Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, No. 745, Wuluo Road, Hongshan District, Wuhan 430070, China.
Department of Radiology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, No. 745, Wuluo Road, Hongshan District, Wuhan 430070, China.
J Infect. 2020 Jul;81(1):e40-e44. doi: 10.1016/j.jinf.2020.04.003. Epub 2020 Apr 12.
2019 novel coronavirus disease (COVID-19) has become a worldwide pandemic. Under such circumstance pregnant women are also affected significantly.
This study aims to observe the clinical features and outcomes of pregnant women who have been confirmed with COVID-19.
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).
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.
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.
2019 年新型冠状病毒病(COVID-19)已成为全球性大流行。在这种情况下,孕妇也受到了显著影响。
本研究旨在观察确诊为 COVID-19 的孕妇的临床特征和结局。
研究对象为 2020 年 1 月 20 日至 2020 年 3 月 5 日在我院分娩的 55 例疑似 COVID-19 的孕妇,这是一家拥有 3 万名新生儿的大型分娩中心。这些患者接受了肺部 CT 扫描和常规血液检查,表现出发热、咳嗽、胸闷或胃肠道症状。他们被安置在隔离套房中,仔细观察临床特征和新生儿情况。在 55 例患者中,有 13 例经产妇咽喉拭子检测为严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)阳性,被归入确诊 COVID-19 组,其余 42 例患者根据新型冠状病毒肺炎防控方案(第 7 版)排除 COVID-19 肺炎,归入对照组。
确诊 COVID-19 组产前发热 2 例,产后发热 8 例;对照组产前发热 11 例,产后发热 20 例(p>0.05)。55 例患者中,仅有 2 例确诊组患者有咳嗽症状。肺部 CT 扫描结果显示磨玻璃样混浊(46.2%,6/13)、斑片状阴影(38.5%,5/13)、纤维影(23.1%,3/13)、胸腔积液(38.5%,5/13)和胸腔增厚(7.7%,1/13),确诊 COVID-19 组与对照组比较差异无统计学意义(p>0.05)。产前和产后,确诊 COVID-19 组与对照组的白细胞计数、中性粒细胞计数、中性粒细胞与淋巴细胞比值、C 反应蛋白水平差异均无统计学意义(p<0.05)。20 例婴儿(来自确诊母亲和正常母亲)在出生后 24 小时内进行了 SARS-CoV-2 咽拭子检查,均未检测到阳性。
无症状和轻症 COVID-19 孕妇的临床症状和实验室指标不明显。肺部 CT 扫描加血常规检查更适合发现无症状或轻症 COVID-19 感染的孕妇,可作为 COVID-19 感染流行地区筛查 COVID-19 孕妇的方法。