key: cord-254278-awdqguoo
authors: Khan, Suliman; Jun, Li; Nawsherwan; Siddique, Rabeea; Li, Yanyan; Han, Guang; Xue, Mengzhou; Nabi, Ghulam; Liu, Jianbo
title: Association of COVID-19 infection with pregnancy outcomes in healthcare workers and general women
date: 2020-04-08
journal: Clin Microbiol Infect
DOI: 10.1016/j.cmi.2020.03.034
sha: 
doc_id: 254278
cord_uid: awdqguoo

nan

Viral pneumonia is thought to be the most common non-obstetric infectious disease 1 during pregnancy, which is associated with maternal and neonatal morbidity and mortality 2 during pregnancy [1] . Atypical pneumonia known as coronavirus disease (COVID-19) caused by 3 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly infectious and is 4 currently spreading rapidly around the globe [2] . Before leading to the global emergency, SARS-5 CoV-2 emerged in Wuhan, Hubei Province, China during December 2019 [3, 4] . Several studies 6 focusing on infected patients from the general population have been reported, however, limited 7 information is available in the aspects of pregnancy outcomes of COVID-19 infected women. general infected women were included in the study. 15 We conducted a case series study on pregnant women (n =17) infected with COVID-19 16 admitted to Hubei general hospital (Renmin Hospital) from Jan 25 to Feb 15, 2020. COVID-19 17 pneumonia was diagnosed according to the New Coronavirus Pneumonia Prevention and Control 18 Program of 5 th and 6 th editions. All the seventeen pregnant women were found positive for 19 COVID-19 using either quantitative RT-PCR (qRT-PCR) and/or CT scan imaging or both. To 20 assess the neonatal infection with COVID-19, cord blood and neonatal throat swab samples were 21 collected immediately after delivery in the operating room and were tested by using quantitative 22 RT-PCR. All the patients delivered babies by C-section, and the detailed information collected 23 are presented in tables 1-4. We conducted a comprehensive literature search for the current 24 outbreak of COVID-19 infection in pregnant women and a thorough search for the impact of 25 SARS-CoV pregnancy outcomes.

The age range of the patients was 24-34 years and the range of gestational weeks at 27 admission was 35 weeks to 41 weeks. Moreover, the range of gestational weeks at delivery was 28 35 weeks and 5 days to 41weeks. respectively. In twelve individuals, the nucleic acid test from 29 the throat swab was positive for COVID-19 while only in five individuals both the CT scan and nucleic acid test indicated COVID-19. We observed fever in three individuals and complications 1 in five. Other common symptoms were cough (n = 6), diarrhea (n = 3), nasal congestion (n = 2), 2 shortness of breath (n = 2), and sputum production (n = 1). Patients were receiving antibiotics 3 (n=17), hormones (n =8), and antivirals together with Chinese medicine (n= 15). A total of 17 4 neonates including three preterm neonates with birthweight ranging from 2300 g to 3750 g and 5 birth length from 45 cm to 52 cm (49.2 cm) were delivered through C-section. There was no fetal 6 or neonatal death. The ultrasound results and fetal heart rate were normal for all the neonates 7 while the Apgar score for 16 neonates was in the range of 9-10. Only two neonates (case 6 and 8 case 14) after birth were suspected for COVID-19 while five neonates were reported with 9 neonatal pneumonia. Moreover, three cases were found with preterm delivery (Table 1 and Table   10 2).

Based on our findings in these seventeen patients, we suggest that COVID-19 infection 12 may lead to the occurrence of neonatal pneumonia and preterm delivery. However, we cannot In summary, we found two neonates suspected for COVID-19 infection and five neonates 1 with neonatal pneumonia, suggesting the possibility that adverse pregnancy outcomes may be 2 linked to COVID-19 infection. 4/17 (23.5% and 0.63-2.37) 4 out of 17 patients were found with lymphopenia, which could be linked with COVID-19 infection Elevated ALT (>45 U/L) 2/17 (11.7% and 9-46) Two out of 17 patients were found with elevated AST and/or ALT. however, the majority of the patients had normal ALT and AST levels. Elevated AST (>35 U/L) 2/17 (11.7% and 12-39) 4/17 (23.5% and 0.63-2.37) 4 out of 17 patients were found with lymphopenia, which could be linked with COVID-19 infection Elevated ALT (>45 U/L) 2/17 (11.7% and 9-46) Two out of 17 patients were found with elevated AST and/or ALT. however, the majority of the patients had normal ALT and AST levels. Elevated AST (>35 U/L) 2/17 (11.7% and 12-39) 

Potential Maternal and Infant Outcomes from (Wuhan)