Covid-19 during pregnancy: A case series from an universally tested population from the north of Portugal

Dória, Mariana; Peixinho, Catarina; Laranjo, Mafalda; Varejão, Ana Mesquita; Silva, Pedro Tiago

doi:10.1016/j.ejogrb.2020.05.029

Cited by 44 publications

(57 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, in areas with high prevalence of infection, it could be expected that more women may be positive but asymptomatic [23]. 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.…”

Section: Results In the Context Of What Is Knownmentioning

confidence: 91%

“…It is also well established that pregnant women keep their pregnancy supervised by healthcare professionals, allowing close follow-up of their clinical conditions. Therefore, it has been proposed that women admitted for delivery could provide a potential study group with useful estimates of virus circulation among general population [12,13,16]. Given the possibility there is a higher prevalence of SARS CoV-2 infection than reported just by symptoms, screening of unselected population may give a more accurate estimate.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2020

View full text Add to dashboard Cite

Background South America has become the epicenter of coronavirus pandemic. It seems that asymptomatic population may contribute importantly to the spread of the disease. Transmission from asymptomatic pregnant patients' needs to be characterized in larger population cohorts and symptom assessment needs to be standardized. Objective To assess the prevalence of SARS CoV-2 infection in an unselected obstetrical population and to describe their presentation and clinical evolution. Methods A cross-sectional study was designed. Medical records of pregnant women admitted at the Obstetrics & Gynecology department of Clínica Dá vila for labor & delivery, between April 27 th and June 7 th , 2020 were reviewed. All patients were screened with RT-PCR for SARS CoV-2 at admission. After delivery, positive cases were inquired by the researchers for clinical symptoms presented before admission and clinical evolution. All neonates born from mothers with confirmed SARS CoV-2 were isolated and tested for SARS CoV-2 infection. Results A total of 586 patients were tested for SARS CoV-2 during the study period. Outcomes were obtained from 583 patients which were included in the study. Thirty-seven pregnant women had a positive test for SARS CoV-2 at admission. Cumulative prevalence of confirmed SARS CoV-2 infection was 6.35% (37/583) [CI 95%: 4.63-8.65]. From confirmed cases, 43.2% (16/37) were asymptomatic. From symptomatic patients 85.7% (18/21) had mild symptoms and evolved without complications and 14.3% (3/21) presented severe symptoms requiring admission to intensive care unit. Only 5.4% (2/37) of the neonates born to mothers with a positive test at admission had a positive RT-PCR for SARS CoV-2.

show abstract

Section: Results In the Context Of What Is Knownmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Eight studies (95 247 women) compared pregnant populations with non-pregnant populations,2526272829303132 and four studies (2230 women) compared pregnant women with covid-19 versus pregnant women without covid-19 33343536. Forty cohort studies reported on clinical manifestations (13 018 pregnant, 85 084 non-pregnant women),25262728293031323536373839404142434445464748495051525354555657585960616263646566 45 studies reported on covid-19 related maternal outcomes (14 094 pregnant, 85 169 non-pregnant women),2526272829303132353637383940414243454647484950515354555657585961626364656667…”

Section: Resultsmentioning

confidence: 99%

Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis

Allotey

Fernández

Bonet

et al. 2020

BMJ

1,914

153

2,305

View full text Add to dashboard Cite

Objective To determine the clinical manifestations, risk factors, and maternal and perinatal outcomes in pregnant and recently pregnant women with suspected or confirmed coronavirus disease 2019 (covid-19). Design Living systematic review and meta-analysis. Data sources Medline, Embase, Cochrane database, WHO COVID-19 database, China National Knowledge Infrastructure (CNKI), and Wanfang databases from 1 December 2019 to 26 June 2020, along with preprint servers, social media, and reference lists. Study selection Cohort studies reporting the rates, clinical manifestations (symptoms, laboratory and radiological findings), risk factors, and maternal and perinatal outcomes in pregnant and recently pregnant women with suspected or confirmed covid-19. Data extraction At least two researchers independently extracted the data and assessed study quality. Random effects meta-analysis was performed, with estimates pooled as odds ratios and proportions with 95% confidence intervals. All analyses will be updated regularly. Results 77 studies were included. Overall, 10% (95% confidence interval 7% to14%; 28 studies, 11 432 women) of pregnant and recently pregnant women attending or admitted to hospital for any reason were diagnosed as having suspected or confirmed covid-19. The most common clinical manifestations of covid-19 in pregnancy were fever (40%) and cough (39%). Compared with non-pregnant women of reproductive age, pregnant and recently pregnant women with covid-19 were less likely to report symptoms of fever (odds ratio 0.43, 95% confidence interval 0.22 to 0.85; I 2 =74%; 5 studies; 80 521 women) and myalgia (0.48, 0.45 to 0.51; I 2 =0%; 3 studies; 80 409 women) and were more likely to need admission to an intensive care unit (1.62, 1.33 to 1.96; I 2 =0%) and invasive ventilation (1.88, 1.36 to 2.60; I 2 =0%; 4 studies, 91 606 women). 73 pregnant women (0.1%, 26 studies, 11 580 women) with confirmed covid-19 died from any cause. Increased maternal age (1.78, 1.25 to 2.55; I 2 =9%; 4 studies; 1058 women), high body mass index (2.38, 1.67 to 3.39; I 2 =0%; 3 studies; 877 women), chronic hypertension (2.0, 1.14 to 3.48; I 2 =0%; 2 studies; 858 women), and pre-existing diabetes (2.51, 1.31 to 4.80; I 2 =12%; 2 studies; 858 women) were associated with severe covid-19 in pregnancy. Pre-existing maternal comorbidity was a risk factor for admission to an intensive care unit (4.21, 1.06 to 16.72; I 2 =0%; 2 studies; 320 women) and invasive ventilation (4.48, 1.40 to 14.37; I 2 =0%; 2 studies; 313 women). Spontaneous preterm birth rate was 6% (95% confidence interval 3% to 9%; I 2 =55%; 10 studies; 870 women) in women with covid-19. The odds of any preterm birth (3.01, 95% confidence interval 1.16 to 7.85; I 2 =1%; 2 studies; 339 women) was high in pregnant women with covid-19 compared with those without the disease. A quarter of all neonates born to mothers with covid-19 were admitted to the neonatal unit (25%) and were at increased risk of admission (odds ratio 3.13, 95% confidence interval 2.05 to 4.78, I 2 =not estimable; 1 study, 1121 neonates) than those born to mothers without covid-19. Conclusion Pregnant and recently pregnant women are less likely to manifest covid-19 related symptoms of fever and myalgia than non-pregnant women of reproductive age and are potentially more likely to need intensive care treatment for covid-19. Pre-existing comorbidities, high maternal age, and high body mass index seem to be risk factors for severe covid-19. Preterm birth rates are high in pregnant women with covid-19 than in pregnant women without the disease. Systematic review registration PROSPERO CRD42020178076. Readers’ note This article is a living systematic review that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication.

show abstract

“…27 However, these results are not consistent with the majority of studies which have reported few maternal deaths, even among severe/critical cases. 33,34,37,38,45,[47][48][49][50][51][52]…”

Section: Mortalitymentioning

confidence: 99%

Severity of COVID‐19 in pregnancy: A review of current evidence

Kucirka

Norton

Sheffield

2020

American J Rep Immunol

View full text Add to dashboard Cite

Coronavirus disease 19 (COVID-19) has recently emerged as a major threat to human health. Infections range from asymptomatic to severe (increased respiratory rate, hypoxia, significant lung involvement on imaging) or critical (multi-organ failure or dysfunction or respiratory failure requiring mechanical ventilation or high-flow nasal cannula). Current evidence suggests that pregnancy women are at increased risk of severe disease, specifically the need for hospitalization, ICU admission, and mechanical ventilation, and the already complex management of infection with an emerging pathogen may be further complicated by pregnancy. The goal of this review is to provide an overview of what is known about the clinical course of COVID-19 in pregnancy, drawing on (a) experience with other coronaviruses such as SARS and MERS, (b) knowledge of immunologic and physiologic changes in pregnancy and how these might impact infection with SARS-CoV-2, and (c) the current literature reporting outcomes in pregnant women with SARS-CoV-2. We also briefly summarize considerations in management of severe COVID-19 in pregnancy.

show abstract

Covid-19 during pregnancy: A case series from an universally tested population from the north of Portugal

Cited by 44 publications

References 4 publications

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

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

Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis

Severity of COVID‐19 in pregnancy: A review of current evidence

Contact Info

Product

Resources

About