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严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)在妊娠晚期感染:来自中国武汉的 18 例患者报告。

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection during late pregnancy: a report of 18 patients from Wuhan, China.

机构信息

Department Of Obstetrics and Gynecology, Renmin Hospital Of Wuhan University, Wuhan, 430060, China.

Department Of Reproductive Medicine Center, Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Renmin Hospital Of Wuhan University, Wuhan, 430060, China.

出版信息

BMC Pregnancy Childbirth. 2020 Jul 8;20(1):394. doi: 10.1186/s12884-020-03026-3.

Abstract

BACKGROUND

Compared with Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), Corona Virus Disease 2019(COVID-19) spread more rapidly and widely. The population was generally susceptible. However, reports on pregnant women infected with SARS-CoV-2 were very limited. By sharing the clinical characteristics, treatments and outcomes of 18 patients with COVID-19 during late pregnancy, we hope to provide some references for obstetric treatment and management.

METHODS

A total of 18 patients with COVID-19 treated at Renmin Hospital of Wuhan University were collected. The epidemiological characteristics, clinical manifestations, laboratory tests, chest CT and pregnancy outcomes were performed for analysis.

RESULTS

  1. 18 cases of late pregnancy infected with SARS-CoV-2 pneumonia were delivered at 35 weeks to 41 weeks. According to the clinical classification of COVID-19, 1 case was mild type, 16 cases were ordinary type, and 1 case was severe type. 2. According to imaging examinations: 15 (83%) cases showed unilateral or bilateral pneumonia, 2 (11%) cases had pulmonary infection with pleural effusion, and 1 (6%) case had no abnormal imaging changes. 8 (44%) cases were positive and 10 (56%) cases were negative for nasopharyngeal-swab tests of SARS-CoV-2. 3. Among the 18 newborns, there were 3 (17%) premature infants, 1 (6%) case of mild asphyxia, 5 (28%) cases of bacterial pneumonia, 1 (6%) case of gastrointestinal bleeding, 1 (6%) case of necrotizing enteritis, 2 (11%) cases of hyperbilirubinemia and 1 (6%) case of diarrhea. All the newborns were negative for the first throat swab test of SARS-CoV-2 after birth. 4. Follow-up to Mar 7, 2020, no maternal and neonatal deaths occurred.

CONCLUSIONS

The majority of patients in late term pregnancy with COVID-19 were of ordinary type, and they were less likely to develop into critical pneumonia after early isolation and antiviral treatment. Vertical transmission of SARS-CoV-2 was not detected, but the proportion of neonatal bacterial pneumonia was higher than other neonatal diseases in newborns.

摘要

背景

与严重急性呼吸综合征(SARS)和中东呼吸综合征(MERS)相比,2019 年冠状病毒病(COVID-19)传播更快、更广。人群普遍易感。然而,关于感染 SARS-CoV-2 的孕妇的报告非常有限。通过分享 18 例妊娠晚期 COVID-19 患者的临床特征、治疗方法和结局,我们希望为产科治疗和管理提供一些参考。

方法

收集了在武汉大学人民医院治疗的 18 例 COVID-19 妊娠晚期患者。对其流行病学特征、临床表现、实验室检查、胸部 CT 和妊娠结局进行分析。

结果

  1. 18 例妊娠晚期感染 SARS-CoV-2 肺炎的患者在 35 周至 41 周分娩。根据 COVID-19 的临床分类,轻度 1 例,普通型 16 例,重型 1 例。2. 根据影像学检查:单侧或双侧肺炎 15 例(83%),肺炎合并胸腔积液 2 例(11%),无异常影像学改变 1 例(6%)。鼻咽拭子 SARS-CoV-2 检测阳性 8 例(44%),阴性 10 例(56%)。3. 18 例新生儿中,早产儿 3 例(17%),轻度窒息 1 例(6%),细菌性肺炎 5 例(28%),胃肠道出血 1 例(6%),坏死性小肠结肠炎 1 例(6%),高胆红素血症 2 例(11%),腹泻 1 例(6%)。所有新生儿出生后首次咽拭子 SARS-CoV-2 检测均为阴性。4. 截至 2020 年 3 月 7 日随访,母婴均未死亡。

结论

妊娠晚期 COVID-19 患者多为普通型,早期隔离抗病毒治疗后,不易发展为危重型肺炎。未检测到 SARS-CoV-2 的垂直传播,但新生儿细菌性肺炎的比例高于其他新生儿疾病。

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