Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 1.501
Filter
Add filters

Document Type
Year range
2.
Early Hum Dev ; 162: 105460, 2021 11.
Article in English | MEDLINE | ID: covidwho-1632677

ABSTRACT

The outbreak and spread of the coronavirus disease 2019 pandemic has led to an unprecedented wealth of literature on the impact of human coronaviruses on pregnancy. The number of case studies and publications alone are several orders of magnitude larger than those published in all previous human coronavirus outbreaks combined, enabling robust conclusions to be drawn from observations for the first time. However, the importance of learning from previous human coronavirus outbreaks cannot be understated. In this narrative review, we describe what we consider to the major learning points arising from the SARS-CoV-2 pandemic in relation to pregnancy, and where these confound what might have been expected from previous coronavirus outbreaks.


Subject(s)
COVID-19/epidemiology , Pregnancy Complications, Infectious/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Female , Humans , Infectious Disease Transmission, Vertical/statistics & numerical data , Pregnancy , Pregnancy Complications, Infectious/prevention & control , Pregnancy Outcome/epidemiology , Vaccination/statistics & numerical data
3.
J Trop Pediatr ; 68(1)2022 01 07.
Article in English | MEDLINE | ID: covidwho-1630149

ABSTRACT

INTRODUCTION: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has led to a terrifying global pandemic. The presentations in neonates are varied with less case severity compared to adults. AIM: To describe the clinical and laboratory features and outcomes of neonates admitted with SARS-CoV-2 infection during the second surge of COVID-19 pandemic in a Government Medical College, West Bengal, India. MATERIALS AND METHODS: It is a hospital-based observational cross-sectional study conducted in the newborn unit of Burdwan Medical College and Hospital between 1 April 2021 and 31 July 2021 including all SARS-CoV-2 Real time RT-PCR (Reverse transcriptase polymerase chain reaction) positive neonates. The demographic, clinical and laboratory characteristics of all the neonates and their outcomes were documented and analysed. RESULTS: Twenty-two neonates were found to be SARS-CoV-2 RT-PCR positive out of which 9 (40.9%) were found to be asymptomatic and 6 (27.27%) required neonatal intensive care unit admissions. Among the symptomatic neonates, most common presentations were respiratory distress (40.9%) and gastrointestinal manifestations (40.9%). Eight (36.36%) neonates required respiratory support. Three (13.6%) neonates had pneumonia of which one had right middle lobe collapse. Laboratory parameters were nonspecific except for the two (9%) cases of multisystem inflammatory syndrome in neonates. High-resolution computed tomography findings in two cases were suggestive of SARS-CoV-2 infection-induced changes. Two (9%) neonates died of which one was likely due to SARS-CoV-2 infection. CONCLUSION: Neonates with SARS-CoV-2 infection are mostly asymptomatic. However, clinicians must be vigilant as atypical presentations such as consolidation, collapse, meningitis or multisystem inflammatory syndrome may occur.


SARS-CoV-2 infection in neonates is rare with varied presentations ranging from asymptomatic neonates to a few presenting with multiorgan failure. The disease severity and case fatality are much less than in adults. We studied the clinical and laboratory features and outcomes of 22 neonates with SARS-CoV-2 infection during the second surge of COVID-19 pandemic. While nine (40.9%) neonates were asymptomatic, six (27.27%) required NICU admission. Pneumonia is a rare presentation in neonates but severe COVID-19 pneumonia resulting in consolidation and lobar collapse requiring positive pressure ventilation is a possibility. Multisystem inflammatory syndrome in neonates is also a clinical entity probably as a result of hyperinflammatory syndrome due to transplacental transfer of antibodies. They require rigorous treatment, close monitoring and regular follow-ups. Amniotic fluid, placental or cord blood testing is essential to ascertain the definite mode of transmission in these neonates.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Adult , Cross-Sectional Studies , Female , Government , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical , Pandemics , Pregnancy , Pregnancy Complications, Infectious/epidemiology , SARS-CoV-2
4.
Sci Rep ; 12(1): 942, 2022 01 18.
Article in English | MEDLINE | ID: covidwho-1639062

ABSTRACT

There is conflicting evidence regarding the effect of coronavirus disease (COVID-19) in pregnancy. Risk factors for COVID-19 overlap with risk factors for pregnancy complications. We aimed to assess the effects of the COVID-19 pandemic and confirmed SARS-CoV-2 infection on pregnancy outcomes. A retrospective interrupted time-series and matched cohort analysis was performed. Singleton pregnancies completed between 1st January 2016 and 31st January 2021 were included. Trends in outcomes were analysed over time. Modelled COVID-19 transmission data were applied to deliveries since 1st January 2020 to assign a risk of COVID-19 to each pregnancy, and incorporated into a regression model of birthweight. Confirmed COVID-19 cases were matched to controls delivered in the pre-pandemic period, and maternal and neonatal outcomes compared. 43,802 pregnancies were included, with 8343 in the model of birthweight. There was no increase in the risk of stillbirth (p = 0.26) or neonatal death (p = 0.64) during the pandemic. There was no association between modelled COVID-19 attack rate (%) in any trimester and birthweight (first trimester p = 0.50, second p = 0.15, third p = 0.16). 214 COVID-positive women were matched to controls. Preterm birth was more common in symptomatic cases (14/62, 22.6%) compared to asymptomatic cases (9/109, 8.3%, p = 0.008) and controls (5/62, 8.1%, p = 0.025). Iatrogenic preterm birth was more common in cases (21/214, 9.8%) than controls (9/214, 4.2%, p = 0.02). All other examined outcomes were similar between groups. There was no significant impact of COVID-19 on the examined birth outcomes available. Symptomatic COVID-19 should be considered a risk factor for preterm birth, possibly due to an increase in iatrogenic deliveries for maternal indications.


Subject(s)
COVID-19/epidemiology , Models, Biological , Pregnancy Complications, Infectious/epidemiology , SARS-CoV-2 , Adolescent , Adult , England/epidemiology , Female , Humans , Pregnancy , Premature Birth/epidemiology , Retrospective Studies , Stillbirth/epidemiology
5.
BMC Pregnancy Childbirth ; 22(1): 33, 2022 Jan 14.
Article in English | MEDLINE | ID: covidwho-1637845

ABSTRACT

BACKGROUND: COVID-19 vaccines are advised for pregnant women in the United Kingdom (UK) however COVID-19 vaccine uptake among pregnant women is inadequate. METHODS: An online survey and semi-structured interviews were used to investigate pregnant women's views on COVID-19 vaccine acceptability for themselves when pregnant, not pregnant and for their babies. One thousand one hundred eighty-one women, aged over 16 years, who had been pregnant since 23rd March 2020, were surveyed between 3rd August-11th October 2020. Ten women were interviewed. RESULTS: The majority of women surveyed (81.2%) reported that they would 'definitely' or were 'leaning towards' accepting a COVID-19 vaccine when not pregnant. COVID-19 vaccine acceptance was significantly lower during pregnancy (62.1%, p < 0.005) and for their babies (69.9%, p < 0.005). Ethnic minority women were twice as likely to reject a COVID-19 vaccine for themselves when not pregnant, pregnant and for their babies compared to women from White ethnic groups (p < 0.005). Women from lower-income households, aged under 25-years, and from some geographic regions were more likely to reject a COVID-19 vaccine when not pregnant, pregnant and for their babies. Multivariate analysis revealed that income and ethnicity were the main drivers of the observed age and regional differences. Women unvaccinated against pertussis in pregnancy were over four times more likely to reject COVID-19 vaccines when not pregnant, pregnant and for their babies. Thematic analysis of the survey freetext responses and interviews found safety concerns about COVID-19 vaccines were common though wider mistrust in vaccines was also expressed. Trust in vaccines and the health system were also reasons women gave for accepting COVID-19 vaccines. CONCLUSION: Safety information on COVID-19 vaccines must be clearly communicated to pregnant women to provide reassurance and facilitate informed pregnancy vaccine decisions. Targeted interventions to promote COVID-19 vaccine uptake among ethnic minority and lower-income women may be needed.


Subject(s)
COVID-19 Vaccines , COVID-19/prevention & control , Patient Acceptance of Health Care/psychology , Pregnancy Complications, Infectious/prevention & control , Vaccination/psychology , Adult , /statistics & numerical data , Female , Humans , Income , Mothers/psychology , Pregnancy , Pregnant Women/psychology , SARS-CoV-2/immunology , Surveys and Questionnaires , United Kingdom/epidemiology
6.
Front Cell Infect Microbiol ; 11: 791654, 2021.
Article in English | MEDLINE | ID: covidwho-1637681

ABSTRACT

Nowadays, emerging evidence has shown adverse pregnancy outcomes, including preterm birth, preeclampsia, cesarean, and perinatal death, occurring in pregnant women after getting infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the underlying mechanisms remain elusive. Thyroid hormone disturbance has been unveiled consistently in various studies. As commonly known, thyroid hormone is vital for promoting pregnancy and optimal fetal growth and development. Even mild thyroid dysfunction can cause adverse pregnancy outcomes. We explored and summarized possible mechanisms of thyroid hormone abnormality in pregnant women after coronavirus disease 2019 (COVID-19) infection and made a scientific thypothesis that adverse pregnancy outcomes can be the result of thyroid hormone disorder during COVID-19. In which case, we accentuate the importance of thyroid hormone surveillance for COVID-19-infected pregnant women.


Subject(s)
COVID-19 , Criminals , Pregnancy Complications, Infectious , Premature Birth , Female , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical , Pregnancy , Pregnancy Outcome , SARS-CoV-2 , Thyroid Gland , Thyroid Hormones
7.
BMJ Case Rep ; 15(1)2022 Jan 17.
Article in English | MEDLINE | ID: covidwho-1627485

ABSTRACT

A 32-year-old homemaker, 28 weeks pregnant, was admitted to a dedicated COVID-19 hospital with a history of dyspnoea for 1 day; oral and nasopharyngeal swabs were positive for SARS-CoV-2 on real-time PCR. She had type 1 respiratory failure and oxygen saturation of 88%, so was put on non-invasive ventilation. Treatment as per guidelines was started. Given her deteriorating condition, a decision to deliver was taken and induction of labour was done. Her condition improved after delivery; but on day 5, she was suspected to have rhino-orbital mucormycosis and antifungals were started. Her condition improved gradually and she was discharged home. This case highlights the importance of individualised decision-making in cases with COVID-19 infection in pregnancy and that prompt treatment of the complications like mucormycosis would be lifesaving.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Respiratory Insufficiency , Adult , Female , Humans , Pregnancy , Pregnancy Complications, Infectious/drug therapy , SARS-CoV-2 , Treatment Outcome
8.
Obstet Gynecol ; 138(4): 542-551, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1621687

ABSTRACT

OBJECTIVE: To examine whether the coronavirus disease 2019 (COVID-19) pandemic altered risk of adverse pregnancy-related outcomes and whether there were differences by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection status among pregnant women. METHODS: In this retrospective cohort study using Epic's Cosmos research platform, women who delivered during the pandemic (March-December 2020) were compared with those who delivered prepandemic (matched months 2017-2019). Within the pandemic epoch, those who tested positive for SARS-CoV-2 infection were compared with those with negative test results or no SARS-CoV-2 diagnosis. Comparisons were performed using standardized differences, with a value greater than 0.1 indicating meaningful differences between groups. RESULTS: Among 838,489 women (225,225 who delivered during the pandemic), baseline characteristics were similar between epochs. There were no significant differences in adverse pregnancy outcomes between epochs (standardized difference<0.10). In the pandemic epoch, 108,067 (48.0%) women had SARS-CoV-2 testing available; of those, 7,432 (6.9%) had positive test results. Compared with women classified as negative for SARS-CoV-2 infection, those who tested positive for SARS-CoV-2 infection were less likely to be non-Hispanic White or Asian or to reside in the Midwest and more likely to be Hispanic, have public insurance, be obese, and reside in the South or in high social vulnerability ZIP codes. There were no significant differences in the frequency of preterm birth (8.5% vs 7.6%, standardized difference=0.032), stillbirth (0.4% vs 0.4%, standardized difference=-0.002), small for gestational age (6.4% vs 6.5%, standardized difference=-0.002), large for gestational age (7.7% vs 7.7%, standardized difference=-0.001), hypertensive disorders of pregnancy (16.3% vs 15.8%, standardized difference=0.014), placental abruption (0.5% vs 0.4%, standardized difference=0.007), cesarean birth (31.2% vs 29.4%, standardized difference=0.039), or postpartum hemorrhage (3.4% vs 3.1%, standardized difference=0.019) between those who tested positive for SARS-CoV-2 infection and those classified as testing negative. CONCLUSION: In a geographically diverse U.S. cohort, the frequency of adverse pregnancy-related outcomes did not differ between those delivering before compared with during the pandemic, nor between those classified as positive compared with negative for SARS-CoV-2 infection during pregnancy.


Subject(s)
COVID-19/epidemiology , Pregnancy Complications, Infectious/epidemiology , Pregnancy Outcome/epidemiology , Prenatal Care/statistics & numerical data , SARS-CoV-2 , Adult , COVID-19/complications , COVID-19 Testing/statistics & numerical data , Female , Humans , Infant, Newborn , Pregnancy , Pregnancy Complications, Infectious/virology , Retrospective Studies , United States/epidemiology
9.
Saudi Med J ; 43(1): 67-74, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1622885

ABSTRACT

OBJECTIVES: To explore the trimester wise significance of the primary outcome in pregnant women during coronavirus disease-19 (COVID-19) pandemic. METHODS: Retrospective observational study of pregnant women who were infected with COVID-19 from April 2020 until March 2021 at Bahrain Defense Force Hospital, Riffa, Bahrain. The study focused on the effects in relation to gestational age (GA), association with variables, severity, and treatment. A p-value of ≤0.05 was considered significant. RESULTS: During the study period, 74 COVID-19 cases were identified from the recorded 2944 pregnant women. The mean GA at diagnosis was 33.5±12.2 weeks, and the mean GA at birth was 38.4±1.8 weeks. Analysis of the obstetric complications revealed fetal growth restriction (FGR) had a p-value of <0.001. According to the trimester wise analysis, between the gestational period at diagnosis and the outcome of pregnancy, significant p-value of <0.01 was found in miscarriage. There were no significant associations found in GA at diagnosis and delivery, complications in relation to maternal age and body mass index, and no maternal morbidities or mortalities. CONCLUSION: In our study, FGR and miscarriage were the identified complications. However, the maternal and neonatal end result of COVID-19 was satisfactory.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Female , Humans , Infant, Newborn , Pandemics , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Outcome , SARS-CoV-2
12.
Gac Med Mex ; 157(3): 245-250, 2021.
Article in English | MEDLINE | ID: covidwho-1604118

ABSTRACT

INTRODUCTION: In patients with COVID-19, olfactory dysfunction and anosmia have been reported, which in pregnant women occur in up to 24.2 %. OBJECTIVE: To know the frequency at which pregnant women with SARS-CoV-2 infection have olfactory dysfunction. METHODS: Age, gestational age, temperature, presence of nasal constipation or rhinorrhea, myalgia, headache, cough or chest pain were asked. Whether patients perceived and identified the scent of grape juice, coffee powder and menthol was evaluated. Central tendency and dispersion measures, frequencies and percentages were used. Sensitivity, specificity, positive and negative predictive value were calculated. Mann-Whitney's U-test and contrast of proportions were used for comparisons between groups. RESULTS: There was a higher proportion of women with cough, headache, dyspnea, myalgia, odynophagia, rhinorrhea, chest pain, and anosmia in SARS-CoV-2-positive women. In patients without COVID-19, 88.9 % detected each one of the scents; only 31.8 % of the positive group detected grapes scent, 47.7 % coffee and 59.1 % menthol, which had the highest percentages of sensitivity (40 %), specificity (21 %), positive predictive value (59 %) and negative predictive value (11 %). CONCLUSION: Olfactory dysfunction occurs in a significant percentage of pregnant women with COVID-19.


Subject(s)
Anosmia/epidemiology , COVID-19/complications , Olfaction Disorders/epidemiology , Pregnancy Complications, Infectious/epidemiology , Adolescent , Adult , Anosmia/virology , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Olfaction Disorders/virology , Predictive Value of Tests , Pregnancy , Pregnancy Complications, Infectious/virology , Prospective Studies , Sensitivity and Specificity , Young Adult
14.
BMC Pregnancy Childbirth ; 22(1): 14, 2022 Jan 06.
Article in English | MEDLINE | ID: covidwho-1604590

ABSTRACT

BACKGROUND: Coronavirus Disease 2019 (COVID-19) is predominately known as a respiratory disease associated with pneumonia, acute respiratory distress syndrome and multiorgan failure. However, extra-pulmonary complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are increasingly being recognized. In this regard, some studies implied the hemostatic and vascular involvements in patients with SARS-CoV-2 infection. CASE PRESENTATION: We describe a case of spontaneous Intracerebral Hemorrhage (ICH) in a pregnant patient with COVID-19 and history of cesarean section a week before the occurrence of ICH. The patient underwent emergent craniotomy with acceptable outcome. Hemorrhagic events, including ICH, may happen during COVID-19 infection with several possible mechanisms. CONCLUSION: COVID-19 patients, especially high-risk groups, are at a risk of intracranial hemorrhage. Therefore, close follow-up must be maintained and hemorrhagic events must be kept in mind in these cases.


Subject(s)
COVID-19/complications , Cerebral Hemorrhage/virology , Pregnancy Complications, Cardiovascular/virology , Pregnancy Complications, Infectious , SARS-CoV-2 , Adult , Cerebral Hemorrhage/pathology , Cerebral Hemorrhage/surgery , Craniotomy , Critical Care , Female , Humans , Pregnancy , Pregnancy Complications, Cardiovascular/pathology , Pregnancy Complications, Cardiovascular/surgery , Pregnancy Complications, Infectious/virology , Treatment Outcome
15.
J Korean Med Sci ; 36(44): e309, 2021 Nov 15.
Article in English | MEDLINE | ID: covidwho-1593105

ABSTRACT

BACKGROUND: We assessed maternal and neonatal outcomes of critically ill pregnant and puerperal patients in the clinical course of coronavirus disease 2019 (COVID-19). METHODS: Records of pregnant and puerperal women with polymerase chain reaction positive COVID-19 virus who were admitted to our intensive care unit (ICU) from March 2020 to August 2021 were investigated. Demographic, clinical and laboratory data, pharmacotherapy, and neonatal outcomes were analyzed. These outcomes were compared between patients that were discharged from ICU and patients who died in ICU. RESULTS: Nineteen women were included in this study. Additional oxygen was required in all cases (100%). Eight patients (42%) were intubated and mechanically ventilated. All patients that were mechanically ventilated have died. Increased levels of C-reactive protein (CRP) was seen in all patients (100%). D-dimer values increased in 15 patients (78.9%); interleukin-6 (IL-6) increased in 16 cases (84.2%). Sixteen patients used antiviral drugs. Eleven patients were discharged from the ICU and eight patients have died due to complications of COVID-19 showing an ICU mortality rate of 42.1%. Mean number of hospitalized days in ICU was significantly lower in patients that were discharged (P = 0.037). Seventeen patients underwent cesarean-section (C/S) (89.4%). Mean birth week was significantly lower in patients who died in ICU (P = 0.024). Eleven preterm (57.8%) and eight term deliveries (42.1%) occurred. CONCLUSION: High mortality rate was detected among critically ill pregnant/parturient patients followed in the ICU. Main predictors of mortality were the need of invasive mechanical ventilation and higher number of days hospitalized in ICU. Rate of C/S operations and preterm delivery were high. Pleasingly, the rate of neonatal death was low and no neonatal COVID-19 occurred.


Subject(s)
COVID-19/mortality , Pregnancy Complications, Infectious/mortality , Puerperal Disorders/mortality , SARS-CoV-2 , Adult , Antiviral Agents/therapeutic use , COVID-19/blood , COVID-19/diagnostic imaging , COVID-19/therapy , Cesarean Section , Combined Modality Therapy , Critical Illness/mortality , Delivery, Obstetric/statistics & numerical data , Female , Hospital Mortality , Humans , Infant, Newborn , Intensive Care Units/statistics & numerical data , Length of Stay/statistics & numerical data , Lung/diagnostic imaging , Oxygen Inhalation Therapy , Pregnancy , Pregnancy Outcome , Respiration, Artificial , Retrospective Studies , Treatment Outcome , Young Adult
16.
J Coll Physicians Surg Pak ; 32(1): 119-121, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1591380

ABSTRACT

The goal of this study was to investigate the maternal death rate among admitted pregnant patients with SARS-COV-2 during its 4th wave in Pakistan. It was a cross-sectional analytical study, carried on pregnant patients admitted due to COVID-19, in Sadiq Abbasi Hospital from 15th August to 15th September, 2021. Thirty-three PCR confirmed and HRCT suggestive patients were included with mean age of 28 ± 4.5 years and mean gestational age of 28.5 ± 6 weeks. Twenty-seven (81%) were non-vaccinated, 22 (66%) were admitted with severe disease, 13 (39.4%) and 11 (33.3%) were on non-invasive and invasive ventilator support, respectively. Only nine (27%) patients could continue their pregnancy. Fifteen (45%) patients had severe oligohydramnios. Twenty-two (66.7%) patients were died, all were unvaccinated. Regression analysis for maternal mortality predicted by severity and vaccination status was significant with R2=.68, F (1, 31) =66.6, p <.001 CI (-.69, -.42) and R2=.44, F (1, 31) = 24.8, p <.001 CI (-1.14, -.48), respectively. There was substantial mortality in the admitted and non-vaccinated pregnant patients with COVID-19. Key Words: Pregnancy, Vaccination, Severe COVID, Maternal outcome.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Vaccines , Adult , Cross-Sectional Studies , Female , Humans , Infant , Maternal Mortality , Pakistan/epidemiology , Pregnancy , Pregnancy Complications, Infectious/prevention & control , Pregnancy Outcome , SARS-CoV-2 , Young Adult
18.
Rev Bras Ginecol Obstet ; 43(12): 949-960, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1585700

ABSTRACT

OBJECTIVE: To analyze the clinical and obstetric aspects of pregnant women with COVID-19. METHODS: A systematic literature review in the MEDLINE/PubMed, LILACS, SCIELO, and CNKI databases was performed from March to May 2020, with the descriptors: Pregnancy; 2019-nCov; Coronavirus; SARS-Cov-2, Covid-19. Of those chosen were original titles, without language and period restriction and that addressed pregnant women with a clinical and/or laboratory diagnosis of COVID-19. Revisions, editorials, and duplicate titles were excluded. The Newcastle-Ottawa (NOS) and Murad et al. scales were used to assess the quality of the studies. RESULTS: We included 34 articles with 412 pregnant women infected with severe acute respiratory syndrome (SARS-Cov-2), with an average age of 27.5 years of age and 36.0 gestational weeks. The most common symptom was fever (205 [49.7%]), and 89 (21.6%) pregnant women progressed to severe viral pneumonia. Laboratory tests showed an increase in C-reactive protein (154 [37.8%]), and radiological tests showed pneumonia with peripheral ground-glass pattern (172 [51.4%]). Emergency cesarean delivery was indicated for most pregnant women, and the most common gestational complication was premature rupture of ovarian membranes (14 [3.4%;]). We detected 2 (0.5%) neonatal deaths, 2 (0.5%) stillbirths, and 1 (0.2%) maternal death. CONCLUSION: Pregnant women with COVID-19 presented a clinical picture similar to that of non-infected pregnant women, with few obstetric or neonatal repercussions. There was a greater indication of cesarean deliveries before the disease aggravated, and there was no evidence of vertical transmission of the infection.


OBJETIVO: Analisar os aspectos clínicos e obstétricos de gestantes com COVID-19. MéTODOS: Revisão sistemática da literatura nas bases: MEDLINE/PubMed, LILACS, SCIELO e CNKI, realizada de março a maio de 2020, com os descritores Pregnancy; 2019-nCov; Coronavirus; SARS-Cov-2, Covid-19. Elegeram-se títulos originais, sem restrição de idioma e período e que abordassem gestantes com diagnóstico clínico e/ou laboratorial de COVID-19. Excluíram-se revisões, editoriais, títulos duplicados. As escalas de Newcastle-Ottawa (NOS, na sigla em inglês) e a de Murad et al. foram utilizadas para avaliar a qualidade dos estudos. RESULTADOS: Foram incluídos 34 artigos com 412 gestantes infectadas pela síndrome respiratória aguda grave (SARS-Cov, na sigla em inglês) com idade média de 27,5 anos e média de 36,0 semanas gestacionais. O sintoma mais incidente foi a febre (49,7%;205). e 89 (21,6%) gestantes evoluíram para pneumonia viral grave. Os exames laboratoriais demonstraram aumento da proteína C reativa (37,8%; 154) e os radiológicos mostraram pneumonia com padrão em vidro fosco periférico (51,4%; 172). O parto cesáreo de emergência foi indicado para a maior parte das gestantes, e a complicação gestacional mais comum foi a ruptura prematura de membranas ovulares (3,4%; 14). Foram detectados 2 (0,5%) mortes neonatais, 2 (0,5%) natimortos, e 1 (0,2%) morte materna. CONCLUSãO: Gestantes com doença coronavírus (COVID-19, na sigla em inglês apresentaram quadro clínico semelhante a gestantes não infectadas, com poucas repercussões obstétricas ou neonatais. Houve uma maior indicação de partos cesáreos antes do agravamento da doença e não se observaram evidências de transmissão vertical da infecção.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Premature Birth , Adult , Female , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/epidemiology , Pregnancy Outcome , Pregnant Women , SARS-CoV-2
19.
Mol Med ; 27(1): 162, 2021 12 27.
Article in English | MEDLINE | ID: covidwho-1582120

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel type b coronavirus responsible for the COVID-19 pandemic. With over 224 million confirmed infections with this virus and more than 4.6 million people dead because of it, it is critically important to define the immunological processes occurring in the human response to this virus and pathogenetic mechanisms of its deadly manifestation. This perspective focuses on the contribution of the recently discovered interaction of SARS-CoV-2 Spike protein with neuropilin 1 (NRP1) receptor, NRP1 as a virus entry receptor for SARS-CoV-2, its role in different physiologic and pathologic conditions, and the potential to target the Spike-NRP1 interaction to combat virus infectivity and severe disease manifestations.


Subject(s)
Antiviral Agents/pharmacology , COVID-19/drug therapy , Neuropilin-1/chemistry , Neuropilin-1/metabolism , Angiotensin-Converting Enzyme 2/chemistry , Angiotensin-Converting Enzyme 2/metabolism , COVID-19/epidemiology , COVID-19/etiology , Comorbidity , Diabetes Mellitus/epidemiology , Diabetes Mellitus/virology , Female , Host-Pathogen Interactions/drug effects , Host-Pathogen Interactions/immunology , Humans , Infant , Molecular Targeted Therapy/methods , Neuropilin-1/immunology , Pregnancy , Pregnancy Complications, Infectious/drug therapy , Pregnancy Complications, Infectious/virology , SARS-CoV-2/pathogenicity , Spike Glycoprotein, Coronavirus/metabolism
20.
PLoS One ; 16(12): e0261492, 2021.
Article in English | MEDLINE | ID: covidwho-1581740

ABSTRACT

OBJECTIVE: Mortality rates of pregnant and postpartum women grew in the second COVID-19 pandemic year. Our objective is to understand this phenomenon to avoid further deaths. METHODS: We collected data from SIVEP-Gripe, a nationwide Brazilian database containing surveillance data on all severe acute respiratory syndrome caused by COVID-19, between the first notified case (February 2020) until the 17th epidemiological week of 2021. We stratified patients into maternal women (which includes pregnant and postpartum women), non-maternal women and men and divided them by time of diagnosis in two periods: first period (February to December 2020) and second period (the first 17 epidemiological weeks of 2021 before pregnant and postpartum women were vaccinated). RESULTS: During the second period, all patients had higher risk of presenting severe COVID-19 cases, but the maternal population was at a higher risk of death (OR of 2.60 CI 95%: 2.28-2.97)-almost double the risk of the two other groups. Maternal women also had a higher risk of needing intensive care, intubation and of presenting desaturation in the second period. Importantly, maternal women presented fewer comorbidities than other patient groups, suggesting that pregnancy and postpartum can be an important risk factor associated with severe COVID-19. CONCLUSION: Our results suggest that the Gama variant, which has been related to greater virulence, transmissibility and mortality rates leads to more severe cases of COVID-19 for pregnant and postpartum women.


Subject(s)
COVID-19/mortality , Maternal Mortality/trends , Pregnancy Complications, Infectious/epidemiology , Adult , Brazil/epidemiology , COVID-19/epidemiology , COVID-19/virology , Comorbidity , Female , Humans , Male , Middle Aged , Pandemics , Postpartum Period , Pregnancy , Risk Factors , SARS-CoV-2/pathogenicity
SELECTION OF CITATIONS
SEARCH DETAIL
...