Radiological findings and clinical characteristics of pregnant women with COVID‐19 pneumonia

Abstract

Objective:To study chest CT images and clinical characteristics of COVID-19 pneumonia in pregnant patients to examine any correlation.Methods: Between December 31, 2019 and March 7, 2020, 23 hospitalized pregnant patients with confirmed COVID-19 were enrolled in the study. Clinical presentations were collected retrospectively from records, including laboratory testing, chest CT imaging, and symptoms. Descriptive analysis and correlation of patients' clinical and CT characteristics were performed. Laboratory results from time of first admission and CT absorption (defined as reduction in lesion area, decrease in density, and absorption of some solid components) were compared between symptomatic and asymptomatic patients.Results: Fifteen (65.2%) patients were asymptomatic with patchy ground-glass opacity in a single lung lobe. Eight (34.8%) patients were symptomatic with multiple patchy ground-glass shadows, consolidation, and fibrous stripes. Differences in lymphocyte percentage and neutrophil granulocyte rate between first admission and CT absorption were significant (P<0.001). Median absorption time was shorter in the asymptomatic group compared with the symptomatic group (5 vs 10 days; P<0.001). Median hospitalization time between asymptomatic and symptomatic patients was 14 vs 25.5 days;P>0.001. Median absorption time and length of hospitalization for all patients was 6 days (IQR 5-8) and 17 days (IQR 13-25), respectively. Conclusion: Radiological findings and clinical characteristics in pregnant women withCOVID-19 were similar to those of non-pregnant women with COVID-19. Median absorption time and length of hospitalization in asymptomatic patients were significantly shorter than in symptomatic patients. Lymphocyte percentage and neutrophil granulocyte rate may be used as laboratory indicators of CT absorption. K E Y W O R D S

Clinical characteristics, prognostic factors, and maternal and neonatal outcomes of SARS‐CoV‐2 infection among hospitalized pregnant women: A systematic review

“…Four women presented with reduced fetal movements and three with prepartum hemorrhage. Notably, 68 (10.7%) women in 10 studies were asymptomatic on admission 4,5,12,13,21,37,41,53,55,64 …”

“…Chest imaging findings were reported in 42 studies (n=274 women), and comprised 267 computed tomography (CT) scans of the chest, 15 plain chest X‐rays, and 5 CT pulmonary angiogram (CTPA) examinations 4,5,9–11,13,15–17,22–30,33–37,39–41,44,45,49–51,53,57–60,62–66 . In 26 studies, totaling 221 women from China with mild COVID‐19, 196 (88.7%) had abnormal chest CT and X‐ray findings, of whom 17 (8.7%) were asymptomatic at the time of radiologic evaluation 4,5,9–11,13,16,29,34–37,40,41,44,45,49–51,53,57‐60,62–64 . Abnormal pulmonary findings among pregnant women with mild disease included focal unilateral or bilateral ground glass opacities, whereas diffuse, bilateral ground glass opacities with subpleural involvement and pleural effusion were observed among all women with severe and critical COVID‐19.…”

COVID-19 and Neonatal Respiratory Care: Current Evidence and Practical Approach

“…Both infants rapidly improved and did not require respiratory support. In the last case, 23 a preterm infant (31 2/7 weeks' gestation) born by caesarean section for fetal distress had low Apgar's scores, developed respiratory distress syndrome requiring noninvasive support, and later developed 22 Chen Y et al, 3 Li et al, 12 Wang et al, 27 Wu et al, 19 bacteremia and coagulopathy. Testing for SARS-CoV-2 also was positive at approximately 48 hours after birth.…”

“…As of April 12, 2020, the World Health Organization (WHO) had reported nearly 1.7 million people, including thousands of health care workers (HCW), infected with novel coronavirus disease 2019 (COVID- 19) worldwide. In response to the pandemic, hospitals have quickly ramped up efforts to develop and implement guidelines and protocols.…”

Clinical features and outcomes of pregnant women with COVID-19: a systematic review and meta-analysis

“…After removing 248 duplicate documents, 82 papers were deemed ineligible after title and abstract screening, and 22 papers were excluded after further screening through full-text reading. After the exclusion of all the 352 unqualified studies, a total of 14 retrospective case analyses were included in this meta-analysis (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) . The process of study selection is illustrated in Figure 1.…”