Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Universal Testing Experience on a Los Angeles Labor and Delivery Unit

Abstract

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Routine screening for SARS CoV-2 in unselected pregnant women at delivery

“…This could be seen in reports by Sutton et al [10], Vintzileos et al [9], Bianco et al [13] and Dória et al [16] All of them were conducted in areas and timepoints with reported high prevalence of infection [24], and showed higher observed SARS-CoV-2 infection prevalence, ranging between 11 and 19%, with up to 15% of asymptomatic confirmed cases among screened population. On the other side, reports by Naqvi et al [25] and Gagliardi et al [12], reported a low performance of universal screening based either on an overall lower disease burden in their region or due to a referred "steady state" of virus circulation, with less than 1% of asymptomatic confirmed cases. In an intermediate epidemiological situation [24] reports by Khalil et al [11], Miller et al [14] and Ochiai et al [26] presented observed SARS-CoV-2 infection prevalence ranging between 3 and 7%, with up to 6% of asymptomatic confirmed cases among screened population, which are similar to our findings.…”

Outcomes of universal SARS-CoV-2 testing program in pregnant women admitted to hospital and the adjuvant role of lung ultrasound in screening: a prospective cohort study

“…Since the first initiation of implementing universal screening programs by Sutton et al [6] and Vintzileos et al [7], several studies were reported from all over the world [18][19][20]. Following high overall and asymptomatic infection rates from New York studies, results from London were reasonable with a soft decrease from almost one in every five women to one in fourteen [3].…”

Performance of an extended triage questionnaire to detect suspected cases of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in obstetric patients: Experience from two large teaching hospitals in Lombardy, Northern Italy

“…This is particularly important to prevent potential viral spread to other patients and HCWs and mother-to-child transmission when caring for laboring women, in whom delivery can occur before nucleic acid test results are available. In fact, turn-around time of RT-PCR testing is usually >5 hours in most facilities [8,9] and availability of rapid testing is limited [6].…”

“…Second, it investigated the questionnaire's performance in the context of both a targeted and a universal viral screening approach in two consecutive periods of the outbreak. Third, it assessed the universal screening approach over a 6-week time period, which may have allowed to better capture the real trend of infection over time among obstetric patients than much shorter study periods [4,6,8].…”

“…However, limited testing supplies and laboratory workforce may prevent its application in some clinical settings [7]. In addition, although a rapid laboratory testing has been developed [6], most hospitals rely on standard tests with a 5 to 24 hour-turn-around time [8,9]. This may be a problem when caring for a laboring woman in whom delivery can occur before the RT-PCR result is available.…”