Department of Obstetrics and Gynecology, McGill University, Montréal, QC.
Department of Medicine, Division of General Internal Medicine, McGill University Health Centre, Montréal, QC.
J Obstet Gynaecol Can. 2021 May;43(5):571-575. doi: 10.1016/j.jogc.2020.11.001. Epub 2020 Nov 5.
Coronavirus disease 2019 (COVID-19) may present asymptomatically in a large proportion of cases in endemic areas. Accordingly, universal testing has been suggested as a potential strategy for reducing transmission in the obstetrical setting. We describe the clinical characteristics of patients who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy at a designated COVID-19 hospitalization centre in Montréal, Québec.
A single-centre retrospective cohort was constructed to include all pregnant patients who tested positive for SARS-CoV-2 between March 22 and July 31, 2020, and received care at the Jewish General Hospital. Initially, testing was restricted to at-risk patients, identified through the use of a screening questionnaire. Beginning on May 15, 2020, universal testing was implemented, and all pregnant patients admitted to the hospital were tested. Data were collected through chart review.
Of 803 patients tested for SARS-CoV-2 during the study period, 41 (5%) tested positive. Among those patients who were symptomatic, the most commonly reported symptoms were cough (53%), fever (37%), dyspnea (30%), and anosmia and/or ageusia (20%). Before the implementation of universal testing, 13% (3 of 24) of patients with SARS-CoV-2 were asymptomatic. After implementation of universal testing, 80% (8 of 10) of patients with SARS-CoV-2 were asymptomatic.
Our findings suggest that most pregnant patients with SARS-CoV-2 are asymptomatic or have mild symptoms of COVID-19. Particularly in endemic areas, universal testing of pregnant patients presenting to the hospital should be strongly considered as an important measure to prevent in-hospital and community transmission of COVID-19.
在地方性流行地区，2019 年冠状病毒病（COVID-19）可能有很大一部分病例无症状。因此，普遍检测被认为是减少产科环境传播的一种潜在策略。我们描述了在魁北克省蒙特利尔的一家指定 COVID-19 住院中心，对 COVID-19 检测呈阳性的妊娠患者的临床特征。
建立了一个单中心回顾性队列，纳入了 2020 年 3 月 22 日至 7 月 31 日期间 COVID-19 检测呈阳性并在犹太综合医院接受治疗的所有孕妇患者。最初，通过使用筛查问卷来识别高危患者进行检测。从 2020 年 5 月 15 日开始，实施了普遍检测，所有住院的孕妇患者都接受了检测。数据通过病历回顾收集。
在研究期间对 803 名患者进行了 SARS-CoV-2 检测，其中 41 名（5%）检测呈阳性。在有症状的患者中，最常见的症状是咳嗽（53%）、发热（37%）、呼吸困难（30%）以及嗅觉丧失和/或味觉丧失（20%）。在实施普遍检测之前，有 SARS-CoV-2 的患者中 13%（3/24）无症状。实施普遍检测后，有 SARS-CoV-2 的患者中有 80%（8/10）无症状。
我们的研究结果表明，大多数 COVID-19 检测呈阳性的孕妇患者无症状或有轻度 COVID-19 症状。特别是在地方性流行地区，应强烈考虑对住院的孕妇患者进行普遍检测，作为预防 COVID-19 在医院和社区内传播的重要措施。
