Clinical Implications of Universal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Testing in Pregnancy

Abstract

The data in this report reflect events and activities as of April 4, 2020 at 05:00 PM. All data in this report are preliminary and subject to change as cases continue to be investigated.

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

“…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. In our study, at the moment of the initial recruitment, according to the official data reported by the National Ministry of Health, there were about 7858 confirmed cases of SARS CoV-2 in the city of Santiago, with a cumulative incidence of 96.7 per 100000 habitants.…”

“…Two-sided p-values of less than 0.05 were considered statistically significant. The statistical package used for analysis was Stata v. 14…”

“…Currently, it has become evident that asymptomatic-people dissemination may play an important role in the spread of the virus [8]. The reported rates of asymptomatic pregnant women ranges from 43% to 89%, with estimates from 4 to 9 undetected cases per each symptomatic patient, supporting universal screening as a possible strategy [9][10][11][12][13][14][15]. It is also well established that pregnant women keep their pregnancy supervised by healthcare professionals, allowing close follow-up of their clinical conditions.…”

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

“…symptoms, such as loss of smell or taste, may also have played an important role [3,29]. Olfactory and taste disorders have been reported as the only symptoms of infection in up to 17% of SARS-CoV-2 positive individuals, and to display a higher predictive ability of having the virus than fever or persistent cough [16,18,19].…”

“…Universal screening by reverse transcription-polymerase chain reaction (RT-PCR) of nasopharyngeal swabs has been proposed as the optimal approach [3][4][5][6]. However, limited testing supplies and laboratory workforce may prevent its application in some clinical settings [7].…”