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Maternal and neonatal outcomes associated with COVID-19 infection: A systematic review.

与新型冠状病毒肺炎感染相关的孕产妇和新生儿结局: 系统综述。

  • 影响因子:3.02
  • DOI:10.1371/journal.pone.0234187
  • 作者列表:"Smith V","Seo D","Warty R","Payne O","Salih M","Chin KL","Ofori-Asenso R","Krishnan S","da Silva Costa F","Vollenhoven B","Wallace E
  • 发表时间:2020-06-04
Abstract

BACKGROUND:COVID-19 has created an extraordinary global health crisis. However, with limited understanding of the effects of COVID-19 during pregnancy, clinicians and patients are forced to make uninformed decisions. OBJECTIVES:To systematically evaluate the literature and report the maternal and neonatal outcomes associated with COVID-19. SEARCH STRATEGY:PubMed, MEDLINE, and EMBASE were searched from November 1st, 2019 and March 28th, 2020. SELECTION CRITERIA:Primary studies, reported in English, investigating COVID-19-positive pregnant women and reporting their pregnancy and neonatal outcomes. DATA COLLECTION AND ANALYSIS:Data in relation to clinical presentation, investigation were maternal and neonatal outcomes were extracted and analysed using summary statistics. Hypothesis testing was performed to examine differences in time-to-delivery. Study quality was assessed using the ICROMS tool. MAIN RESULTS:Of 73 identified articles, nine were eligible for inclusion (n = 92). 67.4% (62/92) of women were symptomatic at presentation. RT-PCR was inferior to CT-based diagnosis in 31.7% (26/79) of cases. Maternal mortality rate was 0% and only one patient required intensive care and ventilation. 63.8% (30/47) had preterm births, 61.1% (11/18) fetal distress and 80% (40/50) a Caesarean section. 76.92% (11/13) of neonates required NICU admission and 42.8% (40/50) had a low birth weight. There was one indeterminate case of potential vertical transmission. Mean time-to-delivery was 4.3±3.08 days (n = 12) with no difference in outcomes (p>0.05). CONCLUSIONS:COVID-19-positive pregnant women present with fewer symptoms than the general population and may be RT-PCR negative despite having signs of viral pneumonia. The incidence of preterm births, low birth weight, C-section, NICU admission appear higher than the general population.

摘要

背景: 新型冠状病毒肺炎造成了一场非同寻常的全球健康危机。然而,由于对怀孕期间新型冠状病毒肺炎的影响了解有限,临床医生和患者被迫做出不知情的决定。 目的: 系统评价文献报道与新型冠状病毒肺炎相关的孕产妇和新生儿结局。 检索策略: 从 2019 年 11 月 1 日和 2020 年 3 月 28 日检索了PubMed、MEDLINE和EMBASE。 选择标准: 主要研究,英文报告,调查COVID-19-positive孕妇,报告其妊娠和新生儿结局。 数据收集和分析: 提取与临床表现、调查孕产妇和新生儿结局相关的数据,并使用汇总统计进行分析。进行假设检验以检查交付时间的差异。使用ICROMS工具评估研究质量。 主要结果: 在 73 篇确定的文章中,9 篇符合纳入条件 (n = 92)。67.4% (62/92) 的女性在就诊时有症状。在 31.7% (26/79) 的病例中,RT-PCR低于基于CT的诊断。产妇死亡率为 0%,只有一名患者需要重症监护和通气。早产 63.8% 例 (30/47),胎儿窘迫 61.1% 例 (11/18),剖腹产 80% 例 (40/50)。76.92% (11/13) 的新生儿需要NICU入院,42.8% (40/50) 的新生儿出生体重较低。有一个不确定的潜在垂直传播案例。平均分娩时间为 4.3 ± 3.08 天 (n = 12),结局无差异 (p>0.05)。 结论: COVID-19-positive孕妇的症状比普通人群少,尽管有病毒性肺炎的迹象,但RT-PCR可能是阴性的。早产、低出生体重、剖腹产、NICU入院的发生率明显高于普通人群。

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DOI:10.3346/jkms.2020.35.e79
作者列表:["Lim J","Jeon S","Shin HY","Kim MJ","Seong YM","Lee WJ","Choe KW","Kang YM","Lee B","Park SJ"]

METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.

影响因子:4.36
发表时间:2020-02-17
DOI:10.1080/22221751.2020.1729071
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METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.

翻译标题与摘要 下载文献
影响因子:2.48
发表时间:2020-04-01
来源期刊:Infection
DOI:10.1007/s15010-020-01401-y
作者列表:["Cheng ZJ","Shan J"]

METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.

呼吸道感染方向

呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。

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