scholarly journals Diagnosis Challenges, Management, and Outcome of Infants Born to Mothers With COVID 19

2020 ◽  
Author(s):  
Gabriela Zaharie ◽  
Monica Hasmasanu ◽  
Daniel Muresan ◽  
Tunde Kovacs ◽  
Melinda Matyas
Keyword(s):  
Hospital Stay ◽  
Pregnant Women ◽  
Distress Syndrome ◽  
Laboratory Data ◽  
Perinatal Transmission ◽  
Risk Category ◽  
Rt Pcr ◽  
Medical Assistance ◽  
High Risk Category ◽  
Pcr Test

Abstract Background: Severe acute respiratory distress syndrome with Coronavirus 2 (SARS-CoV-2) infection affected the pregnant women during the pandemics. Immunological particularity of this population and the increased need for medical assistance put this population in a high-risk category for SARS-Cov-2 infection.Because of high contamination risk and limited studies about vertical transmission, the labor and delivery of positive women require special conditions. Cesarean section is probably the best option for delivery of infants to reduce the risk of infection during birth.Aim: Our study aims to present the management and outcome of infants born to mothers confirmed with coronavirus disease 2019 (COVID19) before delivery.Material and methods: This is longitudinal, retrospective study, analyzing demographics, laboratory data and management of neonates born of mothers with diagnosis of SARS-Cov -2 infection.Results: 5 neonates were born of SARS-Cov-2 positive mothers , all by C- section and had negative real time –PCR ( RT-PCR) test. None of them was breastfed during hospital stay. The negative RT-PCR test allowed us to reduce the hospital stay of infants and care them in non –isolated area.Conclusion: In our study, vertical or perinatal transmission of the infection was not present. The testing of the pregnant women, their isolation and delivery in safe conditions for the medical staff were possible, using adequate protection equipment to limit their infection and the risk for the newborns.

scholarly journals Maternal and Perinatal Outcomes in Patients with Suspected COVID-19 and Their Relationship with a Negative RT-PCR Result

2020 ◽  
Vol 9 (11) ◽  
pp. 3552 ◽  
Author(s):  
Yolanda Cuñarro-López ◽  
Óscar Cano-Valderrama ◽  
Pilar Pintado-Recarte ◽  
Ignacio Cueto-Hernández ◽  
Blanca González-Garzón ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Oxygen Therapy ◽  
Perinatal Outcomes ◽  
Tertiary Hospital ◽  
Monocyte Count ◽  
Rt Pcr ◽  
Negative Test ◽  
Negative Test Result ◽  
Test Result ◽  
Pcr Test

This study was designed to examine maternal-perinatal outcomes in pregnant women with suspected coronavirus disease 2019 (COVID-19) according to the result of a real-time reverse transcription polymerase chain reaction (RT-PCR) test and to investigate possible variables that could be useful for predicting a negative RT-PCR result. Participants of this retrospective cohort study were obstetrics patients with suspected COVID-19 who underwent an RT-PCR test in a tertiary hospital in Madrid, Spain. Maternal-perinatal features were analysed according to the results of this test. Clinical, radiological and analytical characteristics that could be associated with a negative result were also explored. In a final subgroup analysis, patients were included if they had pneumonia and a negative test result for the virus. Out of the 111 obstetric patients with suspected COVID-19 that were enrolled, 38.7% returned a negative result. In this RT-PCR-negative group, we recorded lower rates of pneumonia (21.4% vs. 45.6%, p = 0.009), severe or critical clinical features (4.7% vs. 11.8% and 0.0% vs. 5.9%, p = 0.02, respectively), lower lactate dehydrogenase (LDH) levels (168 UI/L vs. 224.5 UI/L, p = 0.003), a greater need for maternal treatment (60.3% vs 24.4%, p < 0.001), a reduced need for oxygen therapy (2.4% vs 28.8%, p < 0.001) and a lower rate of intensive care unit admission (0.0% vs. 3.7%, p = 0.046) than the RT-PCR-positive group. While no differences were found in other variables, the monocyte count was higher (946.2/μL vs. 518.8/μL, p = 0.022) in this group. The predictive model for a negative test result included the monocyte count, LDH level and no need for oxygen therapy. This model was able to identify 73.5% of patients with a negative RT-PCR result. Only 11% of the patients with pneumonia testing negative for the virus had IgG antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The proportion of pregnant women with suspected COVID-19 and a negative RT-PCR result was nearly 39%. In these patients, the symptoms were mild and the systemic severity of the disease was lower. The monocyte count, LDH level and no need for oxygen therapy were the factors that were more related to a negative test result in this group. These variables could be used to guide the management of patients with suspected COVID-19, mainly while waiting for RT-PCR results or in settings where this test is not available.

scholarly journals A Prospective Study of Feto-Maternal Outcome Among Covid-19 Positive Women Delivered in a Level III Covid Hospital at Moradabad, Western UP

2021 ◽  
Author(s):  
Nupur Nandi ◽  
Ritika Agarwal ◽  
Garima Bajpai
Keyword(s):  
Pregnant Women ◽  
Vertical Transmission ◽  
Ventilatory Support ◽  
Late Pregnancy ◽  
Maternal Outcome ◽  
Data Availability ◽  
Research Centre ◽  
Care Hospital ◽  
Rt Pcr ◽  
Pcr Test

Abstract Background: The ongoing pandemic situation by a highly infective Covid-19 virus is a global health threat. Pregnancy related physiological changes of cardio- respiratory system and relative immunosuppression might cause more infectivity and worsening complications of this novel respiratory virus infection. Limited data availability on feto -maternal outcome of Covid 19 positive pregnant women necessitates the current study.Methodology: A prospective cohort study was conducted in a government designated level III Covid care hospital at Teerthankar Mahaveer Medical College & Research Centre to assess the feto-maternal outcome in Covid 19 RT- PCR test positive pregnant women delivered between April 2020 to September 2020. Mothers were evaluated in terms of asymptomatic status or predominant symptoms (fever, cough, sore throat, and breathlessness), complication if any including need for ventilatory support for extensive pneumonia, or mortality. Neonates were tested for presence of infection by RT-PCR test on day 2 & 5 of delivery, and also looked for any symptoms of the disease or it’s complication.Results: Total 33 women with Covid19 positivity delivered at term pregnancy in the said period of 6 months. The most frequent (45.45%) age group was 26 to 30 years. Asymptomatic Covid 19 positive cases were more (57.58%) prevailing over symptomatic patients. Fever was most frequent (33.33%) physical symptom. Emotional quotient was significantly affected by presence of anxiety amongst 36.36%. Caesarean delivery conducted maintaining all protocol in 60.6% women, but all were indicated for other obstetric reason. None of the mother had developed significant pneumonia or other complication. One case of maternal mortality noted, but was not related to Covid 19 infection. Vertical transmission was nil in our study and no neonate was affected by any complication.Conclusion: Course of disease was not different in pregnant women infected by Covid 19 virus in late pregnancy in comparison to non-pregnant adults. No case of vertical transmission noted, neither any neonatal morbidity nor mortality in present study, shows the importance of following optimum protocol. All pregnant women should be screened for Covid 19 infection in current scenario.

scholarly journals Study of mode of delivery and maternal morbidity in preterm and term COVID-19 positive pregnant women

2021 ◽  
Vol 10 (12) ◽  
pp. 4383
Author(s):  
Saksha Dholakiya ◽  
Pooja S. Singh ◽  
Jaishree Bamniya ◽  
Haresh U. Doshi
Keyword(s):  
Pregnant Women ◽  
Mode Of Delivery ◽  
Initial Assessment ◽  
High Risk Population ◽  
Cesarean Sections ◽  
Rt Pcr ◽  
Third Trimester ◽  
The Third ◽  
Obstetrics And Gynaecology ◽  
Pcr Test

Background: Pregnant women are likely to represent a high-risk population during current coronavirus 2019 pandemic caused by severe acute respiratory syndrome coronavirus-2. The aim and objective of this study was to evaluate how COVID-19 pandemic has affected the mode of delivery and whether complications of the disease and mortality rate are higher in pregnant women than in non‐pregnant women.Methods: This ambispective observational study was conducted in department of obstetrics and gynaecology of our institute. Pregnant women diagnosed with positive for COVID-19 via the SARS-CoV-2 RT-PCR test in the third trimester and all neonates with complete COVID-19 testing and delivery data. This data was analysed.Results: Out of total 66 cases studied, 48 patients (72.7%) were asymptomatic, while 13 (19.7%) had mild respiratory or gastro intestinal symptoms on initial assessment at admission, including cough, sore throat, fever, weakness or diarrhoea. Cesarean sections were performed in 57.6% of cases. There were no cases of maternal or neonatal mortality.Conclusions: The study revealed that COVID-19 positive pregnant women are usually asymptomatic or mild-moderately symptomatic, similar to COVID-19 positive non-pregnant women. There was a noted rise in the rate of caesarean sections as a mode of delivery. 

scholarly journals Trends of COVID-19 Admissions in an Italian Hub during the Pandemic Peak: Large Retrospective Study Focused on Older Subjects

2021 ◽  
Vol 10 (5) ◽  
pp. 1115
Author(s):  
Andrea Ticinesi ◽  
Antonio Nouvenne ◽  
Nicoletta Cerundolo ◽  
Alberto Parise ◽  
Beatrice Prati ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Chronic Diseases ◽  
Laboratory Data ◽  
Second Phase ◽  
Inverse Association ◽  
Rt Pcr ◽  
Respiratory Impairment ◽  
Clinical Records ◽  
Pandemic Wave ◽  
Pcr Test

Older multimorbid frail subjects have been severely involved in the coronavirus disease-19 (COVID-19) pandemic. The aim of this retrospective study is to compare the clinical features and outcomes of patients admitted in different phases of the outbreak in a COVID-19 hospital hub, with a particular focus on age, multimorbidity, and functional dependency. The clinical records of 1264 patients with clinical and radiological features compatible with COVID-19 pneumonia admitted in February–June, 2020, were analyzed, retrieving demographical, clinical, laboratory data, and outcomes. All variables were compared after stratification by the period of admission (first phase: rising slope of pandemic wave; second phase: plateau and falling slope), age, results of the first reverse transcriptase-polymerase chain reaction (RT-PCR) test for detection of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), multimorbidity (≥2 chronic diseases), and presence of disability. Factors independently associated with hospital mortality were determined by multivariate forward-selection logistic regression. Patients admitted during the second phase were older, more frequently multimorbid, disabled, and of female gender. However, on admission they exhibited milder respiratory impairment (PaO2/FiO2 268, IQR 174–361, vs. 238, IQR 126–327 mmHg, p < 0.001) and lower mortality (22% vs. 27%, p < 0.001). Age, respiratory exchanges, positive RT-PCR test, number of chronic diseases (odds ratio (OR) 1.166, 95% confidence interval (CI) 1.036–1.313, p = 0.011), and disability (OR 1.927, 95% CI 1.027–3.618, p = 0.022) were positively associated with mortality, while admission during the second phase exhibited an inverse association (OR 0.427, 95% CI 0.260–0.700, p = 0.001). In conclusion, older multimorbid patients were mainly hospitalized during the second phase of the pandemic wave. The prognosis was strongly influenced by the COVID-19 phenotype and period of admission, not just by age, multimorbidity, and disability.

scholarly journals Maternal and Neonatal Outcomes of SARS-CoV-2 Infection in a Cohort of Pregnant Women with Comorbid Disorders

Viruses ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1277
Author(s):  
Maria de Lourdes Benamor Teixeira ◽  
Orlando da Costa Ferreira Júnior ◽  
Esaú João ◽  
Trevon Fuller ◽  
Juliana Silva Esteves ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Laboratory Data ◽  
Case Series ◽  
Neonatal Outcomes ◽  
Rt Pcr ◽  
Serum Samples ◽  
Middle Income ◽  
Vaccination Programs ◽  
Maternal And Neonatal Outcomes ◽  
Few Data

There are some reports and case series addressing Coronavirus Disease 2019 (COVID-19) infections during pregnancy in upper income countries, but there are few data on pregnant women with comorbid conditions in low and middle income Countries. This study evaluated the proportion and the maternal and neonatal outcomes associated with SARS-CoV-2 infection among pregnant women with comorbidities. Participants were recruited consecutively in order of admission to a maternity for pregnant women with comorbidities. Sociodemographic, clinical, and laboratory data were prospectively collected during hospitalization. Pregnant women were screened at entry: nasopharyngeal swabs were tested by RT-PCR; serum samples were tested for IgG antibodies against spike protein by ELISA. From April to June 2020, 115 eligible women were included in the study. The proportion of SARS-CoV-2 infection was 28.7%. The rate of obesity was 60.9%, vascular hypertension 40.0%, and HIV 21.7%. The most common clinical presentations were ageusia (21.2%), anosmia (18.2%), and fever (18.2%). Prematurity was higher among mothers who had a SARS-CoV-2 infection based on RT-PCR. There were two cases of fetal demise. We found a high proportion of COVID-19 among pregnant women with comorbidities. This underscores the importance of antenatal care during the pandemic to implement universal SARS-CoV-2 screening, precautionary measures, and the rollout of vaccination programs for pregnant women.

scholarly journals Radiological Features on HRCT and RT-PCR Testing for the Diagnosis of Coronavirus Disease 2019 (COVID-19) in China: A Comparative Study of 78 Cases in Pregnant Women

2020 ◽  
Author(s):  
Ming Deng ◽  
Wenbo Sun ◽  
Jinxiang Hu ◽  
Liejun Mei ◽  
Dinghu Weng ◽  
...  
Keyword(s):  
Ct Scan ◽  
Pregnant Women ◽  
Predictive Value ◽  
Lower Lobe ◽  
Ct Scans ◽  
Imaging Features ◽  
Rt Pcr ◽  
Double Positive ◽  
Quantitative Parameters ◽  
Pcr Test

Abstract BackgroundIn the past four months, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global health threat. In the context of the coronavirus disease 2019 (COVID-19) epidemic, pneumonia is a critical disease that threatens the health of pregnant women and fetuses. We aimed to evaluate the quantitative parameters of CT scans performed on pregnant women with COVID-19 who had different reverse transcription-polymerase chain reaction (RT-PCR) results.MethodsPregnant women with suspected cases of COVID-19 pneumonia (confirmed by next-generation sequencing or RT-PCR) who underwent high-resolution lung CT scans were retrospectively enrolled. Patients were grouped based on the results of the RT-PCR and the first CT scan: group 1 (double positive patients; positive RT-PCR and CT scan) and group 2 (negative RT-PCR and positive CT scan). The imaging features and their distributions were extracted and compared between the two groups.ResultsSeventy-eight patients were admitted to the hospital between Dec 20, 2019, and Feb 29, 2020. The mean age of the patients was 31.82 years (SD 4.1, ranged from 21 to 46 years). The cohort included 14 (17.95%) patients with a positive RT-PCR test and 64 (82.05%) with a negative RT-PCR test, there were 37 (47.44%) patients with a positive CT scan, and 41 (52.56%) patients with a negative CT scan. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT-based diagnosis of COVID-19 were 85.71%, 60.94%, 32.40%, 95.12% and 65.38%, respectively. COVID-19 pneumonia mainly involved the right lower lobe of the lung. There were 53 semi-quantitative and 59 quantitative parameters, which were compared between the two groups. There were no significant differences in the quantitative parameters. However, the Hellinger distance was significantly different between the two groups, albeit with a limited diagnostic value (AUC = 0.63).ConclusionsPregnant women with pneumonia usually present with typical abnormal signs on CT. Although multidimensional CT quantitative parameters are somewhat different between groups of patients with different RT-PCR results, it is still impossible to accurately predict whether the RT-PCR will be positive, which would allow for the earlier detection of SARS-CoV-2 infection.

scholarly journals Training of Cadres In The Context of Emergency Identification of Pregnant Women During The Covid 19 Pandemic

2022 ◽  
Vol 4 (2) ◽  
pp. 979-983
Author(s):  
Dyah Puji Astuti ◽  
Kusumastuti Kusumastuti ◽  
Rosmawati Rosmawati
Keyword(s):  
Pregnant Women ◽  
Community Service ◽  
Emergency Services ◽  
Risk Category ◽  
Service Program ◽  
High Risk Category ◽  
Level Of Knowledge ◽  
Training Activities ◽  
Policy Direction ◽  
In Pregnancy

The Covid-19 pandemic has changed many things, including the policy direction for the schedule of examinations for pregnant women, which was initially at least four times during pregnancy to one time, as long as the pregnancy is not problematic. In the midst of the COVID-19 pandemic, many pregnant women are reluctant to check their pregnancy at the hospital for fear of contracting the Corona virus, even though pregnancy checks still need to be carried out regularly. The purpose of this community service is to provide training to health cadres regarding emergencies in pregnancy so that cadres can provide assistance in order to identify emergency conditions during pregnancy during the COVID-19 pandemic. The method of activities carried out is cadre training and assistance to pregnant women. The results showed that after the training activities, the level of knowledge of cadres on emergency services in pregnant women increased and pregnant women in the high risk category were 53.7%. In conclusion, this community service program has succeeded in increasing the knowledge of cadres in assisting pregnant women during the COVID-19 pandemic.

scholarly journals Coronavirus disease 2019 may be driven by an overactivation of the renin-angiotensin-aldosterone system 

2020 ◽  
Author(s):  
Susanne Rysz ◽  
Jonathan Al-Saadi ◽  
Maria Farm ◽  
Francesca Campoccia Jalde ◽  
Margareta Klein ◽  
...  
Keyword(s):  
Distress Syndrome ◽  
Clinical Laboratory ◽  
Laboratory Data ◽  
Large Animal Model ◽  
Large Animal ◽  
Rt Pcr ◽  
Subsequent Increase ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
New Treatments

Abstract SARS-CoV-2 enters the cell through the ACE2 receptor, which is considered one of the main inhibitors in the Renin-Angiotensin-Aldosterone System (RAAS).1​ ,2 The virus has been shown to downregulate the ACE2 receptor, leading to a subsequent increase in the vasopressoragentangiotensinII.3​ Evidently,criticalcoronavirusdisease2019(COVID-19)is thought to be due to a dysregulated immune response, causing a cytokine-release syndrome eventually leading to acute respiratory distress syndrome (ARDS).4​ ,5 ​However, several reports on clinical laboratory features and case-descriptions of critically ill patients with COVID-19 show discrepancies compared to typical ARDS. Here, we show that infusing swines with angiotensin II induces a pathophysiological syndrome closely resembling that of patients with RT-PCR-positive COVID-19. By using multimodal clinical imaging of patients, comparing laboratory data and translational histological features, we show that it is highly likely that an increase in RAAS is one, if not the main, pathogenic feature in critical COVID-19. Furthermore, it is plausible that this large animal model can be used to screen for potential new treatments for patients with severe COVID-19 and that MRI lung perfusion can be used to evaluate the outcome of potential treatments targeting the pathophysiological syndrome.

scholarly journals Radiological Features on HRCT and RT-PCR Testing for the Diagnosis of Coronavirus Disease 2019 (COVID-19) in China: A Comparative Study of 78 Cases in Pregnant Women

2020 ◽  
Author(s):  
Ming Deng ◽  
Wenbo Sun ◽  
Jinxiang Hu ◽  
Liejun Mei ◽  
Dinghu Weng ◽  
...  
Keyword(s):  
Ct Scan ◽  
Pregnant Women ◽  
Predictive Value ◽  
Lower Lobe ◽  
Ct Scans ◽  
Imaging Features ◽  
Rt Pcr ◽  
Double Positive ◽  
Quantitative Parameters ◽  
Pcr Test

Abstract Objective: We aimed to evaluate the quantitative parameters of CT scans performed on pregnant women with COVID-19 who had different reverse transcription-polymerase chain reaction (RT-PCR) results.Methods: Pregnant women with suspected cases of COVID-19 pneumonia (confirmed by next-generation sequencing or RT-PCR) who underwent high-resolution lung CT scans were retrospectively enrolled. Patients were grouped based on the results of the RT-PCR and the first CT scan: group 1 (double positive patients; positive RT-PCR and CT scan) and group 2 (negative RT-PCR and positive CT scan). The imaging features and their distributions were extracted and compared between the two groups.Results: Seventy-eight patients were admitted to the hospital between Dec 20, 2019, and Feb 29, 2020. The mean age of the patients was 31.82 years (SD 4.1, ranged from 21 to 46 years). The cohort included 14 (17.95%) patients with a positive RT-PCR test and 64 (82.05%) with a negative RT-PCR test, there were 37 (47.44%) patients with a positive CT scan, and 41 (52.56%) patients with a negative CT scan. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT-based diagnosis of COVID-19 were 85.71%, 60.94%, 32.40%, 95.12% and 65.38%, respectively. COVID-19 pneumonia mainly involved the right lower lobe of the lung. There were 53 semi-quantitative and 59 quantitative parameters, which were compared between the two groups. There were no significant differences in the quantitative parameters. However, the Hellinger distance was significantly different between the two groups, albeit with a limited diagnostic value (AUC=0.63).Conclusions: Pregnant women with pneumonia usually present with typical abnormal signs on CT. Although multidimensional CT quantitative parameters are somewhat different between groups of patients with different RT-PCR results, it is still impossible to accurately predict whether the RT-PCR will be positive, which would allow for the earlier detection of SARS-CoV-2 infection.

scholarly journals Coronavirus disease 2019 may be driven by an overactivation of the renin-angiotensin-aldosterone system 

2020 ◽  
Author(s):  
Susanne Rysz ◽  
Jonathan Al-Saadi ◽  
Maria Farm ◽  
Francesca Campoccia Jalde ◽  
Margareta Klein ◽  
...  
Keyword(s):  
Distress Syndrome ◽  
Clinical Laboratory ◽  
Laboratory Data ◽  
Large Animal Model ◽  
Large Animal ◽  
Rt Pcr ◽  
Subsequent Increase ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
New Treatments

Abstract SARS-CoV-2 enters the cell through the ACE2 receptor, which is considered one of the main inhibitors in the Renin-Angiotensin-Aldosterone System (RAAS).1​ ,2 The virus has been shown to downregulate the ACE2 receptor, leading to a subsequent increase in the vasopressoragentangiotensinII.3​ Evidently,criticalcoronavirusdisease2019(COVID-19)is thought to be due to a dysregulated immune response, causing a cytokine-release syndrome eventually leading to acute respiratory distress syndrome (ARDS).4​ ,5 ​However, several reports on clinical laboratory features and case-descriptions of critically ill patients with COVID-19 show discrepancies compared to typical ARDS. Here, we show that infusing swines with angiotensin II induces a pathophysiological syndrome closely resembling that of patients with RT-PCR-positive COVID-19. By using multimodal clinical imaging of patients, comparing laboratory data and translational histological features, we show that it is highly likely that an increase in RAAS is one, if not the main, pathogenic feature in critical COVID-19. Furthermore, it is plausible that this large animal model can be used to screen for potential new treatments for patients with severe COVID-19 and that MRI lung perfusion can be used to evaluate the outcome of potential treatments targeting the pathophysiological syndrome.

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