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两波疫情期间无症状未免疫低危产妇人群中的 SARS-CoV-2 流行率。

The rate of SARS-CoV-2 among asymptomatic non-immunised low-risk parturient women between the two waves.

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt.

Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.

出版信息

J Obstet Gynaecol. 2022 Aug;42(6):1868-1873. doi: 10.1080/01443615.2022.2049720. Epub 2022 Apr 29.

Abstract

This study was conducted to evaluate the rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and immunity among asymptomatic non-immunised low-risk parturient women and their newborns. A cross-sectional study conducted in a tertiary hospital during the nadir period of new cases in Egypt. All asymptomatic pregnant, low risk and non-immunised women were included. All eligible participants had been subjected to SARS-CoV-2 nasopharyngeal swabs according to CDC and sampling of maternal and umbilical blood to evaluate the presence of coronavirus disease 2019 (COVID-19) IgM and IgG antibodies by immunochromatographic assay. Two cases out of 171 (1.2%) parturient women were tested positive for PCR swab to COVID-19 infection. Furthermore, COVID-19 IgG and IgM antibodies testing showed that 67.8% of women were negative for both IgG and IGM, 24.6% were positive for IgG only, 4.1% were positive for IgM only, while 3.5% were positive for both IgG and IgM. Regarding neonatal testing for immunity, 28.1% of the neonates were positive to IgG only and none for IgM.The rate of positive PCR patients among asymptomatic low-risk parturient women was 1.2%. About quarter of women had got herd immunity as evident by positive IgG antibodies. IgG antibodies transferred to the neonates in almost all cases.Impact Statement Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global public health emergency. Asymptomatic pregnant women with coronavirus disease can transmit their infection to their newborn, family members and the health care providers. The study showed very low (1.2%) prevalence of COVID positive cases among asymptomatic pregnant women admitted to our facility. Only two cases out of 171 parturient women tested PCR positive for COVID-19 infection (1.2%). SARS-Cov-2 IgG and IgM antibodies testing showed, about a quarter (24.6%) were positive for IgG antibodies, 4.1% were positive for IgM antibodies, while 3.5% were positive for both IgG and IgM. On the other hand, 28.1% of the neonates were positive to IgG only and none of the newborns had had IgM antibodies in their cord blood. The first wave of COVID-19 pandemic in Egypt left behind at least a quarter of pregnant women with a positive antibody denoting some immunity. This immunity is usually transmitted to the neonates in almost all cases.

摘要

这项研究旨在评估无症状未免疫的低危产妇及其新生儿中严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染和免疫的发生率。这是在埃及新发病例高峰期进行的一项横断面研究。所有无症状、低危且未免疫的孕妇均被纳入研究。所有符合条件的参与者均接受了 SARS-CoV-2 鼻咽拭子检测,根据美国疾病控制与预防中心 (CDC) 的标准进行,并采集了产妇和脐血样本,通过免疫层析法检测 2019 年冠状病毒病 (COVID-19) IgM 和 IgG 抗体。在 171 名产妇中,有 2 例(1.2%)PCR 拭子检测 COVID-19 感染呈阳性。此外,COVID-19 IgG 和 IgM 抗体检测显示,67.8%的女性 IgG 和 IgM 均为阴性,24.6%仅 IgG 阳性,4.1%仅 IgM 阳性,3.5% IgG 和 IgM 均为阳性。关于新生儿免疫检测,28.1%的新生儿仅 IgG 阳性,无一例 IgM 阳性。在无症状低危产妇中,PCR 阳性患者的比例为 1.2%。约四分之一的女性产生了针对 IgG 的群体免疫,因为 IgG 抗体阳性。IgG 抗体几乎在所有情况下都转移到新生儿身上。

意义陈述

由严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 引起的 2019 年冠状病毒病 (COVID-19) 已成为全球公共卫生紧急事件。患有冠状病毒病的无症状孕妇可将其感染传播给新生儿、家庭成员和医护人员。该研究显示,在我院就诊的无症状孕妇中,COVID 阳性病例的患病率非常低(1.2%)。171 名产妇中只有 2 例(1.2%)PCR 检测 COVID-19 感染呈阳性。SARS-CoV-2 IgG 和 IgM 抗体检测显示,约四分之一(24.6%)的 IgG 抗体阳性,4.1%的 IgM 抗体阳性,3.5%的 IgG 和 IgM 抗体均阳性。另一方面,28.1%的新生儿仅 IgG 阳性,而新生儿脐带血中均无 IgM 抗体。在埃及的 COVID-19 大流行第一波期间,至少有四分之一的孕妇产生了针对 IgG 的阳性抗体,表明存在一定的免疫力。这种免疫力几乎在所有情况下都会传递给新生儿。

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