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在纽约一家生殖内分泌学诊所进行的普遍 SARS-CoV-2 检测的早期经验。

Early experience with universal SARS-CoV-2 testing in a New York-based reproductive endocrinology ‎practice.

机构信息

Montefiore Medical Center,Institute for Reproductive Medicine and Health, Hartsdale, NY, USA.

Division of Reproductive Endocrinology and Infertility, Montefiore Medical Center, Bronx, NY, USA.

出版信息

Syst Biol Reprod Med. 2021 Apr;67(2):144-150. doi: 10.1080/19396368.2021.1884317. Epub 2021 Mar 16.

Abstract

The SARS-CoV-2 pandemic peak around March 2020 led to temporary closures of most fertility clinics. Many clinics reopened but required universal SARS-CoV-2 screening. However, the rate of positive results and the necessity for such testing is unknown. We report here on early results from asingle-center academic NewYork fertility practice utilizing universal SARS-CoV-2 screening. This mixed prospective retrospective cohort included 164 patients who underwent at least one SARS-CoV-2 screening test for fertility treatment between May and July2020. Patients completed 1 to 3 nasopharyngeal SARS-CoV-2 tests per cycle and remained symptom-free to continue fertility treatments. SARS-CoV-2 test results, past results, history of Covid-19 infection, and patient/cycle characteristics were recorded and tabulated through October2020. Outcomes included positive SARS-CoV-2 RNA tests, rate of prior Covid-19 infections, and clinical courses of patients testing positive. Patients underwent 263 cycles entailing 460 total SARS-CoV-2 screening tests. Fifteen patients reported astrong prior clinical history of Covid-19. Six patients experienced apositive SARS-CoV-2 test (2.3% of all cycles). Among 77 cycles (n = 58 patients) entailing one SARS-CoV-2 test, 2 cases (2.6%) were noted. Among 173 cycles (n = 121 patients) entailing two SARS-CoV-2 tests, 4 cycles (2.3%) were noted. Zero (0%) of 13 cycles (n = 13 patients) entailing 3 SARS-CoV-2 tests were positive. All patients were cleared to resume treatment within one month. Overall, anew asymptomatic infection was identified in 2 cycles (0.8%), while 4 of the 6 positive SARS-CoV-2 tests were among patients with aprior history of Covid-19. 3 of 4 also had adocumented prior positive RNA test. Our data suggest that universal SARS-CoV-2 screening among fertility patients is feasible, with an approximately 2% positive rate per cycle among the patients of this study. Most positive patients had aprior remote infection, but their infectiousness while being screened remains unclear. REI: reproductive endocrinology and infertility; IUI: intrauterine insemination; IVF: fertilization; sono: sonography; cryo: cryopreservation; FET: frozen embryo transfer.

摘要

2020 年 3 月左右,SARS-CoV-2 大流行达到高峰,导致大多数生育诊所暂时关闭。许多诊所重新开放,但需要进行普遍的 SARS-CoV-2 筛查。然而,阳性结果的比率和进行此类检测的必要性尚不清楚。我们在此报告一家位于纽约的学术生育实践中心的早期结果,该中心利用普遍的 SARS-CoV-2 筛查。这项混合前瞻性回顾性队列研究包括 164 名患者,他们在 2020 年 5 月至 7 月期间接受了至少一次生育治疗的 SARS-CoV-2 筛查测试。患者每周期进行 1 到 3 次鼻咽 SARS-CoV-2 测试,并且无症状继续进行生育治疗。通过 2020 年 10 月记录并制表了 SARS-CoV-2 检测结果、既往结果、Covid-19 感染史以及患者/周期特征。结果包括 SARS-CoV-2 RNA 检测阳性、既往 Covid-19 感染率以及检测呈阳性的患者的临床过程。患者接受了 263 个周期,总共进行了 460 次 SARS-CoV-2 筛查测试。15 名患者报告了强烈的既往临床新冠病毒感染史。6 名患者 SARS-CoV-2 检测呈阳性(占所有周期的 2.3%)。在 77 个周期(n=58 名患者)中进行了一次 SARS-CoV-2 检测,发现 2 例(2.6%)。在 173 个周期(n=121 名患者)中进行了两次 SARS-CoV-2 检测,发现 4 个周期(2.3%)。在进行了 3 次 SARS-CoV-2 检测的 13 个周期(n=13 名患者)中,无一例呈阳性。所有患者均在一个月内获准恢复治疗。总的来说,在 2 个周期(0.8%)中发现了新的无症状感染,而在 6 例 SARS-CoV-2 检测阳性的患者中,有 4 例有新冠病毒感染史。其中 4 例的既往 RNA 检测也呈阳性。我们的数据表明,对生育患者进行普遍的 SARS-CoV-2 筛查是可行的,在本研究的患者中,每个周期的阳性率约为 2%。大多数阳性患者有既往的远程感染,但他们在筛查期间的传染性尚不清楚。REI:生殖内分泌与不孕;IUI:宫腔内人工授精;IVF:体外受精;sono:超声检查;cryo:冷冻保存;FET:冷冻胚胎移植。

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