Summary
This retrospective study aimed to investigate the clinical characteristics and neonatal outcomes of pregnant women with SARS-COV-2 in Wuhan Children’s Hospital and further suggested a possible management strategy for infected pregnant women under epidemic situation. In this study, 8 pregnant women with SARS-COV-2 who were admitted into Wuhan Children’s Hospital, China from February 1, 2020 to March 30, 2020 and the clinical features, laboratory data, maternal and neonatal outcomes were analyzed. The mean age of the women at the time of admission was 30.6 years. The mean gestational age of the women was 37 weeks+4 days, and one woman presented with dichorionic diamniotic (DCDA) twin pregnancy. Except for one woman who was febrile, others had no typical clinical symptoms. For all pregnant women, the count of white blood cells and lymphocytes appeared normal, but 6 had a lower percentage of lymphocytes. C-reactive protein (CRP) levels were normal for all the women. One neonate was tested positive for the coronavirus IgG and IgM antibodies. The clinical symptoms of the pregnant women with SARS-COV-2 were mild, and the laboratory data showed similar characteristics to those of non-infected pregnant women. Since one neonate was tested positive for coronavirus, there is a possibility of vertical transmission of SARS-CoV-2. Prompt and efficient screening, triage, and isolation of pregnant women are effective management strategies to reduce nosocomial infection during the SARS-COV-2 epidemic.
Key words: SARS-COV-2, vertical transmission, pregnant women, neonates, clinical features, maternal and child outcomes
Footnotes
This project was supported by Wuhan Health Commission Fund, China (No. WX14A08).
Conflict of Interest Statement
We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted.
These authors contributed equally to this work.
Contributor Information
Yu Chen, Email: 64812727@qq.com.
Xiang-li Pang, Email: 489626237@qq.com.
Wen-ping Ding, Email: dwpkitty@163.com.
Jing Yang, Email: dryangqing@hotmail.com.
Yan Zhou, Email: zhouyan030118@126.com.
References
- 1.WHO. Coronavirus disease 2019 (SARS-COV-2) Situation Report. Available at https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Accessed at 2020.
- 2.Meng Y, Wu P, Lu W, et al. Sex-specific clinical characteristics and prognosis of coronavirus disease-19 infection in Wuhan, China: A retrospective study of 168 severe patients. PLoS Pathog. 2020;16(4):e1008520. doi: 10.1371/journal.ppat.1008520. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Yu N, Li W, Kang Q, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. Lancet Infect Dis. 2020;20(5):559–564. doi: 10.1016/S1473-3099(20)30176-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Iqbal SN, Overcash R, Mokhtari N, et al. An Uncomplicated Delivery in a Patient with Covid-19 in the United States. N Engl J Med. 2020;382(16):e34. doi: 10.1056/NEJMc2007605. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.National Health Commission & State Administration of Traditional Chinese Medicine of the People’s Republic of China. Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7). (http://www.nhc.gov.cn/). 2020.
- 6.Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061–1069. doi: 10.1001/jama.2020.1585. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Niu S, Tian S, Lou J, et al. Clinical characteristics of older patients infected with COVID-19: A descriptive study. Arch Gerontol Geriatr. 2020;89:104058. doi: 10.1016/j.archger.2020.104058. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Team C-R. Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12-March 16, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(12):343–346. doi: 10.15585/mmwr.mm6912e2. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Zhao X, Jiang Y, Zhao Y, et al. Analysis of the susceptibility to COVID-19 in pregnancy and recommendations on potential drug screening. Eur J Clin Microbiol Infect Dis. 2020;39(7):1209–1220. doi: 10.1007/s10096-020-03897-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Pacheco LD, Saad AF, Saade G. Early Acute Respiratory Support for Pregnant Patients with Coronavirus Disease 2019 (COVID-19) Infection. Obstet Gynecol. 2020;136(1):42–45. doi: 10.1097/AOG.0000000000003929. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Dong L, Tian J, He S, et al. Possible Vertical Transmission of SARS-CoV-2 from an Infected Mother to Her Newborn. JAMA. 2020;323(18):1846–1848. doi: 10.1001/jama.2020.4621. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.Xu QC, Shen J, Pan LL, et al. Coronavirus disease 2019 in pregnancy. Int J Infect Dis. 2020;95:376–383. doi: 10.1016/j.ijid.2020.04.065. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Lu D, Sang L, Du S, et al. Asymptomatic COVID-19 infection in late pregnancy indicated no vertical transmission. J Med Virol. 2020;92(9):1660–1664. doi: 10.1002/jmv.25927. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Yan J, Guo J, Fan C, et al. Coronavirus disease 2019 in pregnant women: a report based on 116 cases. Am J Obstet Gynecol. 2020;223(1):111 e111–111 e114. doi: 10.1016/j.ajog.2020.04.014. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Alzamora MC, Paredes T, Caceres D, et al. Severe COVID-19 during Pregnancy and Possible Vertical Transmission. Am J Perinatol. 2020;37(8):861–865. doi: 10.1055/s-0040-1710050. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Ferrazzi E, Frigerio L, Savasi V, et al. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020;127(9):1116–1121. doi: 10.1111/1471-0528.16278. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Scorzolini L, Corpolongo A, Castilletti C, et al. Comment on the Potential Risks of Sexual and Vertical Transmission of COVID-19. Clin Infect Dis. 2020;71(16):2298. doi: 10.1093/cid/ciaa445. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Zhang ZJ, Yu XJ, Fu T, et al. Novel coronavirus infection in newborn babies aged <28 days in China. Eur Respir J. 2020;55(6):2000697. doi: 10.1183/13993003.00697-2020. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 19.Hantoushzadeh S, Shamshirsaz AA, Aleyasin A, et al. Maternal death due to COVID-19. Am J Obstet Gynecol. 2020;223(1):109 e101–109 e116. doi: 10.1016/j.ajog.2020.04.030. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Costantine MM, Landon MB, Saade GR. Protection by Exclusion: Another Missed Opportunity to Include Pregnant Women in Research During the Coronavirus Disease 2019 (COVID-19) Pandemic. Obstet Gynecol. 2020;136(1):26–28. doi: 10.1097/AOG.0000000000003924. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Wang SS, Zhou X, Lin XG, et al. Experience of Clinical Management for Pregnant Women and Newborns with Novel Coronavirus Pneumonia in Tongji Hospital, China. Curr Med Sci. 2020;40(2):285–289. doi: 10.1007/s11596-020-2174-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22.Zheng F, Liao C, Fan QH, et al. Clinical Characteristics of Children with Coronavirus Disease 2019 in Hubei, China. Curr Med Sci. 2020;40(2):275–280. doi: 10.1007/s11596-020-2172-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
