Screening all pregnant women admitted to labor and delivery for the virus responsible for coronavirus disease 2019

To the Editors:

We read with great interest the study of Vintzileos et al and their call for universal obstetrical coronavirus disease 2019 (COVID-19) screening to conserve limited personal protective equipment (PPE) and to allow appropriate triage, adequate obstetrical and neonatal management, and safe patient transport in overcrowded hospitals.¹ However, we disagree with their call for universal COVID-19 testing of asymptomatic pregnant women, rather we suggest continued adherence to the public health guidelines for COVID-19 diagnostic testing.^{2 , 3} The COVID-19 test is extremely specific because it identifies the viral RNA to which the individual has been exposed during the preceding 21 days. The viral load peaks between 7 to 10 days after onset of symptoms and declines throughout the next 3 weeks. Detection is performed by the highly specific (96% specificity) polymerase chain reaction.⁴ The false-negative test rates for this test range from 30% to 3% in asymptomatic and symptomatic populations, respectively.⁵ A positive COVID-19 test result provides no information regarding the individual’s current or future ability to transmit the virus. We therefore recommend continued use of universal PPE during testing, limited to diagnosis in disease management, and as the foundation of a contact public health tracing program. We ask the authors whether there was any difference in the temperature upon admission between women who received positive test results for COVID-19 and women who received negative test results for COVID-19.