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中国武汉2019冠状病毒病肺炎孕妇的临床表现及新生儿结局

Clinical Manifestation and Neonatal Outcomes of Pregnant Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China.

作者信息

Xu Shuang, Shao Fei, Bao Banghe, Ma Xuedi, Xu Zhouming, You Jiwen, Zhao Peng, Liu Yuwei, Ng Michael, Cui Hao, Yu Changxiao, Zhang Qing, Li Dandan, Tang Ziren, Sun Peng

机构信息

Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing Chaoyang Hospital, Beijing, China.

出版信息

Open Forum Infect Dis. 2020 Jul 5;7(7):ofaa283. doi: 10.1093/ofid/ofaa283. eCollection 2020 Jul.

Abstract

BACKGROUND

Clinical manifestation and neonatal outcomes of pregnant women with coronavirus disease 2019 (COVID-19) were unclear in Wuhan, China.

METHODS

We retrospectively analyzed clinical characteristics of pregnant and nonpregnant women with COVID-19 aged from 20 to 40, admitted between January 15 and March 15, 2020 at Union Hospital, Wuhan, and symptoms of pregnant women with COVID-19 and compared the clinical characteristics and symptoms to historic data previously reported for H1N1.

RESULTS

Among 64 patients, 34 (53.13%) were pregnant, with higher proportion of exposure history (29.41% vs 6.67%) and more pulmonary infiltration on computed tomography test (50% vs 10%) compared to nonpregnant women. Of pregnant patients, 27 (79.41%) completed pregnancy, 5 (14.71%) had natural delivery, 18 (52.94%) had cesarean section, and 4 (11.76%) had abortion; 5 (14.71%) patients were asymptomatic. All 23 newborns had negative reverse-transcription polymerase chain results, and an average 1-minute Apgar score was 8-9 points. Pregnant and nonpregnant patients show differences in symptoms such as fever, expectoration, and fatigue and on laboratory tests such as neurophils, fibrinogen, D-dimer, and erythrocyte sedimentation rate. Pregnant patients with COVID-19 tend to have more milder symptoms than those with H1N1.

CONCLUSIONS

Clinical characteristics of pregnant patients with COVID-19 are less serious than nonpregnant. No evidence indicated that pregnant women may have fetal infection through vertical transmission of COVID-19. Pregnant patients with H1N1 had more serious condition than those with COVID-19.

摘要

背景

在中国武汉,2019冠状病毒病(COVID-19)孕妇的临床表现及新生儿结局尚不清楚。

方法

我们回顾性分析了2020年1月15日至3月15日在武汉协和医院收治的年龄在20至40岁之间的COVID-19孕妇和非孕妇的临床特征,以及COVID-19孕妇的症状,并将临床特征和症状与先前报道的甲型H1N1流感的历史数据进行比较。

结果

64例患者中,34例(53.13%)为孕妇,与非孕妇相比,暴露史比例更高(29.41%对6.67%),计算机断层扫描检查显示肺部浸润更多(50%对10%)。在孕妇中,27例(79.41%)完成妊娠,5例(14.71%)自然分娩,18例(52.94%)剖宫产,4例(11.76%)流产;5例(14.71%)患者无症状。所有23名新生儿的逆转录聚合酶链反应结果均为阴性,平均1分钟阿氏评分8 - 9分。孕妇和非孕妇在发热、咳痰、疲劳等症状以及中性粒细胞、纤维蛋白原、D - 二聚体和红细胞沉降率等实验室检查方面存在差异。COVID-19孕妇的症状往往比甲型H1N1流感孕妇更轻。

结论

COVID-19孕妇的临床特征不如非孕妇严重。没有证据表明孕妇可能通过COVID-19垂直传播导致胎儿感染。甲型H1N1流感孕妇的病情比COVID-19孕妇更严重。

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