ISIDOG Recommendations Concerning COVID-19 and Pregnancy

Donders, Francesca; Lonnée-Hoffmann, Risa; Tsiakalos, Aristotelis; Mendling, Werner; Martinez-de-Oliveira, José; Judlin, P; Xue, Fengxia; Donders, Gilbert; Workgroup, Isidog Covid Guideline

doi:10.3390/diagnostics10040243

Cited by 100 publications

(150 citation statements)

References 83 publications

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“…Given the observations of thromboses in the placenta, the known increased risks of venous thromboembolic disease in the postpartum period, the demonstrated coagulopathy associated with severe COVID-19, 15,16 women with COVID-19, even if asymptomatic, may be at increased risk for venous thromboembolic disease events, and prophylactic anticoagulation postpartum may also be warranted, consistent with other recommendations. 17,18…”

Section: Discussionmentioning

confidence: 99%

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

Prabhu

Cagino

Matthews

et al. 2020

BJOG

255

256

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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.

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Section: Discussionmentioning

confidence: 99%

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

Prabhu

Cagino

Matthews

et al. 2020

BJOG

255

256

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“…Data on pregnancy and COVID-19 is limited, but based on the experience with influenza, SARS, and MERS, pregnant women, especially those in the second and third trimesters of gestation, have a higher risk of complications and death in comparison with no pregnant women (22)(23)(24). In the present analysis pregnant women, in comparison to no pregnant, were 3.56 times more likely to die because of coronavirus.…”

Section: Discussionmentioning

confidence: 99%

Early estimation of the risk factors for hospitalisation and mortality by COVID-19 in Mexico

Carrillo-Vega¹,

Salinas-Escudero

García-Peña³

et al. 2020

Preprint

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Background. With its high prevalence of chronic non-degenerative diseases, it is suspected that in Mexico there is a high risk of fatal complications from COVID-19. The present study aims to estimate the risk factors for hospitalisation and death in the Mexican population infected by SARS-CoV-2.Methods and Findings. We used the publicly available data released by the Epidemiological Surveillance System for Viral Respiratory Diseases of the Mexican Ministry of Health (Secretaría de Salud, SS). All records of positive SARS-CoV-2 cases were included. Two multiple logistic regression models were fitted to estimate the association between the hospitalisation and mortality, with other covariables. Data on 10,544 individuals (57.68% men), with mean age 46.47±15.62, were analysed.Men were about 1.54 times as likely to be hospitalized than women (p<0.001, 95% C.I. 1.37-1.74); individuals aged 50-74 and ≥74 years were more likely to be hospitalized than people from 25-49 years (OR 2.05, p<0.001, 95% C.I. 1.81-2.32, and OR 23.84, p<0.001, 95% C.I. 2.90-5.15, respectively).People with hypertension, obesity, and diabetes were more likely to be hospitalised than people without these morbidities (p<0.01). Men had more risk of death in comparison to women (OR=1.53, p<0.001, 95% C.I. 1.30-1.81) and individuals aged 50-74 and ≥75 years were more likely to die than people from 25-49 years (OR 1.96, p<0.001, 95% C.I. 1. and OR 3.74, p<0.001, respectively). Hypertension, obesity, and diabetes presented in combination, provided a higher risk of dying in comparison to not having these diseases (OR=2.10; p<0.001, 95% C.I. 1.50-2.93).Hospitalisation, intubation and pneumonia conferred a higher risk of dying (OR 5.02, p<0.001, OR 4.27, p<0.001, and OR=2.57; p<0.001, respectively). The main limitation of our study is the lack of information on mild (asymptomatic) or moderate cases of COVID-19. Conclusions.The present study points out that in Mexico, where an important proportion of the population develops two or more chronic conditions simultaneously, high mortality is a sever outcome for those infected by SARS-CoV-2.

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“…To address the safety issues for the obstetrical management and delivery of pregnant women with COVID-19, the advice for those women with SARS-CoV-2 infections during pregnancy and puerperium was prepared by numerous experts from the fields of obstetrics and gynecology, pediatrics, infectious diseases, and critical care (21,(70)(71)(72)(73)(74)(75). Similar to the recommendations for the non-pregnant, early isolation, early diagnosis, and early management are still the core criteria of prevention and control transmission for pregnant women with suspected and probable SARS-CoV-2 infection.…”

Section: Future Perspective: Management Guidelines For Obstetric Patimentioning

confidence: 99%

Potential Effect of COVID-19 on Maternal and Infant Outcome: Lesson From SARS

Wang

Han

et al. 2020

Front. Pediatr.

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The coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, is highly infectious and its ongoing outbreak has been declared a global pandemic by the WHO. Pregnant women are susceptible to respiratory pathogens and the development of severe pneumonia, suggesting the urgent need to assess the potential maternal and infant outcome of pregnancy with COVID-19. The intrauterine vertical transmission potential of SARS-CoV-2 also remains controversial. Herein, we discuss the potential effect of COVID-19 on maternal and infant outcomes based on current studies, including those published in Chinese, in a total of 80 mothers with COVID-19 and 80 infants. We also comprehensively explored the mother-to-child transmission routes of SARS-CoV-2, in particular the route of intrauterine vertical transmission. Given SARS-CoV-2 is a sister to SARS-CoV, of the SARS-related coronavirus species, we made a comprehensive comparison between them to learn from experiences with SARS. Although there is no evidence supporting the intrauterine vertical transmission of SARS-CoV-2, our comprehensive analysis suggests that the adverse maternal and infant outcomes caused by COVID-19 cannot be underestimated. Further, we speculated that the inconsistency between nucleic acids and serological characteristics IgM to SARS-CoV-2 of infants' specimens may be caused by the disruption of the amniotic barrier by the inflammatory factors induced by SARS-CoV-2 infection. Our review is beneficial to understand the effect of SARS-CoV-2 on maternal and infant outcomes.

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ISIDOG Recommendations Concerning COVID-19 and Pregnancy

Cited by 100 publications

References 83 publications

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

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

Early estimation of the risk factors for hospitalisation and mortality by COVID-19 in Mexico

Potential Effect of COVID-19 on Maternal and Infant Outcome: Lesson From SARS

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