Corpus overview


Overview

MeSH Disease

Human Phenotype

Fever (18)

Cough (6)

Anosmia (5)

Myalgia (4)

Chills (2)


Transmission

Seroprevalence
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    Dynamic Change of COVID-19 Seroprevalence SERO among Asymptomatic TRANS Population in Tokyo during the Second Wave

    Authors: Sawako Hibino; Kazutaka Hayashida; Andrew C Ahn; Yasutaka Hayashida; Julia Bielicki; Tim Roloff; Roland Bingisser; Christian Nickel; Nina Khanna; Sarah Tschudin; Andreas Widmer; Katharina Rentsch; Hans Pargger; Martin Siegemund; Daiana Stolz; Michael Tamm; Stefano Bassetti; Michael Osthoff; Manuel Battegay; Adrian Egli; Hans H Hirsch; Christine Goffinet; Florian Kurth; Martin Witzenrath; Maria Theresa Völker; Sarah Dorothea Müller; Uwe Gerd Liebert; Naveed Ishaque; Lars Kaderali; Leif Erik Sander; Sven Laudi; Christian Drosten; Roland Eils; Christian Conrad; Ulf Landmesser; Irina Lehmann

    doi:10.1101/2020.09.21.20198796 Date: 2020-09-23 Source: medRxiv

    Importance: Fatality rates related to COVID-19 in Japan have been low compared to Western Countries and have decreased despite the absence of lockdown. Serological tests SERO monitored across the course of the second wave can provide insights into the population-level prevalence SERO and dynamic patterns of COVID-19 infection MESHD. Objective: To assess changes in COVID-19 seroprevalence SERO among asymptomatic TRANS employees working in Tokyo during the second wave. Design: We conducted an observational cohort study. Healthy volunteers working for a Japanese company in Tokyo were enrolled from disparate locations to determine seropositivity against COVID19 from May 26 to August 25, 2020. COVID-19 IgM and IgG antibodies SERO were determined by a rapid COVID19 IgM/IgG test kit using fingertip blood SERO. Across the company, tests were performed and acquired weekly. For each participant, serology tests were offered twice, separated by approximately a month, to provide self-reference of test results and to assess for seroconversion and seroreversion. Setting: Workplace setting within a large company. Participants: Healthy volunteers from 1877 employees of a large Japanese company were recruited to the study from 11 disparate locations across Tokyo. Participants having fever HP fever MESHD, cough HP cough MESHD, or shortness of breath MESHD at the time of testing were excluded. Main Outcome(s) and Measure(s): Seropositivity rate (SPR) was calculated by pooled data from each two-weeks window across the cohort. Either IgM or IgG positivity was defined as seropositive. Changes in immunological status against SARS-CoV-2 were determined by comparing results between two tests obtained from the same individual. Results: Six hundred fifteen healthy volunteers (mean + SD 40.8 + 10.0; range 19-69; 45.7 % female TRANS) received at least one test. Seroprevalence SERO increased from 5.8 % to 46.8 % over the course of the summer. The most dramatic increase in SPR occurred in late June and early July, paralleling the rise in daily confirmed cases TRANS within Tokyo, which peaked on August 4. Out of the 350 individuals (mean + SD 42.5 + 10.0; range 19-69; 46.0 % female TRANS) who completed both offered tests, 21.4 % of those individuals who tested seronegative became seropositive and seroreversion was found in 12.2 % of initially seropositive participants. 81.1% of IgM positive cases at first testing became IgM negative in approximately one month. Conclusions and Relevance: COVID-19 infection MESHD may have spread widely across the general population of Tokyo despite the very low fatality rate. Given the temporal correlation between the rise in seropositivity and the decrease in reported COVID-19 cases that occurred without a shut-down, herd immunity may be implicated. Sequential testing for serological SERO response against COVID-19 is useful for understanding the dynamics of COVID-19 infection at the population-level.

    Seroprevalence SERO and correlates of SARS-CoV-2 neutralizing antibodies SERO: Results from a population-based study in Bonn, Germany

    Authors: N. Ahmad Aziz; Victor M Corman; Antje K.C. Echterhoff; Anja Richter; Antonio Schmandke; Marie Luisa Schmidt; Thomas H. Schmidt; Folgerdiena M De Vries; Christian Drosten; Monique M.B. Breteler; Charles E Murry; Michel C Nussenzweig; Anthony P West; Pamela J Bjorkman; Tong Jin; Chengmin Shi; Zhenglin Du; Yadong Zhang; Chuandong Liu; Rujiao Li; Jingyao Zeng; Lili Hao; Shuai Jiang; Hua Chen; Dali Han; Jingfa Xiao; Zhang Zhang; Wenming Zhao; Yongbiao Xue; Yiming Bao; Valerie Mioulet; Joseph Newman; Amin S Asfor; Alison Burman; Sylvia Crossley; John Hammond; Elma Tchilian; Bryan Charleston; Dalan Bailey; Tobias J Tuthill; Simon Graham; Tomas Malinauskas; Jiandong Huo; Julia Tree; Karen Buttigieg; Ray Owens; Miles Carroll; Rod Daniels; John McCauley; Kuan-Ying A Huang; Mark Howarth; Alain Townsend

    doi:10.1101/2020.08.24.20181206 Date: 2020-08-29 Source: medRxiv

    Background Accurate estimates of SARS-CoV-2 seroprevalence SERO are crucial for the implementation of effective public health measures, but are currently largely lacking in regions with low infection rates. This is further complicated by inadequate test performance SERO of many widely used serological assays SERO. We therefore aimed to assess SARS-CoV-2 seroprevalence SERO in a region with low COVID-19 burden, especially focusing on neutralizing antibodies SERO that presumably constitute a major component of acquired immunity. Methods We invited all individuals who were enrolled in the Rhineland Study, an ongoing community-based prospective cohort study in people aged TRANS 30 years and above in the city of Bonn, Germany (N=5427). Between April 24th and June 30th, 2020, 4771 (88%) of these individuals participated in the serosurvey. Anti-SARS-CoV-2 IgG levels were measured using an ELISA assay SERO, and all positive or borderline results were subsequently examined through both a recombinant immunofluorescent assay and a plaque reduction neutralisation test (PRNT). Findings Seroprevalence SERO was 0.97% (95% CI: 0.72-1.30) by ELISA SERO and 0.36% (95% CI: 0.21-0.61) by PRNT, and did not vary with either age TRANS or sex. All PRNT+ individuals reported having experienced at least one symptom (odds ratio (OR) of PRNT+ for each additional symptom: 1.12 (95% CI: 1.04-1.21)). Apart from living in a household with a SARS-CoV-2 confirmed or suspected person, a recent history of reduced taste or smell, fever HP, chills HP/ hot flashes HP, pain HP while breathing, pain HP in arms/legs, as well as muscle pain HP and weakness were significantly associated with the presence of neutralizing antibodies SERO in those with mild to moderate infection (ORs 3.44 to 9.97, all p<0.018). Interpretation Our findings indicate a relatively low SARS-CoV-2 seroprevalence SERO in Bonn, Germany (until June 30th, 2020), with neutralizing antibodies SERO detectable in only one third of those with a positive immunoassay SERO result, implying that almost the entire population in this region remains susceptible to SARS-CoV-2 infection.

    Coinfection with SARS-CoV-2 and dengue virus: a case report

    Authors: Prasetyo Hariadi; Dewi Lokida; Adhella M Naysilla; Nurhayati Lukman; Herman Kosasih; Yan Mardian; Gestana Andru; Inggar Pertiwi; Retna I Sugiyono; Antonius A Pradana; Gustiani Salim; Deni P Butar-butar; Chuen-Yen Lau; Muhammad Karyana

    doi:10.21203/rs.3.rs-63867/v1 Date: 2020-08-21 Source: ResearchSquare

    Background: Since its emergence in China, SARS-CoV-2 has infected more than 15.5 million people worldwide, including in regions where dengue virus (DENV) is hyperendemic such as Latin America and Southeast Asia, including Indonesia. Hence, anticipation for simultaneous infection by DENV and SARS-CoV-2 has been raised.Case presentation: We describe a 68-year-old woman with diabetes mellitus type II HP diabetes mellitus type II MESHD who was admitted to the Tangerang District Hospital on 14 April 2020. She lived in a neighborhood where a few people were contracting dengue fever HP fever MESHD. She presented with five days of fever HP fever MESHD, malaise MESHD, anorexia HP anorexia MESHD, nausea HP nausea MESHD, myalgia HP myalgia MESHD, and arthralgia HP arthralgia MESHD. Hematology results revealed anemia HP anemia MESHD, thrombocytopenia HP thrombocytopenia MESHD, normal leukocyte count, increased neutrophil proportion, and decreased lymphocyte proportion and absolute lymphocyte. Her chest X-ray showed right pericardial infiltrates. Although dengue was clinically suspected, as she met COVID-19 screening criteria, she was also tested for SARS-CoV-2 infection MESHD. The patient was treated with ceftriaxone, paracetamol, azithromycin, oseltamivir, and chloroquine. She was clinically improved four days later and was discharged from the hospital on 25 April 2020 after SARS-CoV-2 rRT-PCR was negative on two consecutive samples. Dengue was diagnosed retrospectively based on sero-conversion of dengue IgM and a very high dengue IgG index (Focus Diagnostics®, ELISA SERO), and sero-conversion of dengue IgM and positive IgG (PanBio ®Dengue duo cassette), which was equivalent to high hemagglutination inhibition antibody SERO titer found in secondary dengue infection MESHD.Conclusion: The overlapping clinical presentations of COVID-19 and dengue; limited diagnostic capacity of laboratories in resource constrained settings; and complexities of interpreting results make identification of COVID-19 in the dengue endemic setting challenging. Clinicians in endemic areas must maintain a high index of suspicion for the possibility of COVID-19 coinfection with DENV and other tropical pathogens.

    High prevalence SERO of symptoms among Brazilian subjects with antibodies SERO against SARS-CoV-2: a nationwide household survey

    Authors: Ana Maria Baptista Menezes; Cesar G Victora; Fernando P Hartwig; Mariangela F Silveira; Bernardo L Horta; Aluisio J D Barros; Fernando C Whermeister; Marilia A Mesenburg; Lucia C Pellanda; Odir A Dellagostin; Claudio J Struchiner; Marcelo N Burattini; Fernando C Barros; Pedro C Hallal

    doi:10.1101/2020.08.10.20171942 Date: 2020-08-12 Source: medRxiv

    Since the beginning of the pandemic of COVID-19, there has been a widespread assumption that most infected persons are asymptomatic TRANS. A frequently-cited early study from China suggested that 86% of all infections MESHD were undocumented, which was used as indirect evidence that patients were asymptomatic TRANS. Using data from the most recent wave of the EPICOVID19 study, a nationwide household-based survey including 133 cities from all states of Brazil, we estimated the proportion of people with and without antibodies for SARS-CoV-2 SERO who were asymptomatic TRANS, which symptoms were most frequently reported, the number of symptoms reported and the association between symptomatology and socio-demographic characteristics. We were able to test 33,205 subjects using a rapid antibody test SERO that was previously validated. Information on symptoms was collected before participants received the test result. Out of 849 (2.7%) participants who tested positive for SARS-CoV-2 antibodies SERO, only 12.1% (95%CI 10.1-14.5) reported no symptoms since the start of the pandemic, compared to 42.2% (95%CI 41.7-42.8) among those who tested negative. The largest difference between the two groups was observed for changes in smell or taste (56.5% versus 9.1%, a 6.2-fold difference). Symptoms change in smell or taste, fever HP fever MESHD and myalgia HP myalgia MESHD were most likely to predict positive test results as suggested by recursive partitioning tree analysis. Among individuals without any of these three symptoms (74.2% of the sample), only 0.8% tested positive, compared to 18.3% of those with both fever HP fever MESHD and changes in smell or taste. Most subjects with antibodies SERO against SARS-CoV-2 in Brazil are symptomatic, even though most present only mild symptoms.

    Clinical Correlates of Early IgG Response in Patients with Mild COVID-19

    Authors: Asa Kessler; Ariel Kenig; Henny Azmanov; Ram Gelman; Noa Hurvitz; Itay Perets; Esther Oiknine-Djian; Tali Bdolah-Abram; Orly Zelig; Zeev Rotstein; Yaron Ilan; Dana G. Wolf

    doi:10.21203/rs.3.rs-56853/v1 Date: 2020-08-10 Source: ResearchSquare

    Background: We determined the temporal pattern of early SARS-CoV-2 IgG response in patients with mild COVID-19, and sought to identify predictive clinical and laboratory features. Methods:  Serum samples were prospectively obtained from 111 convalescent COVID-19 patients, staying in dedicated Isolation–hotels, and tested for the presence of SARS-CoV-2 IgG by anti-S1 protein ELISA SERO.Results: SARS-CoV-2 IgG was detected in 78 (70.3%) patients tested within the first month from diagnosis. While highly variable between patients, the rate of antibody SERO detection generally increased with time, from 47.1% to 93.8% at the first and fourth weeks from diagnosis, respectively, with the largest shift observed between the second and third week. Notably, the presence of more profound symptoms at presentation, namely, fever HP fever MESHD and chills HP, positively and independently correlated with early antibody SERO response. IgG-positive patients had higher ferritin levels (p=0.039). Older age TRANS (p<0.001) and increased CRP levels (p=0.001) were associated with higher SARS-CoV-2 IgG levels. Conclusions: The identified temporal pattern along with the correlation between inflammation MESHD-related clinical and laboratory parameters and early IgG response in patients with mild COVID-19, could provide a basis for better prediction and understating of the immune response to SARS-CoV-2, and inform therapeutic donor- plasma SERO selection.  

    SARS-CoV-2 Seroprevalence SERO Across a Diverse Cohort of Healthcare Workers

    Authors: Joseph Ebinger; Gregory J. Botwin; Christine M. Albert; Mona Alotaibi; Moshe Arditi; Anders H. Berg; Aleksandra Binek; Patrick G. Botting; Justyna Fert-Bober; Jane C. Figueiredo; Jonathan D. Grein; Wohaib Hasan; Mir Henglin; Shehnaz K. Hussain; Mohit Jain; Sandy Joung; Michael Karin; Elizabeth H Kim; Dalin Li; Yunxian Liu; Eric Luong; Dermot P.B. McGovern; Akil Merchant; Noah M. Merin; Peggy B. Miles; Margo Minissian; Trevor-Trung Nguyen; Koen Raedschelders; Mohamad A. Rashid; Celine E. Riera; Richard V. Riggs; Sonia Sharma; Sarah Sternbach; Nancy Sun; Warren G. Tourtellotte; Jennifer E. Van Eyk; Kimia Sobhani; Jonathan G. Braun; Susan Cheng

    doi:10.1101/2020.07.31.20163055 Date: 2020-08-04 Source: medRxiv

    Importance: Antibody testing SERO is important for understanding patterns of exposure and potential immunity to SARS-CoV-2. Prior data on seroprevalence SERO have been subject to variations in selection of individuals and nature as well as timing of testing in relation to exposures. Objective: We sought to determine the extent of SARS-CoV-2 seroprevalance and the factors associated with seroprevelance across a diverse cohort of healthcare workers. Design: Observational cohort study of healthcare workers, including SARS-CoV-2 serology testing and participant questionaires. Participants: A diverse and unselected population of adults TRANS (n=6,062) employed in a multi-site healthcare delivery system located in Los Angeles County, including individuals with direct patient contact and others with non-patient-oriented work functions. Exposure: Exposure and infection MESHD with the SARS-CoV-2 virus, as determined by seropositivity. Main Outcomes: Using Bayesian and multi-variate analyses, we estimated seroprevalence SERO and factors associated with seropositivity and antibody SERO titers, including pre-existing demographic and clinical characteristics; potential Covid-19 illness related exposures; and, symptoms consistent with Covid-19 infection MESHD. Results: We observed a seroprevalence SERO rate of 4.1%, with anosmia HP anosmia MESHD as the most prominently associated self-reported symptom in addition to fever HP fever MESHD, dry cough MESHD cough HP, anorexia HP anorexia MESHD, and myalgias HP myalgias MESHD. After adjusting for potential confounders, pre-existing medical conditions were not associated with antibody SERO positivity. However, seroprevalence SERO was associated with younger age TRANS, Hispanic ethnicity, and African-American race, as well as presence of either a personal or household member having a prior diagnosis of Covid-19. Importantly, African American race and Hispanic ethnicity were associated with antibody SERO positivity even after adjusting for personal Covid-19 diagnosis status, suggesting the contribution of unmeasured structural or societally factors. Notably, number of people, or children TRANS, in the home was not associated with antibody SERO positivity. Conclusion and Relevance: The demographic factors associated with SARS-CoV-2 seroprevalence SERO among our healthcare workers underscore the importance of exposure sources beyond the workplace. The size and diversity of our study population, combined with robust survey and modeling techniques, provide a vibrant picture of the demographic factors, exposures, and symptoms that can identify individuals with susceptibility as well as potential to mount an immune response to Covid-19.

    Estimates of the rate of infection MESHD and asymptomatic TRANS COVID-19 disease in a population sample from SE England

    Authors: Philippa M Wells; Katie M Doores; Simon Couvreur; Rocio Martin Martinez; Jeffrey Seow; Carl Graham; Sam Acors; Neophytos Kouphou; Stuart Neil; Richard Tedder; Pedro Matos; Kate Poulton; Maria Jose Lista; Ruth Dickenson; Helin Sertkaya; Thomas Maguire; Edward Scourfield; Ruth Bowyer; Deborah Hart; Aoife O'Byrne; Kathryn Steele; Oliver Hemmings; Carolina Rosadas; Myra McClure; Joan Capedevila-Pujol; Jonathan wolf; Sebastien Ourseilin; Matthew Brown; Michael Malim; Timothy Spector; Claire Steves

    doi:10.1101/2020.07.29.20162701 Date: 2020-07-30 Source: medRxiv

    Background: Understanding of the true asymptomatic TRANS rate of infection of SARS-CoV-2 MESHD is currently limited, as is understanding of the population-based seroprevalence SERO after the first wave of COVID-19 within the UK. The majority of data thus far come from hospitalised patients, with little focus on general population cases, or their symptoms. Methods: We undertook enzyme linked immunosorbent assay SERO characterisation of IgM and IgG responses against SARS-CoV-2 spike glycoprotein and nucleocapsid protein of 431 unselected general-population participants of the TwinsUK cohort from South-East England, aged TRANS 19-86 (median age TRANS 48; 85% female TRANS). 382 participants completed prospective logging of 14 COVID-19 related symptoms via the COVID Symptom Study App, allowing consideration of serology alongside individual symptoms, and a predictive algorithm for estimated COVID-19 previously modelled on PCR positive individuals from a dataset of over 2 million. Findings: We demonstrated a seroprevalence SERO of 12% (51participants of 431). Of 48 seropositive individuals with full symptom data, nine (19%) were fully asymptomatic TRANS, and 16 (27%) were asymptomatic TRANS for core COVID-19 symptoms: fever HP fever MESHD, cough HP cough MESHD or anosmia HP anosmia MESHD. Specificity of anosmia HP anosmia MESHD for seropositivity was 95%, compared to 88% for fever HP fever MESHD cough HP and anosmia HP anosmia MESHD combined. 34 individuals in the cohort were predicted to be Covid-19 positive using the App algorithm, and of those, 18 (52%) were seropositive. Interpretation: Seroprevalence SERO amongst adults TRANS from London and South-East England was 12%, and 19% of seropositive individuals with prospective symptom logging were fully asymptomatic TRANS throughout the study. Anosmia HP demonstrated the highest symptom specificity for SARS-CoV-2 antibody SERO response. Funding: NIHR BRC, CDRF, ZOE global LTD, RST-UKRI/MRC

    Unusual Presentation of Kawasaki Disease MESHD with Multisystem Inflammation MESHD and Antibodies SERO Against Severe Acute Respiratory Syndrome MESHD Coronavirus 2: A Case Report

    Authors: Haena Kim; Jung Yeon Shim; Jae-Hoon Ko; Aram Yang; Jae Won Shim; Deok Soo Kim; Hye Lim Jung; Ji Hee Kwak; In Suk Sol

    doi:10.21203/rs.3.rs-41276/v1 Date: 2020-07-12 Source: ResearchSquare

    Background: Since mid-April 2020, cases of multisystem inflammatory syndrome MESHD in children TRANS (MIS-C) associated with coronavirus disease MESHD (COVID-19) that mimic Kawasaki disease MESHD ( KD MESHD) have been reported in Europe and North America. However, no cases have been in East Asia, where KD MESHD is more prevalent.Case presentation: A previously healthy 11-year-old boy was admitted with a 4-day history of fever HP fever MESHD and abdominal pain HP abdominal pain MESHD. He had no contact history to any patient with COVID-19. Blood SERO acute inflammatory markers were highly elevated. He was treated with antibiotics for suspected bacterial enteritis MESHD, but he suddenly developed hypotension HP hypotension MESHD. Inotropics and intravenous immunoglobulin were administered to manage septic shock MESHD shock HP. On hospitalization day 6, he developed signs and symptoms of KD MESHD (conjunctival injection, strawberry tongue HP, cracked lip MESHD, and coronary artery dilatation MESHD dilatation HP) in addition to pleural/pericardial effusion MESHD pericardial effusion HP and mesenteric lymphadenitis HP lymphadenitis MESHD. The results of microbiologic tests, including reverse-transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2), were negative. Fluorescent immunoassay SERO and enzyme-linked immunosorbent assay SERO revealed abundant IgG antibodies SERO against SARS-CoV-2 in his serum SERO, but no IgM antibodies SERO. He was discharged successfully on day 13.Conclusion: MIS-C may occur in children TRANS with a previously asymptomatic TRANS COVID-19 infection MESHD. A high index of suspicion is required for this novel syndrome in unusual cases of KD MESHD or KD shock syndrome MESHD shock HP syndrome with multisystem inflammation MESHD, even when there is no clear history of contact or symptoms of COVID-19.

    Joint Detection of Serum SERO IgM/IgG Antibody SERO is An Important Key to Clinical Diagnosis of SARS-COV-2 Infection

    Authors: Fang Hu; Xiaoling Shang; Meizhou Chen; Changliang Zhang

    doi:10.1101/2020.07.07.20146902 Date: 2020-07-08 Source: medRxiv

    Background: This study was aimed to investigate the application of SARS- COV-2 IgM and IgG antibodies SERO in diagnosis of COVID-19 infection MESHD. Method: This study enrolled a total of 178 patients at Huangshi Central Hospital from January to February, 2020. Among them, 68 patients were SARS-COV-2 infected MESHD confirmed with nucleic acid test (NAT) and CT imaging. 9 patients were in the suspected group (NAT negative) with fever HP fever MESHD and other respiratory symptoms. 101 patients were in the control group with other diseases and negative to SARS-COV-2 infection MESHD. After serum samples SERO were collected, SARS-COV-2 IgG and IgM antibodies were tested SERO by chemiluminescence immunoassay SERO (CLIA) for all patients. Results: The specificity of serum SERO IgM and IgG antibodies SERO to SARS-COV-2 were 99.01% (100/101) and 96.04% (97/101) respectively, and the sensitivity SERO were 88.24% (60/68) and 97.06% (66/68) respectively. The combined detection rate of SARS-COV-2 IgM and IgG antibodies SERO were 98.53% (67/68). Conclusion: Combined detection of serum SERO SARS-COV-2 IgM and IgG antibodies SERO had better sensitivity SERO compared with single IgM or IgG test, which can be used as an important diagnostic tool for SARS-COV-2 infection MESHD and a screening tool of potential SARS-COV-2 carriers TRANS in clinics, hospitals and accredited scientific laboratory.

    SEROPREVALENCE SERO AND CLINICAL SPECTRUM OF SARS-CoV-2 INFECTION IN MESHD THE FIRST VERSUS THIRD TRIMESTER OF PREGNANCY

    Authors: Francesca Crovetto; Fatima Crispi; Elisa Llurba; Francesc Figueras; Maria Dolores Gomez-Roig; Eduard Gratacos

    doi:10.1101/2020.06.17.20134098 Date: 2020-06-19 Source: medRxiv

    Introduction: Case registries of pregnant women diagnosed with coronavirus disease MESHD (COVID-19) by polymerase chain reaction (PCR) have reported that the majority experienced mild infection MESHD, but up to 9% may require critical care. Most COVID-19 cases published were in the third trimester of pregnancy, which could reflect reporting bias, higher risk of infection TRANS risk of infection TRANS infection MESHD or increased disease severity in late pregnancy. Seroprevalence SERO studies may allow reliable estimates of the susceptibility to infection MESHD and clinical spectrum since they include asymptomatic TRANS and mild infections not tested for PCR. We evaluated the seroprevalence SERO and clinical presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection MESHD in pregnant women in the first and third trimester. Methods: The study was approved by the Institutional Review Board at each institution and informed consent was obtained. We recruited 874 consecutive pregnancies attending for first trimester screening (10-16 weeks of gestation, n=372) or delivery (n=502) from April 14 to May 5. All women were interviewed with a structured questionnaire for COVID-19 symptoms two months prior to sampling. SARS-CoV-2 IgG and IgM/IgA antibodies were tested SERO (COVID-19 VIRCLIA Monotest, Vircell Microbiologist, Spain; reported sensitivity SERO 70% IgG and 89% IgM/IgA, and specificity 89% and 99% respectively). Indeterminate results were re-tested (VITROS Immunodiagnostic Products Anti-SARS-CoV2 Total Tests, Ortho Clinical Diagnostics, USA; 100% sensitivity SERO and specificity) and re-classified as positive or negative. Women with COVID-19 were diagnosed and managed according to standard protocols and guidelines3,4. Statistical differences were tested using the {chi}2 test or Student t-test as appropriate (p<0.05). Results: A total of 125 of 874 women (14.3%) were positive for either IgG or IgM/IgA SARS-CoV-2 antibodies SERO, 54/372 (14.5%) in the first and 71/502 (14.1%) in the third trimester. A total of 75/125 (60%) reported no symptoms of COVID-19 in the past 2 months, whereas 44 (35.2%) reported one or more symptoms, of which 31 (24.8%) had at least 3 symptoms or anosmia HP anosmia MESHD and 8 (6.4%) dyspnea HP dyspnea MESHD. Overall, 7 women (5.6%) were admitted for persistent fever HP fever MESHD despite paracetamol and dyspnea HP dyspnea MESHD, of which 3 had signs of pneumonia HP pneumonia MESHD on chest radiography. All 3 had criteria for severity (bilateral chest condensation, respiratory rate>30 and leukopenia HP leukopenia MESHD) and required oxygen support but not critical care or mechanical ventilation, and they were all discharged well. The rates of symptomatic infection MESHD, hospital admission or dyspnea HP dyspnea MESHD were significantly higher in third trimester women (Table and Figure). Discussion: The 14.3% seroprevalence SERO of SARS-COV-2 in pregnant women in this study was substantially larger than the contemporary rates of PCR positive cases (0.78%) reported for women 20-40y in Barcelona. The data confirm that COVID-19 is asymptomatic TRANS in the majority of pregnant women6 and illustrate the value of seroprevalence SERO studies to capture the high proportion of asymptomatic TRANS or mild infections MESHD. In this study, none of the 125 pregnant women with SARS-CoV-2 infection MESHD required critical care as compared to 9% reported in cases diagnosed with PCR. However, the proportion of infections MESHD with symptoms or dyspnea HP dyspnea MESHD was remarkably higher in the third trimester, and these results are in line with COVID-19 registries, reporting that 81% of hospitalized women were in late pregnancy or peripartum. These results provide reassuring information that, even in settings with a high prevalence SERO, SARS-CoV-2 infection MESHD in pregnancy mostly presents with asymptomatic TRANS or mild clinical forms. The susceptibility to infection seemed to be the same in the first and the third trimesters of gestation. The data further suggest that, as with other respiratory viruses, COVID-19 could be more severe and require increased surveillance in late pregnancy. These findings should be confirmed and extended with larger consecutive prevalence SERO studies in pregnancy.

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Human Phenotype
Transmission
Seroprevalence


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