Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York-Presbyterian Hospital, New York, New York.
Division of Obstetric Anesthesia, Columbia University Medical Center, New York-Presbyterian Hospital, New York, New York.
Am J Obstet Gynecol MFM. 2020 May;2(2):100118. doi: 10.1016/j.ajogmf.2020.100118. Epub 2020 Apr 9.
Novel coronavirus disease 2019 is rapidly spreading throughout the New York metropolitan area since its first reported case on March 1, 2020. The state is now the epicenter of coronavirus disease 2019 outbreak in the United States, with 84,735 cases reported as of April 2, 2020. We previously presented an early case series with 7 coronavirus disease 2019-positive pregnant patients, 2 of whom were diagnosed with coronavirus disease 2019 after an initial asymptomatic presentation. We now describe a series of 43 test-positive cases of coronavirus disease 2019 presenting to an affiliated pair of New York City hospitals for more than 2 weeks, from March 13, 2020, to March 27, 2020. A total of 14 patients (32.6%) presented without any coronavirus disease 2019-associated viral symptoms and were identified after they developed symptoms during admission or after the implementation of universal testing for all obstetric admissions on March 22. Among them, 10 patients (71.4%) developed symptoms of coronavirus disease 2019 over the course of their delivery admission or early after postpartum discharge. Of the other 29 patients (67.4%) who presented with symptomatic coronavirus disease 2019, 3 women ultimately required antenatal admission for viral symptoms, and another patient re-presented with worsening respiratory status requiring oxygen supplementation 6 days postpartum after a successful labor induction. There were no confirmed cases of coronavirus disease 2019 detected in neonates upon initial testing on the first day of life. Based on coronavirus disease 2019 disease severity characteristics by Wu and McGoogan, 37 women (86%) exhibited mild disease, 4 (9.3%) severe disease, and 2 (4.7%) critical disease; these percentages are similar to those described in nonpregnant adults with coronavirus disease 2019 (about 80% mild, 15% severe, and 5% critical disease).
自 2020 年 3 月 1 日报告首例病例以来,新型冠状病毒病 2019 迅速在纽约大都市地区蔓延。截至 2020 年 4 月 2 日,该州已成为美国冠状病毒病 2019 疫情的中心,报告病例 84735 例。我们之前介绍了一组 7 例新型冠状病毒病 2019 阳性孕妇的早期病例,其中 2 例最初无症状表现,后来被诊断为新型冠状病毒病 2019。现在,我们描述了 2020 年 3 月 13 日至 3 月 27 日期间在纽约市两家附属医院就诊的 43 例新型冠状病毒病 2019 检测阳性病例。共有 14 名患者(32.6%)无任何新型冠状病毒病 2019 相关病毒症状,他们是在入院后或 3 月 22 日对所有产科入院患者进行普遍检测后出现症状时被发现的。其中,10 名患者(71.4%)在分娩入院期间或产后早期出现新型冠状病毒病 2019 症状。在另外 29 名有症状的新型冠状病毒病 2019 患者中,3 名女性最终因病毒症状而需要产前入院,另一名患者在成功引产 6 天后因呼吸状况恶化需要吸氧补充治疗而再次就诊。在新生儿出生第一天的初步检测中,没有发现新生儿确诊为新型冠状病毒病 2019。根据 Wu 和 McGoogan 的新型冠状病毒病 2019 疾病严重程度特征,37 名女性(86%)表现为轻症,4 名(9.3%)为重症,2 名(4.7%)为危重症;这些百分比与 Wu 和 McGoogan 描述的非孕妇新型冠状病毒病 2019 患者相似(约 80%轻症,15%重症,5%危重症)。