancy Complications, Infectious/diagnosis , SARS-CoV-2 , Adult , COVID-19/blood , COVID-19 Testing/blood , Case-Control Studies , Coronavirus , Female , Fibrin Fibrinogen Degradation Products/analysis , Humans , Pregnancy , Pregnancy Complications, Infectious/blood , Pregnant Women , Procalcitonin/blood , Retrospective Studies
5.
Am J Obstet Gynecol ; 223(1): 111.e1-111.e14, 2020 07.
Article in English | MEDLINE | ID: covidwho-380476

ABSTRACT

BACKGROUND: The coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, is a global public health emergency. Data on the effect of coronavirus disease 2019 in pregnancy are limited to small case series. OBJECTIVE: To evaluate the clinical characteristics and outcomes in pregnancy and the vertical transmission potential of severe acute respiratory syndrome coronavirus 2 infection. STUDY DESIGN: Clinical records were retrospectively reviewed for 116 pregnant women with coronavirus disease 2019 pneumonia from 25 hospitals in China between January 20, 2020, and March 24, 2020. Evidence of vertical transmission was assessed by testing for severe acute respiratory syndrome coronavirus 2 in amniotic fluid, cord blood, and neonatal pharyngeal swab samples. RESULTS: The median gestational age on admission was 38+0 (interquartile range, 36+0-39+1) weeks. The most common symptoms were fever (50.9%, 59/116) and cough (28.4%, 33/116); 23.3% (27/116) patients presented without symptoms. Abnormal radiologic findings were found in 96.3% (104/108) of cases. Of the 116 cases, there were 8 cases (6.9%) of severe pneumonia but no maternal deaths. One of 8 patients who presented in the first trimester and early second trimester had a missed spontaneous abortion. Of 99 patients, 21 (21.2%) who delivered had preterm birth, including 6 with preterm premature rupture of membranes. The rate of spontaneous preterm birth before 37 weeks' gestation was 6.1% (6/99). One case of severe neonatal asphyxia resulted in neonatal death. Furthermore, 86 of the 100 neonates tested for severe acute respiratory syndrome coronavirus 2 had negative results; of these, paired amniotic fluid and cord blood samples from 10 neonates used to test for severe acute respiratory syndrome coronavirus 2 had negative results. CONCLUSION: Severe acute respiratory syndrome coronavirus 2 infection during pregnancy is not associated with an increased risk of spontaneous abortion and spontaneous preterm birth. There is no evidence of vertical transmission of severe acute respiratory syndrome coronavirus 2 infection when the infection manifests during the third trimester of pregnancy.


Subject(s)
Coronavirus Infections/pathology , Pneumonia, Viral/pathology , Pregnancy Complications, Infectious/virology , Abortion, Spontaneous/virology , Adult , Amniotic Fluid/virology , Betacoronavirus , COVID-19 , China , Coronavirus Infections/complications , Female , Fetal Blood/virology , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical , Pandemics , Pneumonia, Viral/complications , Pregnancy , Pregnancy Complications, Infectious/pathology , Pregnancy Outcome , Premature Birth/virology , SARS-CoV-2
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