tetano
Editor, Senior Moderator
EClinicalMedicine
. 2020 Jun 15;23:100407.
doi: 10.1016/j.eclinm.2020.100407. eCollection 2020 Jun.
Incidence and Clinical Profiles of COVID-19 Pneumonia in Pregnant Women: A Single-Centre Cohort Study From Spain
Rafael San-Juan[SUP] 1 [/SUP], Patricia Barbero[SUP] 2 [/SUP], Mario Fern?ndez-Ruiz[SUP] 1 [/SUP], Francisco L?pez-Medrano[SUP] 1 [/SUP], Manuel Lizaso?in[SUP] 1 [/SUP], Pilar Hern?ndez-Jim?nez[SUP] 1 [/SUP], Jos? Tiago Silva[SUP] 1 [/SUP], Mar?a Ruiz-Ruig?mez[SUP] 1 [/SUP], Laura Corbella[SUP] 1 [/SUP], Isabel Rodr?guez-Goncer[SUP] 1 [/SUP], Mar?a Dolores Folgueira[SUP] 3 [/SUP], Antonio Lalueza[SUP] 4 [/SUP], Emma Batllori[SUP] 2 [/SUP], Inma Mej?a[SUP] 2 [/SUP], Laura Forc?n[SUP] 2 [/SUP], Carlos Lumbreras[SUP] 4 [/SUP], Antonio Garc?a-Burguillo[SUP] 2 [/SUP], Alberto Galindo[SUP] 2 [/SUP], Jos? Mar?a Aguado[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Information regarding the incidence and characteristics of COVID-19 pneumonia amongst pregnant women is scarce.
Methods: Single-centre experience with 32 pregnant women diagnosed with COVID-19 between March 5 to April 5, 2020 at Madrid, Spain.
Findings: COVID-19 pneumonia was diagnosed in 61?5% (32/52) women. Only 18?7% (6/32) had some underlying condition (mostly asthma). Supplemental oxygen therapy was required in 18 patients (56?3%), with high-flow requirements in six (18?7%). Eight patients (25?0%) fulfilled the criteria for acute distress respiratory syndrome. Invasive mechanical ventilation was required in two patients (6?2%). Tocilizumab was administered in five patients (15?6%). Delivery was precipitated due to COVID-19 in three women (9?4%). All the newborns had a favourable outcome, with no cases of neonatal SARS-CoV-2 transmission. Severe cases of pneumonia requiring supplemental oxygen were more likely to exhibit bilateral alveolar or interstitial infiltrates on chest X-ray (55?6% vs. 0?0%; P-value = 0?003) and serum C-reactive protein (CRP) levels >10 mg/dL (33?0% vs. 0?0%; P-value = 0?05) at admission than those with no oxygen requirements.
Interpretation: Pregnant women with COVID-19 have a high risk of developing pneumonia, with a severe course in more than half of cases. The presence of bilateral kung infiltrates and elevated serum CRP at admission may identify women at-risk of severe COVID-19 pneumonia.
Funding: Instituto de Salud Carlos III (COV20/00,181), Spanish Ministry of Science and Innovation.
Keywords: ALT, alanine aminotransferase; ARDS, acute respiratory distress syndrome; AST, aspartate aminotransferase; COVID-19; COVID-19, coronavirus disease 2019; CRP, C-reactive protein; CT, computerized tomography; Coronavirus; HCQ, hydroxychloroquine; ICU, intensive care unit; IFN-β, interferon-β; IMV, invasive mechanical ventilation; IQR, interquartile range; IV, intravenous; LPV/r, lopinavir/ritonavir; Pneumonia; Pregnancy; RT-PCR, reverse transcription polymerase chain reaction; Risk stratification; SARS-CoV-2; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; TCZ, tocilizumab; URTI, upper respiratory tract infection; ePaO2/FiO2, estimated arterial oxygen/fraction of inspired oxygen ratio.
. 2020 Jun 15;23:100407.
doi: 10.1016/j.eclinm.2020.100407. eCollection 2020 Jun.
Incidence and Clinical Profiles of COVID-19 Pneumonia in Pregnant Women: A Single-Centre Cohort Study From Spain
Rafael San-Juan[SUP] 1 [/SUP], Patricia Barbero[SUP] 2 [/SUP], Mario Fern?ndez-Ruiz[SUP] 1 [/SUP], Francisco L?pez-Medrano[SUP] 1 [/SUP], Manuel Lizaso?in[SUP] 1 [/SUP], Pilar Hern?ndez-Jim?nez[SUP] 1 [/SUP], Jos? Tiago Silva[SUP] 1 [/SUP], Mar?a Ruiz-Ruig?mez[SUP] 1 [/SUP], Laura Corbella[SUP] 1 [/SUP], Isabel Rodr?guez-Goncer[SUP] 1 [/SUP], Mar?a Dolores Folgueira[SUP] 3 [/SUP], Antonio Lalueza[SUP] 4 [/SUP], Emma Batllori[SUP] 2 [/SUP], Inma Mej?a[SUP] 2 [/SUP], Laura Forc?n[SUP] 2 [/SUP], Carlos Lumbreras[SUP] 4 [/SUP], Antonio Garc?a-Burguillo[SUP] 2 [/SUP], Alberto Galindo[SUP] 2 [/SUP], Jos? Mar?a Aguado[SUP] 1 [/SUP]
Affiliations
- PMID: 32632417
- PMCID: PMC7295514
- DOI: 10.1016/j.eclinm.2020.100407
Abstract
Background: Information regarding the incidence and characteristics of COVID-19 pneumonia amongst pregnant women is scarce.
Methods: Single-centre experience with 32 pregnant women diagnosed with COVID-19 between March 5 to April 5, 2020 at Madrid, Spain.
Findings: COVID-19 pneumonia was diagnosed in 61?5% (32/52) women. Only 18?7% (6/32) had some underlying condition (mostly asthma). Supplemental oxygen therapy was required in 18 patients (56?3%), with high-flow requirements in six (18?7%). Eight patients (25?0%) fulfilled the criteria for acute distress respiratory syndrome. Invasive mechanical ventilation was required in two patients (6?2%). Tocilizumab was administered in five patients (15?6%). Delivery was precipitated due to COVID-19 in three women (9?4%). All the newborns had a favourable outcome, with no cases of neonatal SARS-CoV-2 transmission. Severe cases of pneumonia requiring supplemental oxygen were more likely to exhibit bilateral alveolar or interstitial infiltrates on chest X-ray (55?6% vs. 0?0%; P-value = 0?003) and serum C-reactive protein (CRP) levels >10 mg/dL (33?0% vs. 0?0%; P-value = 0?05) at admission than those with no oxygen requirements.
Interpretation: Pregnant women with COVID-19 have a high risk of developing pneumonia, with a severe course in more than half of cases. The presence of bilateral kung infiltrates and elevated serum CRP at admission may identify women at-risk of severe COVID-19 pneumonia.
Funding: Instituto de Salud Carlos III (COV20/00,181), Spanish Ministry of Science and Innovation.
Keywords: ALT, alanine aminotransferase; ARDS, acute respiratory distress syndrome; AST, aspartate aminotransferase; COVID-19; COVID-19, coronavirus disease 2019; CRP, C-reactive protein; CT, computerized tomography; Coronavirus; HCQ, hydroxychloroquine; ICU, intensive care unit; IFN-β, interferon-β; IMV, invasive mechanical ventilation; IQR, interquartile range; IV, intravenous; LPV/r, lopinavir/ritonavir; Pneumonia; Pregnancy; RT-PCR, reverse transcription polymerase chain reaction; Risk stratification; SARS-CoV-2; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; TCZ, tocilizumab; URTI, upper respiratory tract infection; ePaO2/FiO2, estimated arterial oxygen/fraction of inspired oxygen ratio.