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SARS-CoV-2 proteins

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    Pregnancy and neonatal outcomes of COVID-19 MESHD, co-reporting of common outcomes from the PAN-COVID and AAP HGNC SONPM registry

    Authors: Edward Mullins; Mark Hudak; Jay Banerjee; Trace Getzlaff; Julia Townson; Kimberly Barnette; Rebecca Playle; Tom Bourne; - PAN-COVID-investigators; - National Perinatal COVID-19 Registry Study Group; Christoph Lees

    doi:10.1101/2021.01.06.21249325 Date: 2021-01-09 Source: medRxiv

    BackgroundFew large, cohort studies report data on individuals maternal, fetal, perinatal, and neonatal outcomes associated with SARS-CoV-2 infection MESHD in pregnancy. We report outcomes from a collaboration formed early during the pandemic between the investigators of two registries, the UK and global Pregnancy and Neonatal outcomes in COVID-19 MESHD (PAN-COVID) study and the US American Academy of Pediatrics Section on Neonatal Perinatal Medicine (AAP SONPM) National Perinatal COVID-19 MESHD Registry. MethodsPAN-COVID (suspected or confirmed SARS-CoV-2 infection MESHD at any stage in pregnancy) and the AAP HGNC SONPM registry (positive maternal testing for SARS-CoV-2 from 14 days before delivery to 3 days after delivery) studies collected data on maternal, fetal, perinatal and neonatal outcomes. PAN-COVID results are presented as all inclusions and those with confirmed SARS-CoV-2 infection MESHD only. ResultsWe report 4004 women in pregnancy affected by suspected or confirmed SARS-CoV-2 infection MESHD (1606 from PAN-COVID and 2398 from the AAP SONPM) from January 1st 2020 to July 25th 2020 (PAN-COVID) and August 8th ( AAP HGNC SONPM). For obstetric outcomes in PAN-COVID and AAP HGNC SONPM, respectively, maternal death occurred in 0.5% and 0.17%, early neonatal death MESHD in 0.2% and 0.3%, and stillbirth MESHD in 0.50% and 0.65% of women. Delivery was pre-term (<37 weeks gestation) in 12% of all women in PAN-COVID, in 16.2% of those women with confirmed infection in PAN-COVID and 16.2% of women in AAP HGNC SONPM. Very preterm delivery (< 27 weeks gestation) occurred in 0.6% in PAN-COVID and 0.7% in AAP HGNC SONPM. Neonatal SARS-CoV-2 infection MESHD SARS-CoV-2 infection MESHD was reported in 0.8% of PAN-COVID all inclusions, 2.0% in PAN-COVID confirmed infections and 1.8% in the AAP HGNC SONPM study; the proportions of babies tested were 9.5%, 20.7% and 87.2% respectively. The proportion of SGA babies was 8.2% in PAN-COVID all inclusions, 9.7% in PAN-COVID confirmed infection and 9.6% in AAP HGNC SONPM. Gestational age adjusted mean z-scores were -0.03 for PAN-COVID and -0.18 for AAP SONPM. ConclusionsThe findings from the UK and US SARS-CoV-2 in pregnancy registries were remarkably concordant. Pre-term delivery affected a higher proportion of women in pregnancy than expected from historical and contemporaneous national data. The proportions of women affected by stillbirth MESHD, small for gestational age infants and early neonatal death MESHD were comparable to historical and contemporaneous UK and US data. Although maternal death MESHD was uncommon, the proportion was higher than expected from UK and US population data, likely explained by under-ascertainment of women affected by milder and asymptomatic infection in pregnancy. The data presented support strong guidance for enhanced precautions to prevent SARS-COV-2 infection MESHD in pregnancy, particularly in the context of increased risks of preterm delivery and maternal mortality, and for priority vaccination of women planning pregnancy. What is known about SARS-COV-2 infection MESHD in pregnancy and neonates?Cohort, population surveillance studies and living systematic reviews have included limited numbers of women in pregnancy affected by COVID-19 MESHD and report that most women and infants had good outcomes. What this study addsPreterm deliveries occurred in a high proportion of women participating in these two registries in comparison to contemporaneous and historical national data in the UK and US. The majority of preterm deliveries occurred late preterm (between 32+0 and 36+6 weeks gestation). SARS-COV-2 infection MESHD in pregnancy did not appear to be associated with a clinically significant effect on the rate of stillbirth, fetal growth, or neonatal outcomes. Although maternal death MESHD was uncommon, the proportion was higher than expected from UK and US population data, likely explained by under-ascertainment of women affected by milder and asymptomatic infection in pregnancy.

    The incidence, characteristics and outcomes of pregnant women hospitalized with symptomatic and asymptomatic SARS-CoV-2 infection MESHD in the UK from March to September 2020: a national cohort study using the UK Obstetric Surveillance System (UKOSS)

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

    doi:10.1101/2021.01.04.21249195 Date: 2021-01-05 Source: medRxiv

    Background: Evidence on risk factors, incidence and impact of SARS-CoV-2 infection MESHD in pregnant mothers and their babies has rapidly expanded but there is a lack of population level data to inform accurate incidence rates and unbiased descriptions of characteristics and outcomes. The primary aim of this study was to describe the incidence, characteristics and outcomes of hospitalized pregnant women with symptomatic and asymptomatic SARS-CoV-2 in the UK compared to pregnant women without SARS-CoV-2 in order to inform future clinical guidance and management. Methods and Findings: We conducted a national, prospective cohort study of all hospitalized pregnant women with confirmed SARS-CoV-2 from 1st March 2020 to 31st August 2020 using the UK Obstetric Surveillance System (UKOSS) across all 194 hospitals in the UK with a consultant-led maternity unit. Incidence was estimated using the latest national maternity data. Overall, 1148 hospitalized women had confirmed SARS-CoV-2 in pregnancy, 63% of which were symptomatic. Therefore, the estimated incidence of hospitalization with symptomatic SARS-CoV-2 was 2.0 per 1000 maternities (95% CI 1.9-2.2) and for asymptomatic SARS-CoV-2 was 1.2 per 1000 maternities (95% CI 1.1-1.4). Compared to pregnant women without SARS-CoV-2, women hospitalized with symptomatic SARS-CoV-2 were more likely to be overweight or obese MESHD (adjusted OR 1.86, 95% CI 1.39-2.48 and aOR 2.07, 95% CI 1.53-2.29 respectively), to be of Black, Asian or Other minority ethnic group (aOR 6.24, 95% CI 3.93-9.90, aOR 4.36, 95% CI 3.19-5.95 and aOR 12.95, 95% CI 4.93-34.01 respectively), and to have a relevant medical comorbidity (aOR 1.83, 95% CI 1.32-2.54). Compared to pregnant women without SARS-CoV-2, hospitalized pregnant women with symptomatic SARS-CoV-2 were more likely to be admitted to intensive care (aOR 57.67, 95% CI 7.80-426.70) but the absolute risk of poor outcomes was low. Cesarean births and neonatal unit admission were increased regardless of symptom status (symptomatic aOR 2.60, 95% CI 1.97-3.42 and aOR 3.08, 95% CI 1.99-4.77 respectively; asymptomatic aOR 2.02, 95% CI 1.52-2.70 and aOR 1.84, 95% 1.12-3.03 respectively). Iatrogenic preterm births were more common in women with symptomatic SARS-CoV-2 (aOR 11.43, 95% CI 5.07-25.75). The risks of stillbirth MESHD or neonatal death MESHD were not significantly increased, regardless of symptom status but numbers were small. The limitations of this study include the restriction to women hospitalized with SARS-CoV-2, who may by nature of their admission have been at greater risk of adverse outcome. Conclusions: We have identified factors that increase the risk of symptomatic and asymptomatic SARS-CoV-2 in pregnancy. The increased risks of cesarean and iatrogenic preterm birth provide clear evidence of the indirect impact of SARS-CoV-2 on mothers and maternity care in high income settings. Clinicians can be reassured that the majority of women do not experience severe complications of SARS-CoV-2 in pregnancy and women with mild disease can be discharged to continue their pregnancy safely.

    The usability of Jordan Stillbirths and Neonatal Deaths Surveillance MESHD (JSANDS) system: Results of focus group discussions

    Authors: Yousef S. Khader; Khulood Kayed Shattnawi; Nihaya Al-Sheyab; Mohammad S. Alyahya; Anwar Batieha

    doi:10.21203/rs.3.rs-83240/v3 Date: 2020-09-24 Source: ResearchSquare

    Background: Jordan Stillbirths and Neonatal Deaths Surveillance system MESHD (JSANDS) is a newly developed system and is currently implemented in five large hospitals in Jordan. This study aimed at exploring the healthcare professionals’ perception about the usability of JSANDS. Methods: A descriptive qualitative approach, using focus group discussions, was adopted. A total of 5 focus groups including 23 focal points were conducted in five participating hospitals in Jordan.  Results: Data analysis identified nine main issues related to the JSANDS system: the system usefulness, the system performance, data quality, the system limitations, human rights, female empowerment, nurses’ competencies strengthened, the sustainability of the JSANDS, and COVID-19 MESHD impact on the system. Users reported that JSANDS data were useful, the system was simple and easy to use, and the data were accurate and complete. However, some users reported that some technical issues need to be enhanced. Conclusions: JSANDS was perceived positively by the current users. According to them, it provides a formative and comprehensive data on stillbirths and neonatal deaths MESHD and their causes, and therefore, was recommended to be adopted by its users and scaled up.  

    Further Evaluation of the Mother-to-Child Transmission Potential of SARS-CoV-2 Infection MESHD During Pregnancy: A Retrospective Study

    Authors: Xuechen Yu; Huijun Chen; Fan Luo; Juanjuan Guo; Yuan Qiao; Wei Zhang; Jiafu Li; Dongchi Zhao; Dan Xu; Qing Gong; Lingyun Yang; Pu Yang; Yuming Cao; Xue Wen; Wei Hou; Huixia Yang; Yuanzhen Zhang

    doi:10.21203/rs.3.rs-77490/v1 Date: 2020-09-14 Source: ResearchSquare

    Background. This study aimed to comprehensively evaluate the clinical characteristics of COVID-19 MESHD in perinatal period, and systematically assess the mother-to-child transmission potential of SARS-CoV-2Methods. We retrospectively analyzed the data of 23 pregnant patients in late pregnancy. Clinical specimens, including maternal and neonatal throat swabs, vaginal secretions, placenta tissues, and breast milk MESHD, were collected for the nucleic acid test of the virus. Pregnancy outcomes and neonatal results were also analyzed.Results. Overall, 10 patients (43.5%) had no symptoms and were found by routine chest CT. Complications appeared after COVID-19 MESHD onset included PROM (17.4%) and fetal distress (4.3%). Typical signs of viral pneumonia MESHD were recorded in chest CT of all patients. No patients developed severe pneumonia MESHD or died of COVID-19 MESHD. All of 25 neonates were born alive. No severe asphyxia MESHD or neonatal death MESHD was observed. Although three neonates were tested transiently suspected positive for SARS-CoV-2 after being transferred to neonatology department, no newborns developed COVID-19 MESHD. Out of various clinical specimens tested, only a rectal swab sample from one pregnant patient was tested positive for SARS-CoV-2, while all the other specimens including first sample of newborn throat swabs were negative. Pathological examination found no obvious chorioamnionitis MESHD or clear virus inclusion body in placenta, and ACE2 HGNC (angiotension-converting enzyme 2) was expressed at a moderate level.Conclusions. As in the general population of COVID-19 MESHD, asymptomatic patients were present in pregnant women. There is no confirmatory evidence for mother-to-child transmission in COVID-19 MESHD patients with late pregnancy.

    Resilience and vulnerability of maternity services in Zimbabwe: a comparative analysis of the effect of Covid-19 MESHD 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 MESHD Covid-19 pandemic MESHD 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 MESHD 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 MESHD 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 MESHD emergency measures at Mpilo Central Hospital.Results: Between January-March and April-June 2020, average monthly deliveries fell 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 HGNC), uterine rupture MESHD, severe preeclampsia/eclampsia MESHD), 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 MESHD 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.

    Impact of COVID-19 MESHD infection on maternal and neonatal outcomes: a review of 287 pregnancies

    Authors: Fatemeh Azarkish; Roksana Janghorban

    doi:10.1101/2020.05.09.20096842 Date: 2020-05-15 Source: medRxiv

    Pregnant women are vulnerable group in viral outbreaks especially in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. The aim of this review was to identify maternal and neonatal outcomes in available articles on pregnancies affected by COVID-19 MESHD. The articles that had assessed outcomes of pregnancy and perinatal of women with COVID-19 MESHD between Oct HGNC 2019 and Apr 30, 2020 without language limitation were considered. All kinds of studies such as case report, case series, retrospective cohort, case control were included. We searched databases, selected relevant studies and extracted data regarding maternal and neonatal outcomes from each article. Data of 287 pregnant women with COVID-19 MESHD of 6 countries were assessed from 28 articles between December 8, 2019 and April 6, 2020. Most pregnant women reported in their third trimester, 102 (35.5%) cases were symptomatic at the time of admission. Common onset symptoms, abnormal laboratory findings, and chest computed tomography pattern were fever MESHD (51.5%), lymphocytopenia MESHD (67.9%), and multiple ground-glass opacities (78.5%) respectively. 93% of all deliveries were done through cesarean section. No maternal mortality and 3 % ICU admission were reported. Vertical transmission was not reported but its possibility was suggested in three neonates. One neonatal death MESHD, one stillbirth, and one abortion MESHD were reported. All newborns were not breastfed. This review showed fewer adverse maternal and neonatal outcomes in pregnant women with COVID-19 MESHD in comparison with previous coronavirus outbreak infection MESHD in pregnancy. Limited data are available regarding possibility of virus transmission in utero, during vaginal childbirth and breastfeeding. Effect of COVID-19 MESHD on first and second trimester and ongoing pregnancy outcomes in infected MESHD mothers is still questionable.

    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 and describe outcomes, including transmission of infection, 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 MESHD 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 was 34 weeks (IQR 29-38). Black or other minority ethnicity (aOR 4.49, 95%CI 3.37-6.00), older maternal age (aOR 1.35, 95%CI 1.01-1.81 comparing women aged 35+ with those aged 30-34), overweight and 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 of SARS-CoV-2 to infants was uncommon. The strong association between admission with infection and black or minority ethnicity requires urgent investigation and explanation. Study Registration: ISRCTN 40092247

    Effects of Coronavirus Disease 2019 MESHD ( COVID-19 MESHD) on Maternal, Perinatal and Neonatal Outcomes: a Systematic Review of 266 Pregnancies

    Authors: Juan Juan; Maria M Gil; Zhihui Rong; Yuanzhen Zhang; Huixia Yang; Liona Chiu Yee Poon

    doi:10.1101/2020.05.02.20088484 Date: 2020-05-06 Source: medRxiv

    Objective: To perform a systematic review of available published literature on pregnancies affected by COVID-19 MESHD to evaluate the effects of COVID-19 MESHD on maternal, perinatal and neonatal outcomes. Methods: We performed a systematic review to evaluate the effects of COVID-19 MESHD on pregnancy, perinatal and neonatal outcomes. We conducted a comprehensive literature search using PubMed, EMBASE, Cochrane library, China National Knowledge Infrastructure Database and Wan Fang Data until April 20, 2020 (studies were identified through PubMed alert after April 20, 2020). For the research strategy, combinations of the following keywords and MeSH terms were used: SARS-CoV-2, COVID-19 MESHD, coronavirus disease 2019 MESHD, pregnancy, gestation, maternal, mothers, vertical transmission, maternal-fetal transmission, intrauterine transmission, neonates, infant, delivery. Eligibility criteria included laboratory-confirmed and/or clinically diagnosed COVID-19 MESHD, patient was pregnant on admission, availability of clinical characteristics, including maternal, perinatal or neonatal outcomes. Exclusion criteria were unpublished reports, unspecified date and location of the study or suspicion of duplicate reporting, and unreported maternal or perinatal outcomes. No language restrictions were applied. Results: We identified several case-reports and case-series but only 19 studies, including a total of 266 pregnant women with COVID-19 MESHD, met eligibility criteria and were finally included in the review. In the combined data from seven case-series, the maternal age ranged from 20 to 41 years and the gestational age on admission ranged from 5 to 41 weeks. The most common symptoms at presentation were fever MESHD, cough, dyspnea MESHD/ shortness of breath MESHD and fatigue MESHD. The rate of severe pneumonia MESHD was relatively low, with the majority of the cases requiring intensive care unit admission. Almost all cases from the case-series had positive computer tomography chest findings. There were six and 22 cases that had nucleic-acid testing in vaginal mucus and breast milk MESHD samples, respectively, which were negative for SARS-CoV-2. Only a few cases had spontaneous miscarriage or abortion MESHD. 177 cases had delivered, of which the majority by Cesarean section. The gestational age at delivery ranged from 28 to 41 weeks. Apgar scores at 1 and 5 minutes ranged from 7 to 10 and 8 to 10, respectively. A few neonates had birthweight less than 2500 grams and over one-third of cases were transferred to neonatal intensive care unit. There was one case each of neonatal asphyxia MESHD and neonatal death MESHD. There were 113 neonates that had nucleic-acid testing in throat swab, which was negative for SARS-CoV-2. From the case-reports, two maternal deaths among pregnant women with COVID-19 MESHD were reported. Conclusions: The clinical characteristics of pregnant women with COVID-19 MESHD are similar to those of nonpregnant adults with COVID-19 MESHD. Currently, there is no evidence that pregnant women with COVID-19 MESHD are more prone to develop severe pneumonia MESHD, in comparison to nonpregnant patients. The subject of vertical transmission of SARS-CoV-2 remains controversial and more data is needed to investigate this possibility. Most importantly, in order to collect meaningful pregnancy and perinatal outcome data, we urge researchers and investigators to reference previously published cases in their publications and to record such reporting when the data of a case is being entered into a registry or several registries.

    Pregnancy outcomes, Newborn complications and Maternal-Fetal Transmission of SARS-CoV-2 in women with COVID-19 MESHD: A systematic review

    Authors: Rahul Gajbhiye; Deepak Modi; Smita Mahale

    doi:10.1101/2020.04.11.20062356 Date: 2020-04-15 Source: medRxiv

    Abstract Objective: The aim of this systematic review was to examine published and preprint reports for maternal and fetal outcomes in pregnant women with COVID-19 MESHD and also assess the incidence of maternal-fetal transmission of SARS CO-V-2 infection MESHD. Design : Systematic review Data sources:We searched PUMBED. Medline, Embase, MedRxiv and bioRxiv databases upto 31st March 2020 utilizing combinations of word variants for " coronavirus " or " COVID-19 MESHD " or " severe acute respiratory syndrome MESHD " or " SARS-COV-2 " and " pregnancy " . We also included data from preprint articles. Study selection : Original case reports and case series on pregnant women with a confirmed diagnosis of SARS-CoV-2 infection MESHD. Data extraction : We included 23 studies [China (20), USA (01), Republic of Korea (01) and Honduras, Central America (01) reporting the information on 172 pregnant women and 162 neonates. The primary outcome measures were maternal health characteristics and adverse pregnancy outcomes, neonatal outcomes and SARS-CoV-2 infection MESHD in neonates was extracted. Treatments given to pregnant women with COVID-19 MESHD were also recorded. Results: Out of 172 women affected by COVID-19 MESHD in pregnancy, 160 women had delivered 162 newborns (2 set of twins, 12 ongoing pregnancies). In pregnant women with COVID-19 MESHD, the most common symptoms were fever MESHD (54%), cough (35%), myalgia MESHD (17%), dyspnea MESHD (12%) and diarrhea MESHD (4%). Pneumonia was diagnosed by CT scan imaging in 100 % of COVID-19 MESHD pregnant women. Pregnancy complications included delivery by cesarean section (89%), preterm labor MESHD (21%), fetal distress (9%) and premature rupture of membranes (8%). The most common co-morbidities associated with pregnant women with COVID-19 MESHD were diabetes MESHD (11%), hypertensive disorders MESHD (9%), placental disorders MESHD (5%), co-infections MESHD (6%), scarred uterus (5%), hypothyroidism MESHD (5%) and anemia MESHD (4%). Amongst the neonates of COVID-19 MESHD mothers, preterm birth (23%), respiratory distress syndrome MESHD (14%), pneumonia MESHD (14%) low birth weight (11%), small for gestational age (3%) were reported. There was one still birth and one neonatal death MESHD reported. Vertical transmission rate of SARS-CoV-2 is estimated to be 11%. Conclusion In pregnant women with COVID-19 MESHD, diabetes MESHD and hypertensive disorders MESHD are common co-morbidities and there is a risk of preterm delivery. Amongst the neonates born to mothers with COVID-19 MESHD, respiratory distress syndrome MESHD and pneumonia MESHD are common occurrence. There is an evidence of vertical transmission of SARS-CoV-2 infection MESHD in women with COVID-19 MESHD.

    Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2) infection during late pregnancy: A Report of 18 patients from Wuhan, China

    Authors: Lu Zhang; Lan Dong; Lei Ming; Min Wei; Jun Li; Ruheng Hu; Jing Yang

    doi:10.21203/rs.3.rs-18247/v3 Date: 2020-03-20 Source: ResearchSquare

    Background: Compared with Severe Acute Respiratory Syndrome MESHD(SARS) and Middle East Respiratory Syndrome(MESR), Corona Virus Disease MESHD 2019( COVID-19 MESHD) spread more rapidly and widely. The population was generally susceptible. However, reports on pregnant women infected with SARS-CoV-2 were very limited. By sharing the clinical characteristics, treatments and outcomes of 18 patients with COVID-19 MESHD during late pregnancy, we hoped to provide some references for obstetric treatment and management.Methods: A total of 18 patients with COVID-19 MESHD treated in Renmin Hospital of Wuhan University were collected. The epidemiological characteristics, clinical manifestations, laboratory tests, chest CT and pregnancy outcomes were performed for analysis.Results: 1. 18 cases of late pregnancy infected with SARS-CoV-2 pneumonia MESHD were delivered at 35 + 5 weeks to 41 weeks. According to the clinical classification of COVID-19 MESHD, 1 case was mild type, 16 cases were ordinary type, and 1 case was severe type. 2. According to Imaging examinations: 15 (83%) cases showed unilateral or bilateral pneumonia MESHD, 2 (11%) cases had pulmonary infection MESHD with pleural effusion MESHD, and 1 (6%) case had no abnormal imaging changes. 8 (44%) cases were positive and 10 (56%) cases were negative for nasopharyngeal-swab tests of SARS-CoV-2. 3. Among the 18 newborns, there were 3 (17%) premature infants, 1 (6%) case of mild asphyxia MESHD, 5 (28%) cases of bacterial pneumonia MESHD, 1 (6%) case of gastrointestinal bleeding MESHD, 1 (6%) case of necrotizing enteritis MESHD, 2 (11%) cases of hyperbilirubinemia MESHD and 1 (6%) case of diarrhea MESHD. All the newborns were negative for the first throat swab test of SARS-CoV-2 after birth. 4. Follow-up to Mar 7, 2020, no maternal and neonatal deaths MESHD occurred.Conclusions: The majority of patients in late term pregnancy with COVID-19 MESHD were of ordinary type, and they less likely developed into critical pneumonia MESHD after early isolation and antiviral treatment. Vertical transmission of SARS-CoV-2 was not detected, but the proportion of neonatal bacterial pneumonia MESHD was higher than other neonatal diseases in newborns.

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