Severe Coronavirus Infections in Pregnancy

Abstract

has been reviewed by the Editorial Board and by special expert referees. Although it is judged not acceptable for publication in Obstetrics & Gynecology in its present form, we would be willing to give further consideration to a revised version. If you wish to consider revising your manuscript, you will first need to study carefully the enclosed reports submitted by the referees and editors. Each point raised requires a response, by either revising your manuscript or making a clear and convincing argument as to why no revision is needed. To facilitate our review, we prefer that the cover letter include the comments made by the reviewers and the editor followed by your response. The revised manuscript should indicate the position of all changes made. We suggest that you use the "track changes" feature in your word processing software to do so (rather than strikethrough or underline formatting).

COVID-19 in pregnancy and the puerperium: A review for emergency physicians

“…Given the relative novelty of the SARS-CoV-2 virus, data regarding its specific pathophysiologic impact in pregnancy are limited. However, recent coronavirus epidemics caused by the Middle Eastern Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV-1) viruses in 2003 and 2012, respectively, can provide valuable informatin [ 5 , 6 ]. MERS-CoV and SARS-CoV-1 appear to cause more severe disease in pregnant patients compared to SARS-CoV-2 [ 6 ].…”

“…Data from SARS-CoV-1 and MERS-CoV can also inform the response to SARS-CoV-2 until more specific data are available. In examining the SARS-CoV-1 and MERS-CoV outbreaks, significant morbidity and mortality were most common among patients in the second and third trimesters of pregnancy [ 5 ]. Adverse outcomes included miscarriage, small for gestational age neonates, and prematurity [ 5 ].…”

“…In examining the SARS-CoV-1 and MERS-CoV outbreaks, significant morbidity and mortality were most common among patients in the second and third trimesters of pregnancy [ 5 ]. Adverse outcomes included miscarriage, small for gestational age neonates, and prematurity [ 5 ]. Fever, cough, and fatigue were the most commonly reported symptoms with both SARS-CoV-1 and MERS-CoV [ 6 ].…”

“…This meta-analysis also noted an increased rate of preterm birth, caesarean delivery, neonatal intensive care unit (NICU) admission, and preeclampsia in women diagnosed with any of the three coronaviruses compared to the general population [ 6 ]. There have been no documented cases of vertical transmission of SARS-CoV-1 or MERS-CoV [ 5 , 6 ].…”

“…Testing in non-pregnant individuals most commonly occurs when they present with symptoms or a concerning contact history, whereas pregnant individuals are often tested for COVID-19 when presenting for care for pregnancy or reasons unrelated to the COVID-19 outbreak [ 5 , 6 ]. A living systematic review of 28 studies including 11,432 patients found that 1 in 10 pregnant or recently-pregnant women presenting or admitted to the hospital tested positive for COVID-19 [ 7 ].…”