Elsevier

Journal of Infection

Volume 81, Issue 1, July 2020, Pages e40-e44
Journal of Infection

Clinical features and outcomes of pregnant women suspected of coronavirus disease 2019

https://doi.org/10.1016/j.jinf.2020.04.003Get rights and content

Highlights

  • The newly identified 2019 novel coronavirus disease (COVID-19) is spreading nationwide. Previous studies mainly focus on non-pregnant population with COVID-19. The purpose of this study is to investigate and analysis the clinical features, imaging findings, related laboratory indicators and outcomes of maternal-fetal for cases of 55 pregnant women who had been initials dignosed with suspected infection COVID-19 at maternal and child health hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, a tertiarycare teaching hospital in Hubei province, Wuhan, China from January 23 to March 5, 2020 . Among the 55 cases, 13 patients were assigned into the confirmed COVID-19 group and the other 42 patients were assigned into the control group for being ruled out COVID-19 pneumonia. All the 13 confirmed pregnant women were diagnosed with asymptomatic and mild COVID-19, and no one of the patients developed severe COVID-19 or died. For the parturient women with asymptomatic and mild COVID-19, the clinical symptoms and laboratory indicators are not obvious. Pulmonary CT image of those manifestations is not the specific clinical features of COVID-19 pneumonia. The count of lymphocyte was lower in the confirmed COVID-19 cases, but there was no change in the normal cases. In Wuhan where the incidence of COVID-19 is high, pulmonary CT screening on admission may be necessary to reduce the transmission of COVID-19 during the outbreak period. Pulmonary CT scan plus blood routine examination of WBC, neutrophil and lymphocyte are more suitable for finding pregnancy women with asymptomatic or mild COVID-19 infection once pregnant women are in labor and have no time to confirm COVID-19, and thus protecting normal pregnancy women and medical staffs.

Summary

Background

2019 novel coronavirus disease (COVID-19) has become a worldwide pandemic. Under such circumstance pregnant women are also affected significantly.

Objective

This study aims to observe the clinical features and outcomes of pregnant women who have been confirmed with COVID-19.

Methods

The research objects were 55 cases of suspected COVID-19 pregnant women who gave a birth from Jan 20th 2020 to Mar 5th 2020 in our hospital-a big birth center delivering about 30,000 babies in the last 3 years. These cases were subjected to pulmonary CT scan and routine blood test, manifested symptoms of fever, cough, chest tightness or gastrointestinal symptoms. They were admitted to an isolated suite, with clinical features and newborn babies being carefully observed. Among the 55 cases, 13 patients were assigned into the confirmed COVID-19 group for being tested positive sever acute respiratory syndrome coronavirus 2(SARS-CoV-2) via maternal throat swab test, and the other 42 patients were assigned into the control group for being ruled out COVID-19 pneumonia based on new coronavirus pneumonia prevention and control program(the 7th edition).

Results

There were 2 fever patients during the prenatal period and 8 fever patients during the postpartum period in the confirmed COVID-19 group. In contrast, there were 11 prenatal fever patients and 20 postpartum fever patients in the control group (p>0.05). Among 55 cases, only 2 case had cough in the confirmed group. The imaging of pulmonary CT scan showed ground- glass opacity (46.2%, 6/13), patch-like shadows(38.5%, 5/13), fiber shadow(23.1%, 3/13), pleural effusion (38.5%, 5/13)and pleural thickening(7.7%, 1/13), and there was no statistical difference between the confirmed COVID-19 group and the control group (p>0.05). During the prenatal and postpartum period, there was no difference in the count of WBC, Neutrophils and Lymphocyte, the radio of Neutrophils and Lymphocyte and the level of CRP between the confirmed COVID-19 group and the control group(p<0.05). 20 babies (from confirmed mother and from normal mother) were subjected to SARS-CoV-2 examination by throat swab samples in 24 h after birth and no case was tested positive.

Conclusion

The clinical symptoms and laboratory indicators are not obvious for asymptomatic and mild COVID-19 pregnant women. Pulmonary CT scan plus blood routine examination are more suitable for finding pregnancy women with asymptomatic or mild COVID-19 infection, and can be used screening COVID-19 pregnant women in the outbreak area of COVID-19 infection.

Keywords

COVID-19
Novel Cornonavirus
Outcomes
Pregnant women
Pulmonary CT scan

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1

These authors contributed equally to this work.

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