孕妇新冠病毒肺炎的发病率及临床特征：来自西班牙的一项单中心队列研究。
Incidence and clinical profiles of COVID-19 pneumonia in pregnant women: A single-centre cohort study from Spain.
作者信息
San-Juan Rafael, Barbero Patricia, Fernández-Ruiz Mario, López-Medrano Francisco, Lizasoáin Manuel, Hernández-Jiménez Pilar, Silva José Tiago, Ruiz-Ruigómez María, Corbella Laura, Rodríguez-Goncer Isabel, Folgueira María Dolores, Lalueza Antonio, Batllori Emma, Mejía Inma, Forcén Laura, Lumbreras Carlos, García-Burguillo Antonio, Galindo Alberto, Aguado José María
机构信息
Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Complutense University, 2ª planta, bloque D. Avda. de Córdoba, s/n. Madrid, Spain.
Unit of Perinatal Medicine, Obstetrics and Gynaecology Department, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Complutense University, Madrid, Spain.
出版信息
EClinicalMedicine. 2020 Jun 15;23:100407. doi: 10.1016/j.eclinm.2020.100407. eCollection 2020 Jun.
BACKGROUND
Information regarding the incidence and characteristics of COVID-19 pneumonia amongst pregnant women is scarce.
METHODS
Single-centre experience with 32 pregnant women diagnosed with COVID-19 between March 5 to April 5, 2020 at Madrid, Spain.
FINDINGS
COVID-19 pneumonia was diagnosed in 61·5% (32/52) women. Only 18·7% (6/32) had some underlying condition (mostly asthma). Supplemental oxygen therapy was required in 18 patients (56·3%), with high-flow requirements in six (18·7%). Eight patients (25·0%) fulfilled the criteria for acute distress respiratory syndrome. Invasive mechanical ventilation was required in two patients (6·2%). Tocilizumab was administered in five patients (15·6%). Delivery was precipitated due to COVID-19 in three women (9·4%). All the newborns had a favourable outcome, with no cases of neonatal SARS-CoV-2 transmission. Severe cases of pneumonia requiring supplemental oxygen were more likely to exhibit bilateral alveolar or interstitial infiltrates on chest X-ray (55·6% vs. 0·0%; -value = 0·003) and serum C-reactive protein (CRP) levels >10 mg/dL (33·0% vs. 0·0%; -value = 0·05) at admission than those with no oxygen requirements.
INTERPRETATION
Pregnant women with COVID-19 have a high risk of developing pneumonia, with a severe course in more than half of cases. The presence of bilateral kung infiltrates and elevated serum CRP at admission may identify women at-risk of severe COVID-19 pneumonia.
FUNDING
Instituto de Salud Carlos III (COV20/00,181), Spanish Ministry of Science and Innovation.
背景
关于孕妇中新型冠状病毒肺炎（COVID-19）的发病率和特征的信息匮乏。
方法
对2020年3月5日至4月5日在西班牙马德里诊断为COVID-19的32名孕妇进行单中心经验研究。
研究结果
61.5%（32/52）的女性被诊断为COVID-19肺炎。只有18.7%（6/32）有一些基础疾病（主要是哮喘）。18名患者（56.3%）需要补充氧气治疗，其中6名（18.7%）需要高流量吸氧。8名患者（25.0%）符合急性呼吸窘迫综合征的标准。2名患者（6.2%）需要有创机械通气。5名患者（15.6%）接受了托珠单抗治疗。3名女性（9.4%）因COVID-19提前分娩。所有新生儿结局良好，无新生儿SARS-CoV-2传播病例。与无需吸氧的病例相比，需要补充氧气的重症肺炎病例在入院时胸部X线更可能表现为双侧肺泡或间质浸润（55.6%对0.0%；P值 = 0.003）以及血清C反应蛋白（CRP）水平>10mg/dL（33.0%对0.0%；P值 = 0.05）。
解读
感染COVID-19的孕妇发生肺炎的风险很高，超过半数病例病情严重。入院时存在双侧肺部浸润和血清CRP升高可能有助于识别重症COVID-19肺炎的高危女性。
资助
卡洛斯三世健康研究所（COV20/00,181），西班牙科学与创新部。
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