Corpus overview


Overview

MeSH Disease

Human Phenotype

Cough (3)

Fever (2)

Dyspnea (2)

Eclampsia (2)

Overweight (1)


Transmission

Seroprevalence
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    Early indirect impact of COVID-19 pandemic on utilization and outcomes of reproductive, maternal, newborn, child TRANS and adolescent health services in Kenya

    Authors: DUNCAN N SHIKUKU; Irene Nyaoke; Sylvia Gichuru; Onesmus Maina; Martin Eyinda; Pamela Godia; Lucy Nyaga; Charles Ameh; Enio Garcia; Alicia Lawrynowicz; Osvaldo Uez; Irene Pagano; Anastasija Caica; Mikus Gavars; Dmitrijs Perminovs; Jelena Storozenko; Oksana Savicka; Elina Dimina; Uga Dumpis; Janis Klovins

    doi:10.1101/2020.09.09.20191247 Date: 2020-09-09 Source: medRxiv

    Background: The COVID-19 global pandemic is expected to result in 8.3-38.6% additional maternal deaths in many low-income countries. The objective of this paper was to determine the initial impact of COVID-19 pandemic on reproductive, maternal, newborn, child TRANS and adolescent health (RMNCAH) services in Kenya. Methods: Data for the first four months (March-June) of the pandemic and the equivalent period in 2019 were extracted from Kenya Health Information System. Two-sample test of proportions for hospital attendance for select RMNCAH services between the two periods were computed. Results: There were no differences in monthly mean ({+/-}SD) attendance between March-June 2019 vs 2020 for antenatal care (400,191.2{+/-}12,700.0 vs 384,697.3{+/-}20,838.6), hospital births (98,713.0{+/-}4,117.0 vs 99,634.5{+/-}3,215.5), family planning attendance (431,930.5{+/-}19,059.9 vs 448,168.3{+/-}31,559.8), post-abortion care (3,206.5{+/-}111.7 vs 448,168.3{+/-}31,559.8) and pentavalent 1 immunisation (114,701.0{+/-}3,701.1 vs 110,915.8{+/-}7,209.4), p>0.05. However, there were increasing trends for adolescent pregnancy rate, significant increases in FP utilization among young people (25.7% to 27.0%), injectable (short-term) FP method uptake (58.2% to 62.3%), caesarean section rate (14.6% to 15.8%), adolescent maternal deaths MESHD (6.2% to 10.9%) and fresh stillbirths (0.9% to 1.0%) with a reduction in implants (long-term) uptake (16.5% to 13.0%) (p<0.05). No significant change in maternal mortality ratio between the two periods (96.6 vs 105.8/100,000 live births, p=0.1023) although the trend was increasing. Conclusion: COVID-19 may have contributed to increased adolescent pregnancy, adolescent maternal death MESHD and stillbirth MESHD rates in Kenya. If this trend persists, recent gains achieved in maternal and perinatal health in Kenya will be lost. With uncertainty around the duration of the pandemic, strategies to mitigate against catastrophic indirect maternal health outcomes are urgently needed. Key words: COVID-19, maternal, reproductive, stillbirths, family planning, adolescent, mortality, Kenya.

    SARS-CoV-2 (COVID-19) infection MESHD in pregnant women: characterization of symptoms and syndromes predictive of disease and severity through real-time, remote participatory epidemiology.

    Authors: Erika Molteni; Christina M Astley; Wenjie Ma; Carole Helene Sudre; Laura A Magee; Benjamin Murray; Tove Fall; Maria F Gomez; Neli Tsereteli; Paul W Franks; John S Brownstein; Richard Davies; Jonathan Wolf; Timothy Spector; Sebastien Ourselin; Claire Steves; Andrew T Chan; Marc Modat; Xuan Ding; Chunhui Yuan; Li Peng; Wei Liu; Xiao Yi; Mengge Lyu; Guixiang Xiao; Xia Xu; Weigang Ge; Jiale He; Jun Fan; Junhua Wu; Meng Luo; Xiaona Chang; Huaxiong Pan; Xue Cai; Junjie Zhou; Jing Yu; Huanhuan Gao; Mingxing Xie; Sihua Wang; Guan Ruan; Hao Chen; Hua Su; Heng Mei; Danju Luo; Dashi Zhao; Fei Xu; Yan Li; Yi Zhu; Jiahong Xia; Yu Hu; Tiannan Guo

    doi:10.1101/2020.08.17.20161760 Date: 2020-08-19 Source: medRxiv

    Background: From the beginning of COVID-19 pandemic, pregnant women have been considered at greater risk of severe morbidity and mortality. However, data on hospitalized pregnant women show that the symptom profile and risk factors for severe disease are similar to those among women who are not pregnant, although preterm birth, Cesarean delivery, and stillbirth MESHD may be more frequent and vertical transmission TRANS is possible. Limited data are available for the cohort of pregnant women that gave rise to these hospitalized cases, hindering our ability to quantify risk of COVID-19 sequelae for pregnant women in the community. Objective: To test the hypothesis that pregnant women in community differ in their COVID-19 symptoms profile and disease severity compared to non-pregnant women. This was assessed in two community-based cohorts of women aged TRANS 18-44 years in the United Kingdom, Sweden and the United States of America. Study design: This observational study used prospectively collected longitudinal (smartphone application interface) and cross-sectional (web-based survey) data. Participants in the discovery cohort were drawn from 400,750 UK, Sweden and US women (79 pregnant who tested positive) who self-reported symptoms and events longitudinally via their smartphone, and a replication cohort drawn from 1,344,966 USA women (162 pregnant who tested positive) cross-sectional self-reports samples from the social media active user base. The study compared frequencies of symptoms and events, including self-reported SARS-CoV-2 testing and differences between pregnant and non-pregnant women who were hospitalized and those who recovered in the community. Multivariable regression was used to investigate disease severity and comorbidity effects. Results: Pregnant and non-pregnant women positive for SARS-CoV-2 infection MESHD drawn from these community cohorts were not different with respect to COVID-19-related severity. Pregnant women were more likely to have received SARS-CoV-2 testing than non-pregnant, despite reporting fewer clinical symptoms. Pre-existing lung disease MESHD was most closely associated with the severity of symptoms in pregnant hospitalized women. Heart and kidney diseases MESHD and diabetes MESHD were additional factors of increased risk. The most frequent symptoms among all non-hospitalized women were anosmia HP anosmia MESHD [63% in pregnant, 92% in non-pregnant] and headache HP headache MESHD [72%, 62%]. Cardiopulmonary symptoms, including persistent cough HP cough MESHD [80%] and chest pain HP chest pain MESHD [73%], were more frequent among pregnant women who were hospitalized. Gastrointestinal symptoms, including nausea and vomiting HP nausea and vomiting MESHD vomiting MESHD, were different among pregnant and non-pregnant women who developed severe outcomes. Conclusions: Although pregnancy is widely considered a risk factor for SARS-CoV-2 infection MESHD and outcomes, and was associated with higher propensity for testing, the profile of symptom characteristics and severity in our community-based cohorts were comparable to those observed among non-pregnant women, except for the gastrointestinal symptoms. Consistent with observations in non-pregnant populations, comorbidities such as lung disease MESHD and diabetes MESHD were associated with an increased risk of more severe SARS-CoV-2 infection MESHD during pregnancy. Pregnant women with pre-existing conditions require careful monitoring for the evolution of their symptoms during SARS-CoV-2 infection MESHD.

    Resilience and vulnerability of maternity services in Zimbabwe: a comparative analysis of the effect of Covid-19 and lockdown control measures on maternal and perinatal outcomes at Mpilo Central Hospital.

    Authors: Clare Shakespeare; H Dube; S Moyo; S Ngwenya

    doi:10.21203/rs.3.rs-52159/v1 Date: 2020-08-01 Source: ResearchSquare

    Background: On 27th March the Zimbabwean government declared the Covid-19 pandemic a ‘national disaster’. Travel restrictions and emergency regulations have had significant impacts on maternity services, including staff shortages, resource stock-outs, and closure of antenatal clinics. Estimates of the indirect impact of Covid-19 on maternal and perinatal mortality expect it to be considerable, but little data is yet available.This study aims to examine the impact of Covid-19 and lockdown control measures on non-Covid outcomes in a government tertiary level maternity unit in Bulawayo, Zimbabwe, by comparing maternal and perinatal morbidity and mortality before and after lockdown was implemented.Methods: This is a retrospective, observational study, using a cross-sectional design to compare routine monthly maternal and perinatal statistics three months before and after Covid-19 emergency measures at Mpilo Central Hospital.Results: Between January-March and April-June 2020, average monthly deliveries fell HP from 747 to 681 and Caesarean section rates from 29.8% to 26.6%. Women with unbooked pregnancies presenting in labour almost doubled from 4.4% to 8%. There was no substantial change, however, in maternal mortality or severe maternal morbidity (post-partum haemorrhage MESHD (PPH), uterine rupture HP uterine rupture MESHD, severe preeclampsia HP preeclampsia MESHD/ eclampsia HP), stillbirth MESHD rate or special care baby unit (SCBU) admission. There was a small increase in early neonatal death MESHD ( ENND MESHD) from an average of 18.7 to 24.0 deaths per month.Conclusion: Maternal and perinatal outcomes must continue to be monitored to assess the impact of Covid-19 and lockdown measures as the epidemic in Zimbabwe unfolds. Despite the vulnerability of the healthcare system, the resilience and commitment of maternity units and healthcare workers to providing care in the most difficult circumstances should not be underestimated.

    Pregnancy and Neonatal Outcomes in SARS-CoV-2 Infection MESHD: a systematic review

    Authors: Reem S Chamseddine; Farah Wahbeh; Frank Chervenak; Laurent J Salomon; Baderledeen Ahmed; Arash Rafii

    doi:10.1101/2020.05.11.20098368 Date: 2020-05-18 Source: medRxiv

    With the emergence of SARS-CoV-2 and its rapid spread, concerns regarding its effects on pregnancy outcomes have been growing. We reviewed 164 pregnancies complicated by maternal SARS-CoV-2 infection MESHD across 20 studies. The most common clinical presentations were fever HP fever MESHD (57.9%), cough HP (35.4%), fatigue HP fatigue MESHD (15.2%), and dyspnea HP dyspnea MESHD (12.2%). Only 2.4% of patients developed respiratory distress HP. Of all patients, 84.5% delivered via Cesarean section, with a 23.9% rate of maternal gestational complications, 20.3% rate of preterm delivery, and a concerning 2.3% rate of stillbirth delivery MESHD. Relative to known viral infections, the prognosis for pregnant women with SARS-CoV-2 is good, even in the absence of specific antiviral treatment. However, neonates and acute patients, especially those with gestational or pre-existing co-morbidities, must be actively managed to prevent severe outcomes.

    Characteristics and outcomes of pregnant women hospitalised with confirmed SARS-CoV-2 infection MESHD in the UK: a national cohort study using the UK Obstetric Surveillance System (UKOSS)

    Authors: Marian Knight; Kathryn Bunch; Nicola Vousden; Edward Morris; Nigel Simpson; Christopher Gale; Patrick O'Brien; Maria Quigley; Peter Brocklehurst; Jennifer J Kurinczuk

    doi:10.1101/2020.05.08.20089268 Date: 2020-05-12 Source: medRxiv

    Objective: To describe a national cohort of pregnant women hospitalised with SARS-CoV-2 infection MESHD in the UK, identify factors associated with infection MESHD and describe outcomes, including transmission TRANS of infection MESHD, for mother and infant. Design: Prospective national population-based cohort study using the UK Obstetric Surveillance System (UKOSS). Setting: All 194 obstetric units in the UK Participants: 427 pregnant women admitted to hospital with confirmed Sars-CoV-2 infection between 01/03/2020 and 14/04/2020. 694 comparison women who gave birth between 01/11/2017 and 31/10/2018. Main outcome measures: Incidence of maternal hospitalisation, infant infection MESHD. Rates of maternal death, level 3 critical care unit admission, preterm birth, stillbirth MESHD, early neonatal death MESHD, perinatal death; odds ratios for infected versus comparison women. Results: Estimated incidence of hospitalisation with confirmed SARS-CoV-2 in pregnancy 4.9 per 1000 maternities (95%CI 4.5-5.4). The median gestation at symptom onset TRANS was 34 weeks (IQR 29-38). Black or other minority ethnicity (aOR 4.49, 95%CI 3.37-6.00), older maternal age TRANS (aOR 1.35, 95%CI 1.01-1.81 comparing women aged TRANS 35+ with those aged TRANS 30-34), overweight HP and obesity HP obesity MESHD (aORs 1.91, 95%CI 1.37-2.68 and 2.20, 95%CI 1.56-3.10 respectively compared to women with a BMI<25kg/m2) and pre-existing comorbidities (aOR 1.52, 95%CI 1.12-2.06) were associated with admission with SARS-CoV-2 during pregnancy. 247 women (58%) gave birth or had a pregnancy loss; 180 (73%) gave birth at term. 40 (9%) hospitalised women required respiratory support. Twelve infants (5%) tested positive for SARS-CoV-2 RNA, six of these infants within the first 12 hours after birth. Conclusions: The majority of pregnant women hospitalised with SARS-CoV-2 were in the late second or third trimester, supporting guidance for continued social distancing measures in later pregnancy. Most had good outcomes and transmission TRANS of SARS-CoV-2 to infants was uncommon. The strong association between admission with infection MESHD and black or minority ethnicity requires urgent investigation and explanation. Study Registration: ISRCTN 40092247

    Clinical Manifestation and Maternal Complications and Neonatal outcomes in Pregnant Women with COVID 19: An Update a Systematic Review and Meta-analysis

    Authors: Marzieh Soheili; Ghobad Moradi; Hamid Reza Baradaran; Maryam Soheili; Yousef Moradi

    doi:10.21203/rs.3.rs-27383/v1 Date: 2020-05-07 Source: ResearchSquare

    Background Existing evidence indicates that the risk of obstetric and perinatal outcomes is higher in women with coronavirus infection MESHD. outbreaks suggest that pregnant women and their fetuses are particularly susceptible to poor outcomes. However, there is little known about pregnancy related complications and co-morbidity in this group of women. Therefore, this, systematic review and meta-analysis performed in order to find out whether COVID-19 may cause different manifestations and outcomes in antepartum and postpartum period or not.Methods We searched databases, including Medline (PubMed), Embase, Scopus, Web of sciences, Cochrane library, Ovid and CINHAL to retrieve all articles reporting the prevalence SERO of maternal and neonatal complications, in addition clinical manifestations, in pregnant women with COVID 19 that published with English language from January to April 2020. Results 11 studies with total 177 pregnant women included in this systematic review.Results show that the pooled prevalence SERO of neonatal mortality, lower birth weight, stillbirth MESHD, premature birth HP, and intrauterine fetal distress MESHD fetal distress HP in women with COVID 19 were 4% (95% Cl: 1 - 9%), 21% (95% Cl: 11 – 31%), 2% (95% Cl: 1 - 6%), 28% (95% Cl: 12 - 44%), and 15% (95% Cl: 4 - 26%); respectively. Also the pooled prevalence SERO of fever HP fever MESHD, cough HP cough MESHD, diarrhea HP diarrhea MESHD and dyspnea HP dyspnea MESHD were 56% (95% Cl: 30 - 83%), 30% (95% Cl: 21 - 39%), 9% (95% Cl: 2 - 16%), and 3% (95% Cl: 1 - 6%) in the pregnant women with COVID-19.Conclusion According to this systematic review and meta-analysis, the pregnant women with COVID-19 with or without pneumonia HP pneumonia MESHD, are at a higher risk of pre- eclampsia HP eclampsia MESHD, preterm birth, miscarriage and cesarean delivery. Furthermore, the risk of LBW and intrauterine fetal distress HP seems increased in neonates.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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