Corpus overview


Overview

MeSH Disease

Human Phenotype

Respiratory distress (52)

Fever (52)

Cough (43)

Pneumonia (24)

Fatigue (19)


Transmission

Seroprevalence
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    Clinical-epidemiological and treatment characteristics of children TRANS with COVID-19 in a tertiary referral center in Peru

    Authors: Christian Chiara-Chilet; Medalit Luna-Vilchez; Julio Maquera-Afaray; Blanca Salazar-Mesones; Diana Portillo-Alvarez; Ramiro Priale-Miranda; Franklin Mendoza-Torres; Aldo Munayco-Perez; Yeny Baca-Cama; Mitsi Santiago-Abad; Jose W Lopez; - Pediatric COVID-19 Working Group INSN SB; Alexandra Trkola; Jan Fehr; Milo A Puhan; Susi Kriemler; Peter Hau; Christopher Bohr; Ralph Burkhardt; Andre Gessner; Bernd Salzberger; Frank Hanses; Florian Hitzenbichler; Daniel Heudobler; Florian Lueke; Tobias Pukrop; Wolfgang Herr; Daniel Wolff; Hendrik Poeck; Christoph Brochhausen; Petra Hoffmann; Michael Rehli; Marina Kreutz; Kathrin Renner

    doi:10.1101/2020.09.18.20186866 Date: 2020-09-18 Source: medRxiv

    Introduction The COVID-19 pandemic has a great impact on children TRANS's health. This study describes the clinical, epidemiological and treatment characteristics of children TRANS presenting COVID-19 at the Instituto Nacional de Salud del Nino San Borja (INSN-SB) Methods This was a retrospective study of patients with a confirmed diagnosis of COVID-19 from March to July 2020. Demographic, clinical, laboratory, radiological, and treatment information were collected. Data analysis included descriptive statistics and bivariate analysis to determine differences between patients in general wards and the intensive care unit (ICU). Results We included 91 patients, 33 being females TRANS (36.3%). The most affected age group TRANS was children TRANS > 2 years of age TRANS (63 cases) with a median age TRANS of 6 years (IQR 3-10), and 61.5% were from Lima. The previous contact was determined in 30.8% of cases. A positive SARS CoV-2 PCR result was obtained in 50.6%. The presence of comorbidity was 53.8%. The most frequent symptoms were: fever HP (39.6%), general malaise (23.1%), cough HP (19.8%), and respiratory distress HP (14.3%). The presence of multisystem inflammatory syndrome MESHD in children TRANS (MIS-C) was confirmed in 6 patients. Antibiotics were administered in 76.9%. The most frequent radiological pattern was bilateral interstitial infiltrates (57.7%). Mortality was higher in patients in the ICU than in the hospitalization ward (27.3% vs. 4.3%, respectively; p = 0.02) Conclusions COVID-19 in children TRANS presents mild and moderate clinical manifestations. The presence of comorbidity is an important factor for hospitalization, and mortality is high upon admission to critical care units.

    Detection of SARS-CoV-2 in peritoneal fluid from patients with kidney disease MESHD and COVID-19: report of two cases

    Authors: Margarita Ibarra-Hernandez; María de la Luz Alcantar-Vallín; Rodolfo I. Cabrera-Silva; Karina Sánchez-Reyes; Monserrat Alvarez-Zavala; Judith C. De Arcos-Jiménez; Luz A. González-Hernández; Vida V. Ruiz-Herrera; Sara A. Aguirre-Díaz; Roxana García-Salcido; Guillermo García-García; Jaime F. Andrade-Villanueva

    doi:10.21203/rs.3.rs-79032/v1 Date: 2020-09-16 Source: ResearchSquare

    Background: Coronavirus disease-2019 (COVID-19) has a broad clinical presentation, involving multiple organs besides the respiratory system. Currently, there is little evidence available on the presence of severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) in peritoneal fluid (PF). In this study, we describe the detection of SARS-CoV-2 in the PF of two patients with COVID 19 and kidney disease MESHD.Case presentation: Case 1: A 71-year-old woman with a history of end-stage kidney disease MESHD who presented with a 15-day evolution of progressive dyspnea HP dyspnea MESHD, accompanied by dry cough MESHD cough HP and fever HP fever MESHD; IgM antibodies SERO to SARS-CoV-2 were detected on admission. Real-time SARS-CoV-2 polymerase chain reaction (qRT-PCR) in the PF was positive. Three days after admission the patient's respiratory distress HP improved and she was discharged after 8 days of hospitalization.Case 2: A 78-year-old woman, with type 2 diabetes MESHD, hypertension HP hypertension MESHD, a 15-day history of polypnea, and a 5-day onset of fever HP fever MESHD and dyspnea HP dyspnea MESHD. IgM and IgG antibodies SERO to SARS-CoV-2 were detected on admission, as well as a positive nasopharyngeal qRT-PCR test for SARS-CoV-2. During hospitalization she developed acute kidney injury HP acute kidney injury MESHD, requiring peritoneal dialysis, SARS-CoV-2 was confirmed in PF by qRT-PCRConclusions: These two cases highlights the importance of increasing the level of awareness for the presence and possible SARS-CoV-2 transmission TRANS through non-respiratory routes, like peritoneal fluid.Emphasis should be given to appropriate preventive strategies for minimizing the risk of transmission TRANS of COVID-19 from patients on peritoneal dialysis in both inpatient and outpatient settings.

    Respiratory Rehabilitation After Blood SERO Transfusion in a COVID-19 Patient: A Case Report

    Authors: Mohammad Javad Mousavi; Narges Obeidi; Saeed keshmiri; Farzan Azodi; Jamile Kiyani; Farhad Abbasi

    doi:10.21203/rs.3.rs-78131/v1 Date: 2020-09-15 Source: ResearchSquare

    Background: The coronavirus disease MESHD 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2), has been identified as the most crucial threat of the century. Due to severe pneumonia HP pneumonia MESHD and acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD), the SARS-CoV-2 can cause shortness of breath MESHD, hypoxemia HP hypoxemia MESHD, and the need to mechanical ventilation, intensive care unit (ICU) management, and eventual death MESHD. We have tried to use a non-invasive approach to prevent patient from needing respiratory support with invasive ventilation (IV). Here, for the first time, improvement of oxygen delivery and oxygen saturation levels were observed in a COVID-19 patient using packed red blood SERO cells (PRBCs) transfusion.Case presentation: A 63-year-old man with a history of smoking and addiction who came to our hospital facility with fever HP fever MESHD, shortness of breath MESHD and decreased blood SERO oxygen saturation. High-resolution chest CT revealed bilateral and multifocal ground-glass opacities consistent with COVID-19. Subsequently, the COVID-19 infection was confirmed TRANS infection was confirmed MESHD by real-time polymerase chain reaction (qRT-PCR) assay of the upper respiratory tract. Conclusions: Oxygen delivery and oxygen saturation improvement were observed in the COVID-19 patient, after PRBCs transfusions.

    Decrease of exercise endurance in critically ill COVID-19 survivors: 4 case reports

    Authors: Qian Geng; Xinxin Yu; Beilan Shen; Shiyue Li; Jinping Zheng; Liping Zhong; Yi Hong; Xiaoyan Huang; Qingsi Zeng; Shaoqiang Li; Feng Ye; Weijie Guan; Yanqing Xie; Nanshan Zhong; Yi Gao

    doi:10.21203/rs.3.rs-72429/v1 Date: 2020-09-04 Source: ResearchSquare

    Background: The Coronavirus Disease MESHD 2019 (COVID-19) already have been as a pandemic. However, knowledge about the sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection MESHD remains limited. Here we descirbe the pulmonary function test (PFT) and cardiopulmonary exercise test (CPET) of critically ill COVID-19 in four cases with sereve acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD) after discharge.Case presentation: We introduce four patients who complained of fever HP fever MESHD, cough HP cough MESHD, chest tightness HP chest tightness MESHD and other symptoms, all of them were confirmed as SARS-CoV-2 infection MESHD by real-time reverse transcription polymerase chain reaction (RT-PCR). They were treated with mechanical ventilation because of severe ARDS MESHD. After respiratory support, antiviral and anti-infective treatment, they were weaned from mechanic ventilation with the improvement of hypoxemia HP hypoxemia MESHD. All patients were discharged from the hospital after completion of treatment and had no mortality. Around 1-month post-discharge, they were followed up for chest computed tomography (CT) scan, and performed PFT and CPET. Peak oxygen uptake of predicted (peakVO2% pred) decreased in all four cases, although spirometry were in the normal range, and only 2 cases had mild decline in carbon monoxide diffusion capacity of predicted (DLCO%pred).Conclusions: We found reduced exercise endurance in all four COVID-19 survivors, even parts of them with normal or slightly abnormal static lung function. We also believe that exercise endurance impairment of COVID-19 convalescents is more likely affected by extrapulmonary factors. Taken the above into consideration, our study highlights that the combination of PFT and CPET are important tests for tracking the development and recovery of COVID-19 survivors.

    Resilience in Cancer Care at the Time of COVID-19: Practical Approach to the Management of Cancer MESHD Patients During the COVID-19 Emergency in a Large Italian Community Hospital

    Authors: Angioletta Lasagna; Simona Secondino; Francesco Agustoni; Teresa Monaco; Ilaria Imarisio; Anna Pagani; Gianpiero Rizzo; Richard J. Tancredi; Emma Pozzi; Elisa Ferraris; Silvia Chiellino; Chiara Gandini; Silvia G. Brugnatelli; Paolo Pedrazzoli

    doi:10.21203/rs.3.rs-64211/v1 Date: 2020-08-22 Source: ResearchSquare

    PurposeWith the emergence of coronavirus disease MESHD 2019 (COVID-19), the Oncologists have had to face the challenge of continuing active treatments without compromising the safety of our patients and healthcare personnel. Methods From February 24th, we reorganized our Oncology Unit with the introduction of a double-step triage strategy for cancer MESHD patients under treatment in order to identify patients at risk from COVID-19 and to avoid their admission to the outpatient clinic and to the inpatient ward.ResultsFrom February 24 to April 7 2020, we have performed 819 phone calls, leading to the authorization of 788 accesses (312 patients) to the outpatient clinic for active treatments. 26 patients (8.3%) with symptoms were kept at home and managed by repeated telephone calls; 23 of them were managed at home with symptomatic treatments and antibiotics and the others 3 were hospitalized for suspected COVID. At the second triage level, 5 patients weren’t admitted to the Outpatient clinic for persistent fever HP fever MESHD or respiratory distress HP respiratory distress MESHD.177 patients were admitted to the inpatient ward: none has been found to be COVID-19 positive and both outpatient and inpatient areas were still COVID-19 free. No healthcare workers became infected by SARS-CoV-2.ConclusionOur practical approach based on a simple double-step triage strategy, allows the identification of patients at risk for active COVID-19 infection MESHD, did not request neither human nor economic extra resources and appears effective, within a large community Hospital, in maintaining cancer MESHD care and therapy while protecting patients and healthcare workers from COVID-19 infection MESHD.

    Prevalence SERO and correlation of symptoms and comorbidities in COVID-19 patients: A systematic review and meta-analysis

    Authors: Mohammad Meshbahur Rahman; Badhan Bhattacharjee; Zaki Farhana; Mohammad Hamiduzzaman; Muhammad Abdul Bake Chowdhury; Mohammad Sorowar Hossain; Mahbubul H Siddiqee; Md. Ziaul Islam; Enayetur Raheem; Md. Jamal Uddin

    doi:10.1101/2020.08.19.20177980 Date: 2020-08-22 Source: medRxiv

    Background: The COVID-19 affected millions of people, and the patients present a constellation of symptoms and comorbidities. We aimed to chronicle the prevalence SERO and correlations of symptoms and comorbidities, and associated covariates among the patients. Methods: We performed a systematic review and meta-analysis [PROSPERO registration: CRD42020182677]. Databases [PubMed, SCOPUS, EMBASE, WHO, Semantic Scholar, and COVID-19 Primer] were searched for clinical studies published in English from January 1 to April 20, 2020. The pooled prevalence SERO of symptoms and comorbidities were identified using the random effect model, and sub-groups analysis of patients age TRANS and locations were investigated. A multivariable factor analysis was also performed to show the correlation among symptoms, comorbidities and age TRANS of the COVID-19 patients. Findings: Twenty-nine articles [China (24); Outside of China (5)], with 4,884 COVID-19 patients were included in this systematic review. The meta-analysis investigated 33 symptoms, where fever HP fever MESHD [84%], cough HP cough MESHD/dry cough HP [61%], and fatigue HP fatigue MESHD/weakness [42%] were found frequent. Out of 43 comorbidities investigated, acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD) [61%] was a common condition, followed by hypertension HP hypertension MESHD [23%] and diabetes MESHD [12%]. According to the patients age TRANS, the prevalence SERO of symptoms like fatigue HP fatigue MESHD/weakness, dyspnea HP dyspnea MESHD/shortness of breath, and anorexia HP anorexia MESHD were highly prevalent in older adults TRANS [[≥]50 years] than younger adults TRANS [<50 years]. Diabetes MESHD, hypertension HP hypertension MESHD, coronary heart disease MESHD, and COPD MESHD/ lung disease MESHD were more prevalent comorbidities in older adults TRANS than younger adults TRANS. The patients from outside of China had significantly higher prevalence SERO [p<0.005] of diarrhea HP diarrhea MESHD, fatigue HP fatigue MESHD, nausea HP nausea MESHD, sore throat, and dyspnea HP dyspnea MESHD, and the prevalent comorbidities in that region were diabetes MESHD, hypertension HP hypertension MESHD, coronary heart disease MESHD, and ARDS MESHD. The multivariable factor analysis showed positive association between a group of symptoms and comorbidities, and with the patients age TRANS. Interpretation: Epitomizing the correlation of symptoms of COVID-19 with comorbidities and patients age TRANS would help clinicians effectively manage the patients.

    Fighting COVID-19 spread among nursing home residents even in absence of molecular diagnosis: a retrospective cohort study.

    Authors: Alessio Strazzulla; Paul Tarteret; Maria Concetta Postorino; Marie Picque; Astrid de Pontfarcy; Nicolas Vignier; Catherine Chakvetadze; Coralie Noel; Cecile Drouin; Zine Eddine Benguerdi; Sylvain Diamantis

    doi:10.21203/rs.3.rs-51305/v1 Date: 2020-07-30 Source: ResearchSquare

    Background Access to molecular diagnosis was limited out-of-hospital in France during the 2020 coronavirus disease 2019 (COVID-19) epidemic. This study describes the evolution of COVID-19 outbreak in a nursing home in absence of molecular diagnosis. Methods A monocentric prospective study was conducted in a French nursing home from March 17th, 2020 to June 11th, 2020. Because of lack of molecular tests for severe acute respiratory syndrome 2 (SARS-Cov2) infection MESHD, probable COVID-19 cases were early identified considering only respiratory and not-respiratory symptoms and therefore preventing measures and treatments were enforced. Once available, serology tests were performed at the end of the study.A chronologic description of new cases and deaths MESHD was made together with a description of COVID-19 symptoms. Data about personal characteristics and treatments were collected and the following comparisons were performed: i) probable COVID-19 cases vs asymptomatic TRANS residents; ii) SARS-Cov2 seropositive residents vs seronegative residents. Results Overall, 32/66 (48.5%) residents and 19/39 (48.7%) members of health-care personnel were classified as probable COVID-19 cases. A total of 34/61 (55.7%) tested residents resulted seropositive. Death occurred in 4/66 (6%) residents. Diagnosis according to symptoms had 65% of sensitivity SERO, 78% of specificity, 79% of positive predictive value SERO and 64% of negative predictive value SERO.In resident population, the following symptoms were registered: 15/32 (46.8%) lymphopenia HP lymphopenia MESHD, 15/32 (46.8%) fever HP fever MESHD, 8/32 (25%) fatigue HP fatigue MESHD, 8/32 (25%) cough HP, 6/32 (18.8%) diarrhoea MESHD, 4/32 (12.5%) severe respiratory distress HP requiring oxygen therapy, 4/32 (12.5%) fall HP, 3/32 (9.4%) conjunctivitis HP conjunctivitis MESHD, 2/32 (6.3%) abnormal pulmonary noise at chest examination and 2/32 (6,25%) abdominal pain HP abdominal pain MESHD. Probable COVID-19 cases were older (81.3 vs 74.9; p=0.007) and they had higher prevalence SERO of atrial fibrillation HP atrial fibrillation MESHD (8/32, 25% vs 2/34, 12%; p=0.030); insulin treatment (4/34, 12% vs 0, 0%; p=0.033) and positive SARS-Cov2 serology (22/32, 69% vs 12/34, 35%; p=0.001) than asymptomatic TRANS residents. Seropositive residents had lower prevalence SERO of diabetes MESHD (4/34, 12% vs 9/27, 33%; p=0.041) and angiotensin-converting-enzyme inhibitors’ intake (1/34, 1% vs 5/27, 19%; p=0.042). Conclusions During SARS-Cov2 epidemic, early detection of respiratory and not-respiratory symptoms allowed to enforce extraordinary measures. They achieved limiting contagion and deaths among nursing home residents, even in absence of molecular diagnosis.

    Elevated oxygen demand in a case of COVID-19 with severe ARDS MESHD: a point for optimal oxygenation therapy including ECMO management

    Authors: Taku Oshima; Takehiko Oami; Mana Yamashiro; Akiko Higashi; Yosuke Hayashi; Natsumi Suga; Shin Takayanagi; Seiichiro Sakao; Taka-aki Nakada

    doi:10.21203/rs.3.rs-51286/v1 Date: 2020-07-30 Source: ResearchSquare

    Background: Coronavirus disease MESHD 2019 (COVID-19) caused by SARS-CoV-2 has become a global pandemic, and those developing critically ill conditions have been reported to have mortality in the range of 39% to 61%. Due to the lack of definitive treatments, mechanical ventilation and supportive oxygenation therapy are key management strategies for the survival of patients with acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD). Optimizing oxygenation therapy is mandatory to treat patients with severe respiratory failure HP respiratory failure MESHD, to sufficiently compensate for the oxygen (O2) demand. We experienced a case of severe ARDS MESHD due to COVID-19 successfully treated with extracorporeal membrane oxygenation (ECMO) after increasing oxygen delivery according to O2 consumption measurement by indirect calorimetryCase Presentation: A 29-year-old obese MESHD but otherwise healthy man was hospitalized for treatment of COVID-19 pneumonia HP pneumonia MESHD presenting with a 4-day history of persisting cough HP cough MESHD, high fever HP, and dyspnea HP dyspnea MESHD. Mechanical ventilation, nitric oxide inhalation, and prone positioning were initiated in the ICU against severe respiratory dysfunction MESHD. Indirect calorimetry on the 3rd and 6th ICU days revealed persistent elevation of oxygen consumption (VO2) of 380 mL/min. Veno-venous ECMO was initiated on the 7th ICU day after further deterioration of respiratory failure MESHD respiratory failure HP. Periodic events of SpO2 decline due to effortful breathing was not resolved by neuromuscular blockade in attempt to reduce O2 consumption. Increasing the ECMO flow induced hemolysis MESHD and hyperkalemia HP hyperkalemia MESHD despite the use of large bore cannulas and ECMO circuit free of clots and defects. The hemoglobin management level was elevated from 10 g/dL to 13 g/dL to increase blood SERO oxygen capacity, enabling the reduction of ECMO flow while attenuating respiratory effort and maintaining SpO2. Lung protective ventilation strategy and prone positioning were continued for successful weaning from ECMO on the 16th ICU day, and the ventilator on the 18th ICU day.Conclusion: The present case of severe ARDS MESHD due to COVID-19 was successfully treated with ECMO. Enhancing oxygen delivery was crucial to compensate for the elevated O2 demand. Measuring O2 consumption by indirect calorimetry can elucidate the oxygen demand for optimizing the oxygenation therapy for successful management and survival of critically ill COVID-19 patients. 

    Acute Demyelinating Encephalomyelitis MESHD ( ADEM MESHD) in COVID-19 infection: A Case Series.

    Authors: Michaela McCuddy; Praful Kelkar; Yu Zhao; David Wicklund

    doi:10.1101/2020.07.15.20126730 Date: 2020-07-17 Source: medRxiv

    Objective: To report three patients infected with COVID-19 with severe respiratory syndrome MESHD requiring intubation, who developed acute demyelinating encephalomyelitis MESHD ( ADEM MESHD). Method: Patient data were obtained from medical records from the North Memorial Health Hospital, Robbinsdale, MN, USA Results: Three patients (two men and one woman, aged TRANS 38 - 63) presented with fatigue HP fatigue MESHD, cough HP cough MESHD and fever HP fever MESHD leading to development of acute respiratory distress syndrome MESHD respiratory distress HP syndrome secondary to COVID-19 infection requiring intubation and ventilatory support. Two patients were unresponsive, one with strong eye deviation to the left and the third patient had severe diffuse weakness MESHD. MRI in all patients showed findings consistent with ADEM MESHD. CSF showed elevated protein in all patients with normal cell count and no evidence of infection MESHD, including negative COVID-19 PCR. All three of the patients received Convalescent plasma SERO therapy for COVID-19. All patients were treated with intravenous corticosteroids and improved, although two responded minimally. Two patients treated with IVIG showed no further improvement. Conclusion: Neurological complications from COVID-19 are being rapidly recognized. Our three cases highlight the occurrence of ADEM MESHD as a postinfectious/immune mediated complication of COVID-19 infection MESHD, which may be responsive to corticosteroid treatment. Early recognition of this complication and treatment is important to avoid long term complications.

    Placental SARS-CoV-2 in a patient with mild COVID-19 disease

    Authors: Albert L. Hsu; Minhui Guan; Eric Johannesen; Amanda J. Stephens; Nabila Khaleel; Nikki Kagan; Breanna C. Tuhlei; Xiu-Feng Wan

    doi:10.1101/2020.07.11.20149344 Date: 2020-07-14 Source: medRxiv

    Background: The full impact of COVID-19 on pregnancy remains uncharacterized. Current literature suggests minimal maternal, fetal, and neonatal morbidity and mortality,1 and COVID-19 manifestations appear similar between pregnant and non-pregnant women.2 We present a case of placental SARS-CoV-2 virus in a woman with an uncomplicated pregnancy and mild COVID-19 disease. Methods: A pregnant woman was evaluated at University of Missouri Women and Childrens Hospital. Institutional review board approval was obtained; information was obtained from medical records. Reverse transcriptase-polymerase chain reaction (RT-PCR) was performed to detect SARS-CoV-2. A gynecological pathologist examined the placenta and performed histolopathology. Sections were formalin-fixed and paraffin-embedded; slides were cut and subjected to hematoxylin-and-eosin or immunohistochemistry (IHC) staining. IHC was performed with specific monoclonal antibodies SERO to detect SARS-CoV-2 antigen or to identify trophoblasts. Findings: A 29 year-old multigravida presented at 40-4/7 weeks for labor induction. With myalgias HP myalgias MESHD two days prior, she tested positive for SARS-CoV-2. Her parents TRANS were in self-isolation for COVID-19 positivity; husband was asymptomatic TRANS and tested negative for COVID-19, but exposed to a workplace (meatpacking facility) outbreak. Prenatal course was uncomplicated, with no gestational hypertension HP hypertension MESHD. She was afebrile and asymptomatic TRANS with normal vital signs throughout hospitalization. Her myalgias HP myalgias MESHD improved prior to admission. A liveborn male TRANS infant was delivered vaginally. Newborn course was uneventful; he was appropriate for gestational age TRANS, physical was unremarkable, and he was discharged home at 36 hours. COVID-19 RT-PCR test was negative at 24 hours. At one-week follow-up, newborn was breastfeeding well, with no fevers HP or respiratory distress HP. Overall placental histology is consistent with acute uterine hypoxia MESHD (subchorionic laminar necrosis MESHD) superimposed on chronic uterine hypoxia MESHD (extra-villous trophoblasts and focal chronic villitis MESHD). IHC using SARS-CoV-2 nucleocapsid-specific monoclonal antibody SERO demonstrated SARS-CoV-2 antigens throughout the placenta in chorionic villi endothelial cells, and rarely in CK7-expressing trophoblasts. Negative control placenta (November 2019 delivery) and ferret nasal turbinate tissues (not shown) were negative for SARS-CoV-2. Interpretation: In this report, SARS-CoV-2 was found in the placenta, but newborn was COVID-19 negative. Our case shows maternal vascular malperfusion, with no features of fetal vascular malperfusion. To our knowledge, this is the first report of placental COVID-19 despite mild COVID-19 disease in pregnancy (with no symptoms of COVID-19 aside from myalgias HP myalgias MESHD); specifically, this patient had no fever HP fever MESHD, cough HP cough MESHD, or shortness of breath MESHD, but only myalgias HP myalgias MESHD and sick contacts. Despite her having mild COVID-19 disease in pregnancy, we demonstrate placental vasculopathy MESHD and presence of SARS-CoV-2 virus across the placenta. Evidence of placental COVID-19 raises concern for possible placental vasculopathy MESHD (potentially leading to fetal growth restriction, pre- eclampsia HP eclampsia MESHD, and other pregnancy complications) as well as for potential vertical transmission TRANS -- especially for pregnant women who may be exposed to COVID-19 in early pregnancy. Further studies are urgently needed, to determine whether women with mild, pre-symptomatic, or asymptomatic TRANS COVID-19 may have SARS-CoV-2 virus that can cross the placenta, cause fetal vascular malperfusion, and possibly affect the fetus. This raises important public health and public policy questions of whether future pregnancy guidance should include stricter pandemic precautions, such as screening for a wider array of COVID-19 symptoms, increased antenatal surveillance, and possibly routine COVID-19 testing on a regular basis throughout pregnancy.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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