Universal SARS-Cov-2 Screening in Women Admitted for Delivery in a Large Managed Care Organization

Fassett, Michael J.; Lurvey, Lawrence D.; Yasumura, Lyn; Nguyen, Marielle; Colli, Joseph J.; Volodarskiy, Marianna; Gullett, Jonathan C.; Braun, David; Fong, Alex; Trivedi, Neha; Bruxvoort, Katia; Chiu, Vicki; Getahun, Darios

doi:10.1055/s-0040-1714060

Cited by 54 publications

(71 citation statements)

References 9 publications

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“…. Similarly, among pregnant women admitted to a large managed care organization in southern California for labor and delivery who were offered universal screening, the prevalence of SARS-CoV-2 infection was 0.4%, and all women with positive test results were asymptomatic (6). Compared with background rates of all pregnant women in the VSD population during the same period, the current findings indicate increased percentages of preterm delivery and stillbirths occur among all pregnant women with SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 Infection Among Hospitalized Pregnant Women: Reasons for Admission and Pregnancy Characteristics — Eight U.S. Health Care Centers, March 1–May 30, 2020

Panagiotakopoulos¹,

Myers²,

Gee³

et al. 2020

MMWR Morb. Mortal. Wkly. Rep.

148

114

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On September 16, 2020, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). Pregnant women might be at increased risk for severe coronavirus disease 2019 (COVID-19), possibly related to changes in their immune system and respiratory physiology* (1). Further, adverse birth outcomes, such as preterm delivery and stillbirth, might be more common among pregnant women infected with SARS-CoV-2, the virus that causes COVID-19 (2,3). Information about SARS-CoV-2 infection during pregnancy is rapidly growing; however, data on reasons for hospital admission, pregnancy-specific characteristics, and birth outcomes among pregnant women hospitalized with SARS-CoV-2 infections are limited. During March 1-May 30, 2020, as part of Vaccine Safety Datalink (VSD) † surveillance of COVID-19 hospitalizations, 105 hospitalized pregnant women with SARS-CoV-2 infection were identified, including 62 (59%) hospitalized for obstetric reasons (i.e., labor and delivery or another pregnancy-related indication) and 43 (41%) hospitalized for COVID-19 illness without an obstetric reason. Overall, 50 (81%) of 62 pregnant women with SARS-CoV-2 infection who were admitted for obstetric reasons were asymptomatic. Among 43 pregnant women hospitalized for COVID-19, 13 (30%) required intensive care unit (ICU) admission, six (14%) required mechanical ventilation, and one died from COVID-19. Prepregnancy obesity was more common (44%) among pregnant women hospitalized for COVID-19 than that among asymptomatic pregnant women hospitalized for obstetric reasons (31%). Likewise, the rate of gestational diabetes (26%) among pregnant women hospitalized for COVID-19 was higher than it was among women hospitalized for obstetric reasons (8%). Preterm delivery occurred in 15% of pregnancies among 93 women who delivered, and stillbirths (fetal death at ≥20 weeks' gestation) occurred in 3%. Antenatal counseling emphasizing preventive measures (e.g., use of masks, frequent hand washing, and social distancing) might help prevent COVID-19 among pregnant women, § especially those with *

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Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 Infection Among Hospitalized Pregnant Women: Reasons for Admission and Pregnancy Characteristics — Eight U.S. Health Care Centers, March 1–May 30, 2020

Panagiotakopoulos¹,

Myers²,

Gee³

et al. 2020

MMWR Morb. Mortal. Wkly. Rep.

148

114

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“…The sensitivity of our screening tests might have been low due to the use self-collected NPS, although recent studies report self-collection protocols to have acceptable sensitivity 9,10 . Tests among symptom-free individuals could also have reduced sensitivity, however, prior studies in asymptomatic pregnant women 11,12 and residents of long-term care facilities 13 Our results suggest that while the healthcare worker force is very likely to be at increased relative risk for infection compared to the general population 8 , the point prevalence of SARS-CoV-2 infection was low in symptom-free Minnesota healthcare workers. If true, the probability of encountering an infected symptom-free healthcare professional during a medically necessary healthcare visit is likely low when community point prevalence is low.…”

Section: Discussionmentioning

confidence: 61%

SARS-CoV-2 Screening Among Symptom-Free Healthcare Workers

Demmer

Ulrich

Wiggen

et al. 2020

Preprint

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Importance: Current evidence suggests that transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is possible among symptom-free individuals but limited data are available on this topic in healthcare workers (HCW). The quality and acceptability of self-collected nasopharyngeal swabs (NPS) is unknown. Objective: To estimate the prevalence of SARS-CoV-2 infection and to assess the acceptability of self-collected NPS among HCW. Design: Cross-sectional convenience sample enrolled between April 20th and June 24th, 2020. We had >95% power to detect at least one positive test if the true underlying prevalence of SARS-CoV2 was > 1%. Setting: The metropolitan area surrounding Minneapolis and St. Paul, Minnesota. Participants: HCW free of self-reported upper respiratory symptoms were recruited. Exposures: Participants completed questionnaires regarding demographics, household characteristics, personal protective equipment (PPE) utilization and comorbidities. Outcomes: A participant self-collected nasopharyngeal swab (NPS) was obtained. SARS-CoV-2 infection was assessed via polymerase chain reaction. NPS discomfort was assessed on a scale of 1 (no discomfort) - 10 (extreme discomfort). NPS duration and depth into the nasopharynx, and willingness to perform future self-collections were assessed. Results: Among n=489 participants 80% were female and mean age+/-SD was 41+/-11. Participants reported being physicians (14%), nurse practitioners (8%), physicians assistants (4%), nurses (51%), medics (3%), or other which predominantly included laboratory technicians and administrative roles (22%). Exposure to a known/suspected COVID-19 case in the 14 days prior to enrollment was reported in 40% of participants. SARS-CoV-2 was not detected in any participant. The mean+/-SD discomfort level of the NPS was 4.5+/-2.0. 95% of participants reported that their self-swab was longer than or equal to the duration of patient swabs they had previously performed, and 89% reported the depth to be deeper than or equal to the depth of previous patient swabs. Over 95% of participants reported a willingness to repeat a self-collected NP swab in the future. Conclusions and Relevance: The point prevalence of SARS-CoV-2 infection was likely very low in symptom-free Minnesota healthcare workers from April 20th and June 24th, 2020. Self-collected NP swabs are well-tolerated and a viable alternative to provider-collected swabs to preserve PPE.

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“…Also in this study, the rate of SARS-CoV-2 infection in the mass screening group of 75 asymptomatic women was 13.3% (10/75) [11]. Another study by Fassett MJ, et al of 3,923 women who were universal screened at the time of hospital admission for delivery showed a very low rate of SARS-CoV-2 infection (17/3.923 = 0.43) and all in all cases there are no symptoms [12]. This suggests that screening for SARS-CoV-2 infection in pregnant women with risk factors (with clinical symptoms or exposure) is a reasonable strategy in middle-low-income countries such as Vietnam.…”

Section: Discussionmentioning

confidence: 88%

SARS-CoV-2 Infection in Pregnancy: A Case Report on the First Emergency Cesarean Section in Vietnam and Literature Review

Dinh¹,

Van²,

Pham³

2020

Obstet Gynecol Cases Rev

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On March 11, the World Health Organization officially declared an outbreak of acute respiratory infections (COVID-19) caused by a new strain of the Corona virus (SARS-CoV-2) as a pandemic [1]. Vietnam reported the first case of SARS-CoV-2 infection on January 22, 2020 being a Chinese coming from Wuhan-where earliest case in the world was detected [2]. As of September 4, 2020, there were 26, 455, 964 cases recorded in the world and in Vietnam the number of infected people is 1046 [3]. Although the number of SARS-CoV-2 infections is increasing globally, evidence of the spread, incidence, and impact of SARS-CoV-2 infection on both mother and child remains limited [4]. Due to physiological changes in the immune system and cardiovascular-respiratory system, pregnant women are considered to be at high risk of viral respiratory infections. Based on data from previous outbreaks of severe acute respiratory syndrome Coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), it has been found that pregnant women are more susceptible to adverse outcomes such as the need of intubation, intensive care, renal failure and death [5]. A meta-analysis by Allotey J, et al., including 77 studies (13,118 women infected with SARS-CoV-2 and 83,486 women of non-pregnant age of childbearing Case RePoRT anD LiTeRaTuRe ReView

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Universal SARS-Cov-2 Screening in Women Admitted for Delivery in a Large Managed Care Organization

Cited by 54 publications

References 9 publications

SARS-CoV-2 Infection Among Hospitalized Pregnant Women: Reasons for Admission and Pregnancy Characteristics — Eight U.S. Health Care Centers, March 1–May 30, 2020

SARS-CoV-2 Infection Among Hospitalized Pregnant Women: Reasons for Admission and Pregnancy Characteristics — Eight U.S. Health Care Centers, March 1–May 30, 2020

SARS-CoV-2 Screening Among Symptom-Free Healthcare Workers

SARS-CoV-2 Infection in Pregnancy: A Case Report on the First Emergency Cesarean Section in Vietnam and Literature Review

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