Corpus overview


MeSH Disease

Human Phenotype

Fever (4)

Cough (4)

Pneumonia (4)

Dyspnea (3)

Obesity (2)


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    Covid-19 in the second half of pregnancy: prevalence SERO and clinical relevance

    Authors: Marta RUGGIERO; Edgardo SOMIGLIANA; Beatrice TASSIS; Letizia LI PIANI; Sara UCEDA RENTERIA; Giussy BARBARA; Giovanna LUNGHI; Enrico FERRAZZI

    doi:10.21203/ Date: 2020-06-09 Source: ResearchSquare

    Evidence on the prevalence SERO and outcome of Covid-19 in pregnancy is yet inconclusive. To draw more information on this issue, we prospectively recruited 315 consecutive women delivering in a referral hospital located in Lombardy, Italy and evaluated the proportion of women who had Covid-19 in pregnancy. All recruited subjects underwent a nasopharyngeal swab to assess the presence of Sars-Cov-2 using Real-time PCR. In addition, two different type of antibodies SERO for the virus were evaluated in peripheral blood SERO, those against the spike proteins S1 and S2 of the envelope and those against the nucleoprotein of the nucleocapsid. Women were considered to have had Covid-19 in pregnancy if at least one of the assessment was positive. Overall, 28 women had a diagnosis of Covid-19 in pregnancy (8.9%, 95%CI: 6.2-12.5%), in line with the local general population. Women diagnosed with the infection MESHD were more likely to report one or more episodes of symptoms suggestive for Covid-19 (n=11, 39.3%) compared to unaffected women (n=39, 13.6%). The corresponding OR was 4.11 (95%CI: 1.79-9.44). Symptoms significantly associated with Covid-19 in pregnancy included fever MESHD fever HP, cough MESHD cough HP, dyspnea MESHD dyspnea HP and anosmia HP. Only one woman necessitated intensive care. No maternal deaths MESHD occurred. Pregnancy outcome in women with and without Covid-19 did not also differ. In conclusion, women in the second half of pregnancy do not appear to be more susceptible to Covid-19 and its complications. In addition, the study suggests that pregnancy outcome may not be significantly affected.

    Risk factors for mortality in pregnant women with SARS-CoV-2 infection MESHD

    Authors: Raigam Jafet Martinez-Portilla; Alexadros Sotiriadis; Johnatan Torres-Torres; Charzakis Christos; Ameth Hawkins-Villarreal; Jose Rafael Villafan-Bernal; Rodolfo A Gurrola-Ochoa; Francesc Figueras

    doi:10.1101/2020.05.31.20107276 Date: 2020-06-02 Source: medRxiv

    Since the first case of pneumonia MESHD pneumonia HP was described, SARS-CoV-2 infection MESHD ( coronavirus disease MESHD [COVID]-19) rapidly spread worldwide With 94,288 infections MESHD and more than 10,000 deaths MESHD, Mexico is the third Latin-American country in number of confirmed cases TRANS and second in mortality1. A major risk factor for adverse outcome in COVID-19 infection MESHD is the presence of advance age TRANS, co-morbidities including diabetes, hypertension MESHD hypertension HP and obesity MESHD obesity HP among other non-communicable diseases2. Epidemiological data from high- prevalence SERO countries reveal that compared to men, women are less likely to die or to require hospital admission to intensive care. This may suggest that pregnant women are not more susceptible to infection MESHD or to experience serious complications. However, whether the presence of co-morbidities or advanced maternal age TRANS confers a higher risk of adverse outcome in pregnant women with COVID-19 is unknown3. In this research letter, we aimed at evaluating the risk factor associated with maternal mortality secondary to COVID-19 infection MESHD in a middle-income country. Advanced maternal age TRANS is linked to an increased risk of mortality, while diabetes is the most important risk factor for maternal death MESHD. This is partly explained by an increasing incidence of non- communicable diseases MESHD in women of advanced age TRANS which is a common feature in most countries4. In the last decades, low- and middle-income countries have experienced accelerated socio-cultural changes associated with its incorporation into the international economic community, which have increased the number of obese and diabetic population, including pregnant women5. This has caused an increased risk for complications and fatality among COVID-19 positive population2,3. Thus, policies for reducing obesity MESHD obesity HP and diabetes in low- and middle-income countries are most needed to reduce the mortality of COVID-19 in pregnant women.

    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 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 MESHD, level 3 critical care unit admission, preterm birth, stillbirth MESHD, early neonatal death, perinatal MESHD death MESHD; 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 MESHD overweight HP and obesity MESHD obesity HP (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

    Effects of Coronavirus Disease MESHD 2019 (COVID-19) 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 to evaluate the effects of COVID-19 on maternal, perinatal and neonatal outcomes. Methods: We performed a systematic review to evaluate the effects of COVID-19 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, coronavirus disease MESHD 2019, pregnancy, gestation, maternal, mothers, vertical transmission TRANS, maternal-fetal transmission TRANS, intrauterine transmission TRANS, neonates, infant, delivery. Eligibility criteria included laboratory-confirmed and/or clinically diagnosed COVID-19, 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, met eligibility criteria and were finally included in the review. In the combined data from seven case-series, the maternal age TRANS ranged from 20 to 41 years and the gestational age TRANS on admission ranged from 5 to 41 weeks. The most common symptoms at presentation were fever MESHD fever HP, cough MESHD cough HP, dyspnea MESHD dyspnea HP/shortness of breath and fatigue MESHD fatigue HP. The rate of severe pneumonia MESHD pneumonia HP 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 samples, respectively, which were negative for SARS-CoV-2. Only a few cases had spontaneous miscarriage or abortion. 177 cases had delivered, of which the majority by Cesarean section. The gestational age TRANS at delivery ranged from 28 to 41 weeks. Apgar scores at 1 and 5 minutes HP Apgar scores at 1 and 5 minutes HP 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 HP 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 MESHD among pregnant women with COVID-19 were reported. Conclusions: The clinical characteristics of pregnant women with COVID-19 are similar to those of nonpregnant adults TRANS with COVID-19. Currently, there is no evidence that pregnant women with COVID-19 are more prone to develop severe pneumonia MESHD pneumonia HP, in comparison to nonpregnant patients. The subject of vertical transmission TRANS 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.

    A case of postpartum maternal death MESHD with COVID-19 in the west of Iran

    Authors: Maryam Ahmadi; Mehrangiz Zamani bonab; Sorour Akbari; Hamideh parsapour; Shohreh Alimohammadi; Ensiyeh Jenabi

    doi:10.21203/ Date: 2020-05-06 Source: ResearchSquare

    Background: There are a limited number of studies about COVID-19 during delivery and postpartum.Case presentation: A 38-years old G3p2 woman at 35 weeks and 4 days of gestation referred with the chief complaints of dyspnea MESHD dyspnea HP, cough MESHD cough HP, headache MESHD headache HP, and fever MESHD fever HP. Pharyngeal swab polymerase chain reaction (PCR) was negative for COVID-19; however, in chest computed tomography (CT) angiography, ground glass was observed in the basal lobe of the left lung. The infant was born via cesarean section with gestational age TRANS of 36 weeks and an Apgar score of 8/9. No infant document was found about COVID-19‎ and other infections MESHD in several days after delivery. The patient died eight days after the onset of symptoms TRANS due to cardiovascular collapse.Conclusions: We reported the first death MESHD of postpartum maternal with COVID-19 and a healthy baby with no evidence of COVID-19 and gestational age TRANS of 36 weeks.

    Pregnancy and breastfeeding during COVID-19 pandemic: A systematic review of published pregnancy cases

    Authors: Carina Rodrigues; Ines Baia; Rosa Domingues; Henrique Barros

    doi:10.1101/2020.04.25.20079509 Date: 2020-04-29 Source: medRxiv

    Background: The COVID-19 pandemic is an emerging concern regarding the potential adverse effects during pregnancy. This study reviews knowledge on the impact of COVID-19 on pregnancy and describes the outcome of published cases of pregnant women diagnosed with COVID-19, as well as the characteristics of COVID-19 positive women who delivered in Portugal by 31 of March 2020. Methods: Searches were conducted in PubMed up to 8 April 2020, using PRISMA standards, to identify original published studies describing pregnant women at any gestational age TRANS diagnosed COVID-19. There were no date or language restrictions on the search. All identified studies were included irrespective of assumptions on study quality. Portuguese cases were ascertained by contact with all Portuguese maternities and based on the information provided by their health professionals. Results: We identified 30 original studies reporting 212 cases of pregnant women with COVID-19 (30 discharged while pregnant), 200 from China and 12 from other countries. The 182 published deliveries resulted in one stillbirth MESHD and 185 live births. Four women with severe COVID-19 required admission to an intensive care unit but no cases of maternal death MESHD were reported. There was one neonatal death MESHD. Preterm births occurred in 28.7% of cases, but it is unclear whether this was iatrogenic. All cases with amniotic fluid, placenta, and/or cord blood SERO analyzed for the SARS-CoV-2 virus were negative. Four newborns were positive for SARS-CoV-2 and three newborns had high levels of IgM antibodies SERO. None of the first eight infants born in Portugal tested positive. Breast milk samples from 13 mothers and described in seven studies showed no evidence of SARS-CoV-2. Conclusion: The evidence related to the effect of COVID-19 on pregnant women is still limited. Pregnant women and newborns should be considered particularly vulnerable populations regarding COVID-19 prevention and management strategies.

    The impact of COVID-19 on pregnancy and neonatal health: a systematic review

    Authors: Mona Mirbeyk; Nima Rezaei

    doi:10.21203/ Date: 2020-04-28 Source: ResearchSquare

    Background: In December 2019, a novel coronavirus disease MESHD (COVID-19) emerged in Wuhan, China. With an incredible rate of contagion, it has reached all over the world, with more than 2 million confirmed cases TRANS at the mid of April. However, the vertical transmission TRANS of COVID-19 is uncertain. This is a systematic review of published studies concerning pregnant women with confirmed COVID-19 and their neonates.Methods: We performed a systematic search in Pubmed, Web of Sciences, Google Scholar, Scopus, and World Health Organization (WHO) COVID-19 database to find articles reporting clinical data of COVID-19-positive pregnant women and their neonates.Results: 37 articles, involving 364 pregnant women with COVID-19 and 302 neonates, were included. The vast majority of pregnant patients were in their third trimester of pregnancy, and only 45 cases were in the first or second trimester (12.4%). Most mothers described mild to moderate manifestations of COVID-19. Of 364 pregnant women, 25 were asymptomatic TRANS at the time of admission. The most common symptoms were fever MESHD fever HP (62.4%) and cough MESHD cough HP (45.3%). Two maternal deaths MESHD occurred. Some pregnant patients (12.1%) had a negative SARS‐CoV‐2 test but displayed clinical manifestations and abnormalities in computed tomography (CT) scan related to COVID‐19. Twenty‐two (6.0%) pregnant patients developed severe pneumonia MESHD pneumonia HP. Two maternal deaths MESHD occurred from severe pneumonia MESHD pneumonia HP and multiple organ dysfunction. Studies included a total of 302 neonates from mothers with COVID‐19. Of the studies that provided data on the timing of birth, there were 65 (23.6%) preterm neonates. One baby was born dead from a mother who also died from COVID-19. Of the babies born alive from mothers with COVID‐19, five newborns faced critical conditions, and two of which later died. A total of 219 neonates underwent nasopharyngeal specimen collection for SARS‐CoV‐2, of which 11 tested positive (5%). Seventeen studies examined samples of the placenta, breast milk, umbilical cord, and amniotic fluid, and all tested negative except one amniotic fluid sample.Conclusions: A systematic review of published studies confirm that the course of COVID-19 in pregnant women resembles that of other populations. However, there is not sufficient evidence to establish an idea that COVID-19 would not complicate pregnancy. 


    Authors: Edward Mullins; David Evans; Russell Viner; Patrick O'Brien; Eddie Morris

    doi:10.1101/2020.03.06.20032144 Date: 2020-03-08 Source: medRxiv

    BACKGROUND Person to person spread of COIVD-19 in the UK has now been confirmed. There are limited case series reporting the impact on women affected by coronaviruses (CoV) during pregnancy. In women affected by SARS and MERS, the case fatality rate appeared higher in women affected in pregnancy compared with non-pregnant women. We conducted a rapid, review to guide management of women affected by COVID -19 during pregnancy and developed interim practice guidance with the RCOG and RCPCH to inform maternity and neonatal service planning METHODS Searches were conducted in PubMed and MedRxiv to identify primary case TRANS reports, case series, observational studies or randomised-controlled trial describing women affected by coronavirus in pregnancy and on neonates. Data was extracted from relevant papers and the review was drafted with representatives of the RCPCH and RCOG who also provided expert consensus on areas where data were lacking RESULTS From 9964 results on PubMed and 600 on MedRxiv, 18 relevant studies (case reports and case series) were identified. There was inconsistent reporting of maternal, perinatal and neonatal outcomes across case reports and series concerning COVID-19, SARS, MERS and other coronaviruses. From reports of 19 women to date affected by COVID-19 in pregnancy, delivering 20 babies, 3 (16%) were asymptomatic TRANS, 1 (5%) was admitted to ICU and no maternal deaths MESHD have been reported. Deliveries were 17 by caesarean section, 2 by vaginal delivery, 8 (42%) delivered pre-term. There was one neonatal death MESHD, in 15 babies who were tested there was no evidence of vertical transmission TRANS. CONCLUSIONS Morbidity and mortality from COVID-19 appears less marked than for SARS and MERS, acknowledging the limited number of cases reported to date. Pre-term delivery affected 42% of women hospitalised with COVID-19, which may put considerable pressure on neonatal services if the UK reasonable worse-case scenario of 80% of the population affected is realised. There has been no evidence of vertical transmission TRANS to date. The RCOG and RCPCH have provided interim guidance to help maternity and neonatal services plan their response to COVID-19.

    Coronavirus Disease MESHD 2019 (COVID-19) During Pregnancy: A Case Series

    Authors: Weiyong Liu; Qianli Wang; Qi Zhang; Ling Chen; Junbo Chen; Bo Zhang; Yanjun Lu; Shaoshuai Wang; Liming Xia; Lu Huang; Kai Wang; Lu Liang; Yongli Zhang; Lance Turtle; David Lissauer; Ke Lan; Ling Feng; Hongjie Yu; Yingle Liu; Ziyong Sun

    id:202002.0373/v1 Date: 2020-02-25 Source:

    Background: Coronavirus disease MESHD 2019 (COVID-19) is a new viral respiratory disease MESHD and whether pregnant women are at increased risk of infection TRANS risk of infection TRANS infection MESHD is unknown. Viral pneumonia MESHD pneumonia HP is an important indirect cause of maternal death MESHD. Little is known about the effects of severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) during pregnancy. Objective: To describe the clinical characteristics of COVID-19 in pregnancy and their newborn infant, and we sought to explored whether the SARS-CoV-2 can be intrauterine vertically transmitted. Study Design: The study was a case series study conducted in the obstetric ward of Tongji Hospital affiliated to Huazhong University of science and technology, Wuhan, China. Demographic, clinical, laboratory and radiological profiles of the SARS-CoV-2 infection MESHD case series. A systematic testing procedure for SARS-CoV-2 infection MESHD using oropharyngeal swab, placenta tissue, vaginal mucus, and breast milk of mothers. and oropharyngeal swab, umbilical cord blood SERO, and serum SERO of newborns was conducted. Results: We have conducted the most thorough virological assessment to date, and we include a longer clinical observation in mother-infant dyads during hospitalization. The clinical course and outcomes of three pregnant women who acquired SARS-CoV-2 infection MESHD late pregnancy are described in mother-infant dyads. Two had caesarean delivery in their third trimester. All patients showed an uneventful perinatal course, and a successful outcome. No infants became infected by vertical transmission TRANS or during delivery. Conclusion: No evidence to suggest the potential risk of intrauterine vertical transmission TRANS in the case series and further in-depth study is needed. Both the pregnancy woman and infant showed fewer adverse maternal and neonatal outcomes.

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MeSH Disease
Human Phenotype

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