Year: 2020
Type: article
Study design: Observational Study
Abstract: Universal Screening for SARS-CoV-2 in Women Admitted for DeliveryTo the Editor: In recent weeks, Covid-19 has rapidly spread throughout New York City.The obstetrical population presents a unique challenge during this pandemic, since these patients have multiple interactions with the health care system and eventually most are admitted to the hospital for delivery.We first diagnosed a case of Covid-19 in an obstetrical patient on March 13, 2020, and we previously reported our early experience with Covid-19 in pregnant women, including two initially asymptomatic women in whom symptoms developed and who tested positive for SARS-CoV-2, the virus that causes Covid-19, after delivery.1,2 After these two cases were identified, we implemented universal testing with nasopharyngeal swabs and a quantitative polymerase-chain-reaction test to detect SARS-CoV-2 infection in women who were admitted for delivery.Between March 22 and April 4, 2020, a total of 215 pregnant women delivered infants at the New York-Presbyterian Allen Hospital and Columbia University Irving Medical Center.All the women were screened on admission for symptoms of Covid-19.Four women (1.9%) had fever or other symptoms of Covid-19 on admission, and all 4 women tested positive for SARS-CoV-2 (Fig. 1).Of the 211 women without symptoms, all were afebrile on admission.Nasopharyngeal swabs were obtained from 210 of the 211 women (99.5%) who did not have symptoms of Covid-19; of these women, 29 (13.7%) were positive for SARS-CoV-2.Thus, 29 of the 33 patients who were positive for SARS-CoV-2 at admission (87.9%) had no symptoms of Covid-19 at presentation.Of the 29 women who had been asymptomatic but who were positive for SARS-CoV-2 on admission, fever developed in 3 (10%) before postpartum discharge (median length of stay, 2 days).Two of these patients received antibiotics for presumed endomyometritis (although 1 patient did not have localizing symptoms), and 1 patient was presumed to be febrile due to Covid-19 and received supportive care.One patient with a swab that was negative
Source: New England Journal of Medicine
DOI: 10.1056/nejmc2009316
Institution: Columbia University Irving Medical Center
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3016031279