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对新型冠状病毒肺炎女性患者阴道分泌物中严重急性呼吸综合征冠状病毒2的评估:一项前瞻性研究。

Evaluation of SARS-CoV-2 in the Vaginal Secretions of Women with COVID-19: A Prospective Study.

作者信息

Barber Elad, Kovo Michal, Leytes Sophia, Sagiv Ron, Weiner Eran, Schwartz Orna, Mashavi Margarita, Holtzman Keren, Bar Jacob, Engel Anat, Ginath Shimon

机构信息

Wolfson Medical Center, Department of Obstetrics & Gynecology, E. Holon 5822012, Israel.

Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.

出版信息

J Clin Med. 2021 Jun 21;10(12):2735. doi: 10.3390/jcm10122735.

Abstract

OBJECTIVE

We aimed to investigate the likelihood of vaginal colonization with Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in pregnant and non-pregnant women with Coronavrus Disease 2019 (COVID-19).

MATERIALS AND METHODS

Vaginal swabs were taken from women diagnosed with mild to moderately acute SARS-CoV-2 infection, at Wolfson Medical Center, Israel, from March 2020 through October 2020. COVID-19 was diagnosed by real-time polymerase chain reaction (RT-PCR) performed on nasopharyngeal swabs. Vaginal swabs were tested for the presence of SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR).

RESULTS

In total, 51 women diagnosed with COVID-19 were included in the study. Of the 51 women with COVID-19 enrolled in this study, 16 (31.4%) were pregnant at enrollment and 35 (68.6%) were non-pregnant. Mean age was 43.5 ± 15.3 years (range 21-74 years). Compared to the non-pregnant group, the pregnant group was characterized by a higher white blood cell and absolute neutrophil count ( = 0.02 and = 0.027, respectively). The non-pregnant patients were more likely to have chronic diseases ( = 0.035) and to be hospitalized ( < 0.001). Only one patient (1.9%) aged 60 years tested positive for SARS-CoV-2 in vaginal secretions. Mean gestational age at the diagnosis of COVID-19 of the pregnant group was 32.3 ± 7.8 weeks. Thirteen patients delivered during the study period; all delivered at term without obstetric complications and all neonates were healthy.

CONCLUSIONS

Detection of SARS-CoV-2 in the vaginal secretions of patients diagnosed with COVID-19 is rare. Vaginal colonization may occur during the viremia phase of the disease, although infectivity from vaginal colonization needs to be proven.

摘要

目的

我们旨在调查2019冠状病毒病(COVID-19)孕妇和非孕妇阴道感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的可能性。

材料与方法

2020年3月至2020年10月期间,在以色列沃尔夫森医疗中心,从诊断为轻度至中度急性SARS-CoV-2感染的女性中采集阴道拭子。COVID-19通过对鼻咽拭子进行实时聚合酶链反应(RT-PCR)诊断。通过逆转录聚合酶链反应(RT-PCR)检测阴道拭子中是否存在SARS-CoV-2。

结果

本研究共纳入51例诊断为COVID-19的女性。在本研究纳入的51例COVID-19女性中,16例(31.4%)在入组时为孕妇,35例(68.6%)为非孕妇。平均年龄为43.5±15.3岁(范围21 - 74岁)。与非孕妇组相比,孕妇组的特点是白细胞和绝对中性粒细胞计数较高(分别为P = 0.02和P = 0.027)。非孕妇患者更有可能患有慢性病(P = 0.035)且更有可能住院(P < 0.001)。仅1例60岁患者(1.9%)阴道分泌物中SARS-CoV-2检测呈阳性。孕妇组诊断COVID-19时的平均孕周为32.3±7.8周。13例患者在研究期间分娩;均足月分娩,无产科并发症,所有新生儿均健康。

结论

在诊断为COVID-19的患者阴道分泌物中检测到SARS-CoV-2的情况很少见。阴道定植可能发生在疾病的病毒血症阶段,尽管阴道定植的传染性尚需证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6881/8234022/10ab035c68f1/jcm-10-02735-g001.jpg

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