Division of Maternal-Fetal Medicine, The University of Texas Medical Branch, Galveston, Texas.
Am J Perinatol. 2021 Apr;38(5):515-522. doi: 10.1055/s-0041-1723761. Epub 2021 Feb 6.
This study aimed to describe baseline characteristics of a cohort of pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and determine if these correlate with disease severity and perinatal outcomes.
This was a retrospective cohort trial conducted at the University of Texas Medical Branch Galveston, Texas. All pregnant women presented to our medical center, who were screened and tested positive for SARS-CoV-2 virus, were included. We stratified our study population in three groups: asymptomatic, symptomatic not requiring oxygen therapy, and patients requiring oxygen support to maintain oxygen saturation >94%. Relevant population characteristics, laboratory data, and maternal and neonatal outcomes were abstracted. A -value <0.05 was considered statistically significant.
Between March and July 2020, 91 women tested positive for SARS-CoV-2 upon admission to our labor and delivery unit. Among these, 61.5% were asymptomatic, 34.1% were symptomatic, and 4.4% required oxygen support. Our population was mainly Hispanic (80.2%), multiparous (76.9%), obese (70.3%), and with a median age of 27 years. Median gestational age at symptom onset or diagnosis was 36 weeks. Significant differences were found between gestational age and disease severity. Maternal characteristics including age, body mass index (BMI), and presence of comorbid conditions did not appear to influence severity of SARS-CoV-2 infection. Significant laboratory findings associated with increasing disease severity included decreasing hemoglobin and white blood cell count, lymphopenia, and increasing levels of inflammatory markers including CRP, ferritin, and procalcitonin. Maternal and neonatal outcomes did not differ among groups. No SARS-CoV-2 was detected by polymerase chain reaction testing in neonates of mothers with COVID-19.
Pregnant patients with COVID-19 infection are predominantly asymptomatic. Patients appear to be at increased risk for more severe infection requiring oxygen support later in pregnancy.
· The majority of pregnant patients with COVID-19 are asymptomatic and <1 in 20 require oxygen support.. · Women in the later stages of pregnancy may be at increased risk for severe infection.. · Anemia, leukopenia, CRP, ferritin, and procalcitonin are associated with increasing severity..
本研究旨在描述一组感染严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 的孕妇的基线特征，并确定这些特征是否与疾病严重程度和围产期结局相关。
这是一项在德克萨斯大学医学分部加尔维斯顿分校进行的回顾性队列研究。所有在我们医疗中心就诊且 SARS-CoV-2 病毒检测呈阳性的孕妇均被纳入本研究。我们将研究人群分为三组：无症状、有症状但无需吸氧治疗以及需要吸氧支持以维持血氧饱和度>94%的患者。提取了相关人口特征、实验室数据以及母婴结局。P 值<0.05 被认为具有统计学意义。
在 2020 年 3 月至 7 月期间，有 91 名在我院分娩病房就诊的孕妇 SARS-CoV-2 检测呈阳性。其中，61.5%为无症状，34.1%有症状，4.4%需要吸氧支持。我们的人群主要为西班牙裔（80.2%）、多产（76.9%）、肥胖（70.3%），中位年龄为 27 岁。症状出现或确诊时的中位妊娠龄为 36 周。妊娠龄与疾病严重程度之间存在显著差异。母体特征，包括年龄、体重指数（BMI）和合并症的存在，似乎并未影响 SARS-CoV-2 感染的严重程度。与疾病严重程度增加相关的显著实验室发现包括血红蛋白和白细胞计数下降、淋巴细胞减少以及 C 反应蛋白（CRP）、铁蛋白和降钙素原等炎症标志物水平升高。各组间母婴结局无差异。未在 COVID-19 母亲的新生儿中通过聚合酶链反应检测到 SARS-CoV-2。
COVID-19 感染的孕妇患者主要为无症状。患者在妊娠晚期似乎有更高的风险需要吸氧支持来治疗更严重的感染。
· 大多数 COVID-19 感染的孕妇无症状，不到 1/20 需要吸氧支持。· 妊娠晚期的女性可能有更高的感染严重程度风险。· 贫血、白细胞减少、CRP、铁蛋白和降钙素原与疾病严重程度增加相关。
