Coronavirus disease 2019 infection among asymptomatic and symptomatic pregnant women: two weeks of confirmed presentations to an affiliated pair of New York City hospitals

Breslin, Noelle; Baptiste, Caitlin; Gyamfi-Bannerman, Cynthia; Miller, Russell S.; Martinez, Rebecca; Bernstein, Kyra; Ring, Laurence E.; Landau, Ruth; Purisch, Stephanie; Friedman, Alexander M.; Fuchs, Karin; Sutton, Desmond; Andrikopoulou, Maria; Rupley, Devon M.; Sheen, Jean‐Ju; Aubey, Janice J.; Zork, Noelia; Moroz, Leslie; Mourad, Mirella; Wapner, Ronald J.; Simpson, Lynn L.; D’Alton, Mary E.; Goffman, Dena

doi:10.1016/j.ajogmf.2020.100118

Cited by 756 publications

(1,019 citation statements)

References 11 publications

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“…Recently published case series discuss clinical features and outcomes of pregnant women with suspected COVID-19. [1][2][3][4] In 1 series of 13 mothers with confirmed SARS-CoV-2 infection postpartum, 2 had a dry cough and 6 had ground-glass opacity infiltrates on chest CT. 1 In another retrospective single-centre study, 7 pregnant (third-trimester) women who tested positive for SARS-CoV-2 infection had infiltrates on CT consistent with infection but did not require intensive care postpartum. 2 Of a total of 20 reported patients, none developed postpartum acute decompensation.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Two recent reports from the same institution in New York described 29 women who had been asymptomatic but tested positive for SARS-CoV-2 infection on screening just before delivery. 3,4 Three women (out of 29) developed fever postpartum; in 2 of these women, the fever was thought to be related to endomyometritis, and in 1 woman, the fever was thought to be related to COVID-19. 3,4 In our case series, the women showed postpartum respiratory distress with deoxygenation and sudden clinical decompensation 28-81 hours postpartum, associated with lymphopenia, elevated CRP and changes in chest CT consistent with SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 Three women (out of 29) developed fever postpartum; in 2 of these women, the fever was thought to be related to endomyometritis, and in 1 woman, the fever was thought to be related to COVID-19. 3,4 In our case series, the women showed postpartum respiratory distress with deoxygenation and sudden clinical decompensation 28-81 hours postpartum, associated with lymphopenia, elevated CRP and changes in chest CT consistent with SARS-CoV-2 infection. Physiologically, it is unclear why these women developed serious symptoms after delivery.…”

Section: Discussionmentioning

confidence: 99%

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Postpartum exacerbation of antenatal COVID-19 pneumonia in 3 women

Wood

et al. 2020

CMAJ

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A 31-year-old pregnant woman (38 wk + 2 d) presented to the obstetrics and gynecology team with a 5-day history of cough, low-grade fever (maximum temperature 37.8°C) and intermittent shortness of breath. She also described bilateral lower-leg edema for 2 days. Because she reported contact with a potentially infected person from Wuhan, China, the epicentre of the coronavirus disease 2019 (COVID-19) outbreak, we placed her immediately in respiratory isolation.The patient's oxygen saturations were 90%-94%, respiratory rate was 28 breaths/min, heart rate was 90 beats/min and blood pressure was 160/100 mm Hg at the time of admission. Results of initial laboratory tests were as follows: leukocyte count 5.1 (reference range 3.5-9.5) ×10 9 /L, lymphocyte count 1.05 (reference range 1.1-3.2) ×10 9 /L and C-reactive protein (CRP) level 7.1 (reference range 0-8) mg/L. Real-time polymerase chain reaction (PCR) testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was positive. Fetal ultrasonography and maternal echocardiography were normal.We performed low-dose computed tomography (CT) of the chest to exclude pulmonary embolism and pneumonia; CT results were normal ( Figure 1A). After a failed induction of labour, the patient underwent a cesarean delivery, delivering a healthy boy weighing 4.2 kg. The newborn tested negative for SARS-CoV-2 by real-time PCR throat and anal swabs. After delivery, we prescribed the patient an antiviral treatment typically used for influenza, umifenovir. PRACTICE | CASES CPD

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Postpartum exacerbation of antenatal COVID-19 pneumonia in 3 women

Wood

et al. 2020

CMAJ

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“…48,49 Multiple individual case reports as well as descriptions of cohorts of pregnant women with COVID-19 have been published describing their clinical course, laboratory and radiological findings, and details of their birthing by cesarean section or, in fewer cases, vaginal delivery. [20][21][22][23][24][25][26][27][28][29][30][31][50][51][52][53] There have now been at least 108 pregnant women with COVID-19 reported which also describe the clinical and laboratory features of the majority of their newborn infants including virologic status for SARS-CoV-2. 54 Thus far, there have been no laboratory confirmed cases of intrauterine transmission of SARS-CoV-2 from an infected mother to her fetus.…”

Section: Sars-cov-2 and Covid 19mentioning

confidence: 99%

Infections in Pregnancy With COVID-19 and Other Respiratory RNA Virus Diseases Are Rarely, If Ever, Transmitted to the Fetus: Experiences With Coronaviruses, Parainfluenza, Metapneumovirus Respiratory Syncytial Virus, and Influenza

Schwartz

Dhaliwal

2020

Archives of Pathology &Amp; Laboratory Medicine

107

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SARS-CoV-2, the agent of COVID-19, is similar to two other coronaviruses, SARS-CoV and MERS-CoV, in causing life-threatening maternal respiratory infections and systemic complications. Because of global concern for potential intrauterine transmission of SARS-CoV-2 from pregnant women to their infants, this report analyzes the effects on pregnancy of infections caused by SARS-CoV-2 and other respiratory RNA viruses, and examines the frequency of maternal-fetal transmission with SARS-CoV-2, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza, respiratory syncytial virus (RSV), parainfluenza (HPIV) and metapneumovirus (hMPV). There have been no confirmed cases of intrauterine transmission reported with COVID-19 or any other coronavirus infections. Influenza virus, despite causing approximately one billion annual infections globally, has only a few cases of confirmed or suspected intrauterine fetal infections reported. RSV is in an unusual cause of illness among pregnant women, and with the exception of one premature infant with congenital pneumonia, no other cases of maternal-fetal infection are described. Parainfluenza virus and human metapneumovirus can produce symptomatic maternal infections but do not cause intrauterine fetal infection. In summary, it appears that the absence thus far of maternal-fetal transmission of the SARS-CoV-2 virus during the COVID-19pandemic is similar to other coronaviruses, and is also consistent with the extreme rarity of suggested or confirmed cases of intrauterine transmission of other respiratory RNA viruses. This observation has important consequences for pregnant women as it appears that if intrauterine transmission of SARS-CoV-2 does eventually occur, it will be a rare event. Potential mechanisms of fetal protection from maternal viral infections are also discussed.

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“…When analysing the published literature on pregnancy and SARS-CoV-2, gaps in knowledge were identified, especially whether being pregnant represents a risk for increased susceptibility to infection, severity of clinical presentation and adverse outcomes for mothers and neonates. [1][2][3][4][5][6][7] Through dialogue with corresponding authorities in other European countries and the US, it became apparent that none had seen a comparatively increased number of pregnant or postpartum women with SARS-CoV-2 infection requiring intensive care.…”

Section: Introductionmentioning

confidence: 99%

Public Health Agency of Sweden's Brief Report: Pregnant and postpartum women with severe acute respiratory syndrome coronavirus 2 infection in intensive care in Sweden

Collin

Byström

Carnahan

et al. 2020

Acta Obstet Gynecol Scand

229

158

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The Public Health Agency of Sweden has analyzed how many pregnant and postpartum women with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection have been treated in intensive care units (ICU) in Sweden between 19 March and 20 April 2020 compared with non‐pregnant women of similar age. Cases were identified in a special reporting module within the Swedish Intensive Care Registry (SIR). Fifty‐three women aged 20‐45 years with SARS‐CoV‐2 were reported in SIR, and 13 of these women were either pregnant or postpartum (<1 week). The results indicate that the risk of being admitted to ICU may be higher in pregnant and postpartum women with laboratory‐confirmed SARS‐CoV‐2 in Sweden, compared with non‐pregnant women of similar age.

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Coronavirus disease 2019 infection among asymptomatic and symptomatic pregnant women: two weeks of confirmed presentations to an affiliated pair of New York City hospitals

Cited by 756 publications

References 11 publications

Postpartum exacerbation of antenatal COVID-19 pneumonia in 3 women

Postpartum exacerbation of antenatal COVID-19 pneumonia in 3 women

Infections in Pregnancy With COVID-19 and Other Respiratory RNA Virus Diseases Are Rarely, If Ever, Transmitted to the Fetus: Experiences With Coronaviruses, Parainfluenza, Metapneumovirus Respiratory Syncytial Virus, and Influenza

Public Health Agency of Sweden's Brief Report: Pregnant and postpartum women with severe acute respiratory syndrome coronavirus 2 infection in intensive care in Sweden

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