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Overview

MeSH Disease

Human Phenotype

Transmission

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

    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 MESHD. 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 MESHD myalgias HP 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 MESHD hypertension HP. She was afebrile and asymptomatic TRANS with normal vital signs throughout hospitalization. Her myalgias MESHD myalgias HP 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 MESHD 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). 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 MESHD in pregnancy (with no symptoms of COVID-19 aside from myalgias MESHD myalgias HP); specifically, this patient had no fever MESHD fever HP, cough MESHD cough HP, or shortness of breath, but only myalgias MESHD myalgias HP and sick contacts. Despite her having mild COVID-19 disease MESHD in pregnancy, we demonstrate placental vasculopathy and presence of SARS-CoV-2 virus across the placenta. Evidence of placental COVID-19 raises concern for possible placental vasculopathy (potentially leading to fetal growth restriction, pre-eclampsia MESHD eclampsia HP, and other pregnancy complications MESHD) 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.

    SARS-COV-2 infection MESHD during pregnancy, a risk factor for eclampsia MESHD eclampsia HP or neurological manifestations of COVID-19? Case report.

    Authors: Alejandro Garcia Rodriguez; Sergio Marcos Contreras; Santiago Manuel Fernandez Manovel; Jose Miguel Marcos Vidal; Fernando Diez Buron; Camino Fernandez Fernandez; Maria del Carmen Riveira Gonzalez

    doi:10.21203/rs.3.rs-40372/v1 Date: 2020-07-06 Source: ResearchSquare

    Background: There are no published cases of tonic-clonic seizures MESHD seizures HP and posterior bilateral blindness MESHD blindness HP during pregnancy and SARS-COV-2 infection MESHD. We do not just face new and unknown manifestations, but also how different patients groups are affected by SARS-Cov-2 infection MESHD, like pregnant women. COVID-19, preeclampsia HP, eclampsia MESHD eclampsia HP and posterior reversible leukoencephalopathy MESHD leukoencephalopathy HP share endothelium damage and similar pathophysiology. Case presentation: We present a case of a 35 years old pregnant woman, who comes to our hospital because of tonic-clonic seizures MESHD seizures HP at home and SARS-COV-2 infection MESHD. After Caesarean section, we initiate antihypertensive treatment with labetalol, amlodipine and captopril. Few hour after C-section, she develops blindness MESHD blindness HP with total recuperation after 72 hours, normal brain CT scan and normal CT angiography. She had normal pregnancy control and no other symptoms before tonic-clonic seizures MESHD seizures HP development. Conclusion: SARS-COV-2 infection MESHD could promote brain endothelial damage and facilitate neurological complications during pregnancy MESHD.

    Management of life-threatening acute respiratory syndrome and severe MESHD pneumonia MESHD pneumonia HP secondary to COVID-19 in pregnancy: a case report and literature review

    Authors: Salwa Yaqoub; Shamsa Ahmad; Zeena Mansoori; Abdulrouf Pallivalapila; Wessam El Kassem; Muna Maslamani; Mahmoud Abu Jubara; Fathima Minisha; Asma Tarannum; Isaac Babarinsa; Ahmed Abdussalam; Hamdy Sayed; Teresa Rivero; Aftab Mohammad; Binny Thomas; Moza Al Hail

    doi:10.21203/rs.3.rs-36328/v1 Date: 2020-06-18 Source: ResearchSquare

    BackgroundAs COVID-19 continues to infect women of all gestational ages TRANS; gravida in labor and the acutely ill parturient are particularly at higher risk of infection TRANS risk of infection TRANS infection MESHD. No therapeutic agent or vaccine is approved to treat COVID-19 till date. Thus, managing COVID-19 and associated complications during pregnancy MESHD is often challenging and requires a multidisciplinary approach to treatment. Case PresentationWe narrate our perspectives on managing a 32-year-old, critically ill obstetric patient at 32-week gestation, diagnosed with acute respiratory distress HP syndrome MESHD (ARDS) secondary to COVID-19 pneumonia MESHD pneumonia HP. Upon confirmation of COVID-19, as per the local protocol antivirals, antimalarial, and antibiotics were commenced. Due to rapidly exacerbating maternal respiratory functions, and potential chances of fetal hypoxemia HP emergency MESHD caesarian was performed. Following delivery, the maternal respiratory functions further deteriorated as she required prolonged mechanical ventilation and initiation of extracorporeal membrane oxygenation until she was clinically stable on day 23. The patient also received convalescent plasma SERO and tocilizumab as a part of the treatment protocol. The newborn was shifted to neonatal intensive care for intubation for respiratory distress HP and was found negative for SARS-CoV-2 and COVID-19 immunoglobulin (Ig). At day 25, the patient was clinically stable and was transferred to step down unit and discharged thereafter. Conclusion Through this case, we present the thought process, multidisciplinary team-based strategy and sequel of managing a complex, critically ill obstetric patient with ARDS and COVID-19 pneumonia MESHD pneumonia HP. We anticipate that this case report will assist other healthcare institutions to manage critically ill patients with COVID-19 pneumonia MESHD pneumonia HP.Key words: COVID-19, maternal, pandemic, perinatal, ECMO, convalescent plasma SERO, pharmacological interventions.

    Pregnancy outcomes, Newborn complications and Maternal-Fetal Transmission TRANS of SARS-CoV-2 in women with COVID-19: 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 and also assess the incidence of maternal-fetal transmission TRANS 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 " 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 were also recorded. Results: Out of 172 women affected by COVID-19 in pregnancy, 160 women had delivered 162 newborns (2 set of twins, 12 ongoing pregnancies). In pregnant women with COVID-19, the most common symptoms were fever MESHD fever HP (54%), cough MESHD cough HP (35%), myalgia MESHD myalgia HP (17%), dyspnea MESHD dyspnea HP (12%) and diarrhea MESHD diarrhea HP (4%). Pneumonia MESHD Pneumonia HP was diagnosed by CT scan imaging in 100 % of COVID-19 pregnant women. Pregnancy complications MESHD included delivery by cesarean section (89%), preterm labor (21%), fetal distress MESHD fetal distress HP (9%) and premature rupture of membranes HP rupture MESHD of membranes (8%). The most common co-morbidities associated with pregnant women with COVID-19 were diabetes (11%), hypertensive disorders (9%), placental disorders (5%), co- infections MESHD (6%), scarred HP uterus (5%), hypothyroidism MESHD hypothyroidism HP (5%) and anemia MESHD anemia HP (4%). Amongst the neonates of COVID-19 mothers, preterm birth (23%), respiratory distress HP syndrome MESHD (14%), pneumonia MESHD pneumonia HP (14%) low birth weight MESHD (11%), small for gestational age HP age TRANS (3%) were reported. There was one still birth and one neonatal death MESHD reported. Vertical transmission TRANS rate of SARS-CoV-2 is estimated to be 11%. Conclusion In pregnant women with COVID-19, diabetes and hypertensive disorders are common co-morbidities and there is a risk of preterm delivery. Amongst the neonates born to mothers with COVID-19, respiratory distress HP syndrome MESHD and pneumonia MESHD pneumonia HP are common occurrence. There is an evidence of vertical transmission TRANS of SARS-CoV-2 infection MESHD in women with COVID-19.

The ZB MED preprint Viewer preVIEW includes all COVID-19 related preprints from medRxiv and bioRxiv, from ChemRxiv, from ResearchSquare, from arXiv and from Preprints.org and is updated on a daily basis (7am CET/CEST).

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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