Coronavirus disease 2019 pandemic: staged management of surgical services for gynecology and obstetrics

LeBrun, Emily E. Weber; Moawad, Nash S.; Rosenberg, Eric I.; Morey, Timothy E.; Davies, Laurie K.; Collins, William O.; Smulian, John C.

doi:10.1016/j.ajog.2020.03.038

Cited by 25 publications

(27 citation statements)

References 8 publications

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“…Pregnant women and their fetuses represent a high-risk population in light of the COVID-19 outbreak [12][13][14][15][16][17][18][19][20] since viral infections such as influenza [21][22][23][24][25][26][27], varicella [28][29][30][31][32], Ebola [33,34], and measles [35,36] show increased severity in this physiological state. Other coronavirus such as SARS-CoV-1 and MERS-CoV have severe effects to both the mother and the fetus, but vertical transmission has not been proven [37][38][39][40][41] albeit these studies included very few number of cases.…”

Section: Main Textmentioning

confidence: 99%

Does the human placenta express the canonical cell entry mediators for SARS-CoV-2?

Piqué-Regi

Romero

Tarca

et al. 2020

Preprint

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The pandemic of coronavirus disease 2019 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected over 3.8 million people, including pregnant women. To date, no consistent evidence of vertical transmission for SARS-CoV-2 exists. This new coronavirus canonically utilizes the angiotensin-converting enzyme 2 (ACE2) receptor and the serine protease TMPRSS2 for cell entry. Herein, building upon our previous single cell study of the placenta (Pique-Regi, 2019), another study, and new single-cell/nuclei RNA-sequencing data, we investigated the expression of ACE2 and TMPRSS2 throughout pregnancy as well as in third-trimester chorioamniotic membranes. We report that co-transcription of ACE2 and TMPRSS2 is negligible, thus not a likely path of vertical transmission for SARS-CoV-2 at any stage of pregnancy. In contrast, receptors for Zika virus and cytomegalovirus which cause congenital infections are highly expressed by placental cell types. These data suggest that SARS-CoV-2 is unlikely to infect the human placenta through the canonical cell entry mediators; yet, other interacting proteins could still play a role in the viral infection.

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Section: Main Textmentioning

confidence: 99%

Does the human placenta express the canonical cell entry mediators for SARS-CoV-2?

Piqué-Regi

Romero

Tarca

et al. 2020

Preprint

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“…The American College of Surgeons (ACS) has advised postponing elective cases until after the acute COVID-19 crisis abates [139]. General guidance to assist FPMRS and other surgical specialties with staged postponement of surgical cases has been published [140]. During the pandemic, there will be a need for urgent surgical intervention in some situations, and a plan for management of these non-elective cases is required.…”

Section: Covid-19-specific Concerns For Fpmrs Patientsmentioning

confidence: 99%

A guide for urogynecologic patient care utilizing telemedicine during the COVID-19 pandemic: review of existing evidence

et al. 2020

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Introduction and hypothesis The COVID-19 pandemic and the desire to "flatten the curve" of transmission have significantly affected the way providers care for patients. Female Pelvic Medicine and Reconstructive Surgeons (FPMRS) must provide high quality of care through remote access such as telemedicine. No clear guidelines exist on the use of telemedicine in FPMRS. Using expedited literature review methodology, we provide guidance regarding management of common outpatient urogynecology scenarios during the pandemic. Methods We grouped FPMRS conditions into those in which virtual management differs from direct in-person visits and conditions in which treatment would emphasize behavioral and conservative counseling but not deviate from current management paradigms. We conducted expedited literature review on four topics (telemedicine in FPMRS, pessary management, urinary tract infections, urinary retention) and addressed four other topics (urinary incontinence, prolapse, fecal incontinence, defecatory dysfunction) based on existing systematic reviews and guidelines. We further compiled expert consensus regarding management of FPMRS patients in the virtual setting, scenarios when in-person visits are necessary, symptoms that should alert providers, and specific considerations for FPMRS patients with suspected or confirmed COVID-19. Results Behavioral, medical, and conservative management will be valuable as first-line virtual treatments. Certain situations will require different treatments in the virtual setting while others will require an in-person visit despite the risks of COVID-19 transmission.Conclusions We have presented guidance for treating FPMRS conditions via telemedicine based on rapid literature review and expert consensus and presented it in a format that can be actively referenced.

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“…At the end of April, the joint American statement (of the eight gynecological and non-gynecological societies) was revealed in which authors took into account an epidemiological situation in a post-peak infectious curve when the risk of SARS-CoV-2 infection will be diminished and 'a normal new' will appear. In that document for benign gynecological indications on re-introduction of hospital and office-based procedures for the practicing gynecologists the CIN2 or CIN3 (HSIL) treatment was incorporated as an elective surgery of high acuity [12,13]. Therefore, Polish interim guidelines suggest in the decision-making that a prioritization of patients should be established after a careful analysis of a clinical status and a patient-related situation, and also should be modified according with the dynamically changing national healthcare environment related to COVID-19.…”

Section: Histologic Hsil Treatmentmentioning

confidence: 99%

Possible deferral of diagnostic and therapeutic procedures for patients with abnormal screening tests results in cervical cancer secondary prevention in current SARS-CoV-2 pandemic Interim guidelines of the Polish Society of Gynecologists and Obstetricians and the Polish Society of Colposcopy and Cervical Pathophysiology

Jach

Mazurec

Trzeszcz³

et al. 2020

Ginekol Pol

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The Polish Society of Gynecologists and Obstetricians and Polish Society of Colposcopy and Cervical Pathophysiology Interim Guidelines goal at aiding gynecologists in providing a cervical cancer prevention care during the evolving SARS-CoV-2 pandemic. Presented guidelines were developed on a review of limited data and updated when new relevant publications were revealed. Timing for deferrals of diagnostic-therapeutic procedures were mostly covered in the guidelines. Also, a support for the existing Polish recommendations on abnormal screening results in a subject of minor and major screening abnormalities terminology were given. The guidelines are obligatory for the specified COVID-19 pandemic period only and they might be changed depending on the new available evidence.

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Coronavirus disease 2019 pandemic: staged management of surgical services for gynecology and obstetrics

Cited by 25 publications

References 8 publications

Does the human placenta express the canonical cell entry mediators for SARS-CoV-2?

Does the human placenta express the canonical cell entry mediators for SARS-CoV-2?

A guide for urogynecologic patient care utilizing telemedicine during the COVID-19 pandemic: review of existing evidence

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