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

Abstract

Objectives 1. To assess the performance of an extended questionnaire in identifying cases of SARS-CoV-2 infection among obstetric patients. 2. To evaluate the rate of infection among healthcare workers involved in women's care.

The experiences of childbearing women who tested positive to COVID-19 during the pandemic in northern Italy

“…Testing for COVID-19 upon woman’s hospital admission by PCR on nasopharyngeal swab was initially performed if temperature above 37.5 °C, cough or gastrointestinal issues were identified. From the 16 th of March 2020, an admission questionnaire was implemented and all women with a positive questionnaire were tested [ 9 ]. In agreement with a disposition of the Lombardy Region Health Care Authority [ 6 ], universal viral screening started on the 8 th of April 2020.…”

A Comprehensive Analysis of Maternal and Newborn Disease and Related Control for COVID-19

“…Carosso et al provided evidence that a newborn could transiently acquire the virus (viral RNA) at the time of birth via the maternal intestinal source [142]. Spread from healthcare workers and the immediate patient environment must also be considered [172,173]. The finding of viral RNA in vagina, placenta, and fetal and newborn surfaces must also be guarded as an indication of infection if actively infected mothers maintain such viral RNA in their blood which could contaminate the latter specimens.…”

“…For pregnancies as in the general population, sentinel points of SARS-CoV-2 contact are often unknown [1,26]. The development of asymptomatic infections in pregnancy is now appreciated [1,2,15,26,30,32,37,39,41,56,61,71,73,75,77,81,104,114,118,119,123,127,[173][174][175][176][177][178]. Screening for temperature on admission to healthcare settings far from guarantees that an infected mother will be detected [26,175,177].…”

“…Regular entry viral screening has its merits, but such a routine will again depend on the prevalence of disease in the community [2,15,26,32,139,173,175,[279][280][281]. In one of the latter studies, the frequency of finding viral RNA in a respiratory specimen from presenting asymptomatic patients in Spain was only 0.5%, but yet overall, including known and symptomatic presentations, 8% of pregnant mothers were infected [175].…”

“…There is also remaining concern about live virus shedding past a two week period [48,172,181]. Infection of the healthcare worker has become a major institutional dilemma in the COVID-19 era and potentially a source for infection [173,250]. The pointed use of telehealth mechanisms to follow pregnancies is just as relevant as it is for following other aspects of healthcare generally [290].…”