Chen et al. (15)
|
Original article
|
All nine pregnant women were confirmed COVID-19 were in their third trimester
|
- Seven women were presented with fever without chill
|
- Other symptoms included cough, myalgia, sore throat and malaise
|
- None of the women developed severe pneumonia
|
- Lymphopenia, elevated C-reactive protein, aminotransferase (ALT) and aspartate aminotransferase (AST) were observed among several patients
|
- Eight out of nine pregnant women presented patchy ground-glass opacity in the lung in CT scan
|
- All pregnant women underwent cesarean section
|
- All deliveries resulted in live births with no evidence of vertical transmission of SARS-CoV-2
|
- The sARS-CoV-2 virus was not present in amniotic fluid, cord blood, neonatal throat swab, and breastmilk
|
Chen et al. (16)
|
Original article
|
All 17 pregnant women were tested positive by RT-PCR for SARS-CoV-2
|
- Four women were presented with mild fever and chill
|
- Other symptoms included cough, fatigue, chest distress, overt dyspnea, and diarrhea
|
- Lymphopenia and elevated C-reactive protein were reported for some patients. However, all patients had a normal level of ALT, AST, creatinine and blood urea nitrogen
|
- All pregnant women presented patchy ground-glass opacity in the lung in CT scan
|
- All pregnant women underwent cesarean section
|
- 14 pregnant women received epidural anesthesia, and 12 of them experienced intraoperative hypotension
|
- Three patients received general anesthesia with tracheal intubation due to deteriorating clinical condition
|
- All deliveries resulted in live births, and none of the newborns were tested positive for SARS-CoV-2
|
Di Mascio et al. (17)
|
Systematic review and meta-analysis
|
All nine pregnant women were confirmed COVID-19 were in their third trimester
|
- Most common symptoms of COVID-19 were fever, cough, and lymphopenia
|
- Radiological findings of pneumonia were presented in most of the cases
|
- No data were presented on miscarriage during the first trimester related to COVID-19 infection
|
- While the sample size is very limited, compared to MERS and SARS, COVID-19 infection resulted in higher rates of miscarriage, preeclampsia and preterm birth
|
- Preterm birth was reported most of the cases (41% before 37 weeks and 15% before 34 weeks)
|
- Preterm rupture of membranes reported for 19%, whereas only one pregnant woman suffered from Pre-eclampsia and no fetal growth restriction were reported
|
- No maternal death was reported
|
- Vertical transmission of SARS-CoV-2 was not reported for any newborns
|
Fan et al. (18)
|
Case report
|
Both pregnant women were physicians with confirmed COVID-19 were in their third trimester
|
- Fever and nasal congestion were reported in both cases
|
- One of the patients presented a rash on her abdomen
|
- CT scan of the chest showed patchy consolidations indicating pneumonia
|
- Complete blood count was indicative of lymphopenia only in one of the cases
|
- Oseltamivir and Lianhua Qingwen capsules were prescribed for both cases. However, one of the pregnant women received Ceftazidime as antibiotic treatment - whereas - the other women received Azithromycin.
|
- One of the cases received methylprednisolone for pneumonia
|
- Both pregnant women underwent cesarean section
|
- Vertical transmission of SARS-CoV-2 was not reported, and the newborns or any products of conception was not tested positive for SARS-CoV-2
|
Li et al. (21)
|
Research Letter
|
The pregnant women were in 35th week of pregnancy with confirmed COVID-19
|
- Clinical symptoms started with dry cough and fever
|
- Radiography of chest presented multiple patchy and scattered infiltrates in both lungs
|
- Antiviral drugs (Lopinavir and Ritonavir) and methylprednisolone were given to the patient.
|
- Emergency cesarean section was conducted on 36th week of the pregnancy, and the women delivered a live and healthy baby
|
- The newborn was not tested positive for SARS-CoV-2 in repeated testing during the postnatal period
|
Liu et al. (23)
|
Original article
|
All 15 pregnant women were confirmed for COVID-19 pneumonia with gestational age ranging from 12-38 weeks
|
- Most prevalent clinical symptoms were fever and cough
|
- Fatigues, muscle ache, dyspnea, sore throat, and diarrhea were observed in fewer patients
|
- Lymphopenia and elevated C-reactive protein was observed among 12 and 10 patients accordingly, which were returned to normal
|
- Early CT scan of the chest indicated ground-glass opacities in the lungs which developed into crazy paving pattern and consolidations
|
- Among the 15 women, ten underwent cesarean section, and one delivered vaginally
|
- The 11 women, who delivered, received antiviral treatment after delivery. The other four women did not receive antiviral treatment. All 15 women received antibiotic treatment
|
- No neonatal complication was observed, and the newborns were not tested positive for SARS-CoV-2
|
Liu et al. (24)
|
Original article
|
Among 41 pregnant women 16 were laboratory positive SARS-CoV-2, 25 were clinically-diagnosed COVID-19 cases. Their gestational age ranging from 22-40 weeks
|
- Initially, the pregnant women presented normal body temperature compared to the non-pregnant group
|
- Leukocytosis and elevated neutrophil ratio were also presented among pregnant women
|
- In the scan of the chest, a higher proportion of pregnant women presented mixed and complete consolidation compared to the non-pregnant group. However, pure ground-glass opacity was more common among the non-pregnant group
|
- Six laboratory-positive and 8 CT-confirmed pregnant women receive Antiviral therapy.
|
- Vertical transmission of SARS-CoV-2 was not reported for any newborns
|
Liu et al. (25)
|
Original article
|
Among 13 pregnant women with SARS-CoV-2 positive, two women were less than 28 weeks of gestation, and 11 were in their third trimester
|
- Most of the patients reported fever and fatigue. Other less prevalent feature included dyspnea
|
- After treatment, three pregnant women were discharged.
|
- Ten pregnant women went through the cesarean section. Among them, five underwent emergency cesarean section due to complications (such as fetal distress [three], premature rupture of the membrane [10] and stillbirth [one])
|
- Six pregnant women experienced preterm birth
|
- One pregnant woman developed severe pneumonia with multiple organ failure, acute respiratory distress syndrome, acute hepatic failure, acute renal failure, and septic shock. Her respiration was supported by extracorporeal membrane oxygenation (ECMO) in the intensive care unit (ICU)
|
- No vertical transmission of SARS-CoV-2 was reported among the live births
|
Mullins et al. (27)
|
Rapid review
|
32 pregnant women with confirmed SARS-CoV-2 infection
|
- fetal growth was not affected, and no information is available related to placental pathology
|
- Of the 32 pregnancies, 30 babies were delivered. Seven women were asymptomatic, and two were admitted to the intensive care unit. However, no maternal death was reported
|
- 47% (15 out of 32) pregnant women delivered prematurely. And most of the delivery was conducted by cesarean section
|
- No vertical transmission of SARS-CoV-2 was reported among the live births
|
Rasmussen et al. (31)
|
Expert review
|
--
|
- Currently, there is no evidence suggesting pregnant women are more suspectable to COVID-19
|
- Most common symptoms of COVID-19 are fever and cough, while lymphopenia was also common in several cases
|
- Premature birth and cesarean section were reported in several studies
|
- Any abnormality of fetal heart rate may indicate an early sign of the mothers’ respiratory deterioration.
|
- There is limited information on perinatal or postnatal modes of transmission
|
Schwartz (32)
|
Case review
|
All 38 pregnant women were in their third trimester in pregnancy, and 37 had confirmed SARS-CoV-2 infection
|
- Clinical features included fever, cough, myalgia, sore throat, malaise, gastrointestinal symptoms and shortness of breath
|
- Laboratory features were indicative of lymphopenia and elevated C-reactive protein, ALT, and AST.
|
- Patchy ground-glass opacity and pulmonary consolidation is observed in lung CT scan
|
- Premature rupture of membranes was observed most of the cases, which lead to premature birth by cesarean section was reported in most of the cases
|
- No vertical transmission of SARS-CoV-2 was reported
|
- One study from the review reported several newborns presented gastrointestinal (gastric bleeding, refusal to feed, bloating and food intolerance) and respiratory symptoms (abnormalities in chest radiography, respiratory distress syndrome, and pneumothorax). Two children developed thrombocytopenia. One premature newborn died on the 9th day due to multiple organ failure, refractory shock, and disseminated intravascular coagulation
|
Wang et al. (35)
|
Case report
|
The pregnant women were in her 40th week of pregnancy with COVID-19
|
- The pregnant women developed low-grade fever two hours after having small vaginal
bleeding and lower abdominal pain
|
- Chest CT scan indicated ground-glass opacities in the lung (left upper and lower lobes)
|
- Laboratory diagnostic presented lymphopenia, neutrophilia, elevated C-reactive protein
|
- Though there was no fetal distress, emergency cesarean delivery was performed, and meconium-stained liquor reported during the operative process
|
- Immediate after delivery, the mother was asymptomatic, but later developed a fever. She received antiviral (Interferon α1b and Ganciclovir) and antibiotic (Abipenem and Moxifloxacin) and methylprednisolone.
|
- The newborn was separated from the mother after the delivery. The infant appeared to be healthy but presented lymphopenia, elevated AST, total bilirubin, indirect bilirubin, and creatine kinase
|
- The pharyngeal swab of the newborn was tested positive for SARS-CoV-2 at 36 hours after birth. However, the cord blood, placental specimens, and breast milk samples were tested negative for SARS-CoV-2.
|
- The CT scan of the infant's chest presented high-density nodular shadow which evolved into scattered with small pieces of patchy shadow in the upper lobe of the right lung
|
Wang et al. (36)
|
Case report
|
A 30-week pregnant woman with COVID-19
|
- The pregnant women presented with fever for one week.
|
- Laboratory findings presented a low level of lymphocytes and albumin
|
- Chest CT scan of lung indicated ground-glass opacities (right side) and subpleural patchy consolidation (left side), which evolved into bilateral ground-glass opacities
|
- To prepare for emergency cesarean delivery, the mother was provided with antivirals (Arbidol, Lopinavir, and Ritonavir), antibiotic (Cefoperazone Sodium and Sulbactam Sodium), Human Serum Albumin, dexamethasone and magnesium sulfate
|
- Vertical transmission of SARS-CoV-2 was not reported, and the newborns or any products of conception was not tested positive for SARS-CoV-2
|
Wen et al. (37)
|
Correspondence
|
A 30-week pregnant woman with COVID-19
|
- During the initial presentation, the pregnant women were presented with mild diarrhea; however, she was afebrile, breathing normally and without any cough or chest pain
|
- The chest CT scan of lung indicated ground-glass opacities and patchy consolidation in multiple regions. The lesions were "distributed along with the bronchial bundles or within the subpleural lung regions." A small collection of fluid found in the left pleural cavity
|
- The patient received interferon, antiviral (Lopinavir and Ritonavir)
|
- The pregnant women were discharged after her nasopharyngeal swabs were negative for SARS-CoV-2 and clinical condition was improved
|
Yu et al. (39)
|
Original article
|
Seven pregnant women with COVID-19 between 37 weeks to 41 weeks of the gestational period
|
- The reported incubation period ranged from two to nine days.
|
- Major clinical feature of six out of seven patients was fever, with few patients reporting cough, shortness of breath and diarrhea
|
- Laboratory report indicated normal leukocyte count and elevated D-dimer for all patients. Five of the women had Neutrophilia, five had Lymphocytopenia, two had thrombocytopenia, and two had elevated ALT and AST.
|
- Chest CT scan of the lung of all seven women was indicative of pneumonia
|
- Antiviral medication (oseltamivir, ganciclovir, interferon, and arbidol) and antibiotic (cephalosporins, quinolones, and macrolides) were given to the patients, along with traditional Chinese medications. Five women were treated with methylprednisolone at the postpartum stage
|
- All patients underwent cesarean section with combined spinal and epidural anesthesia (six patients) or general anesthesia (one patient)
|
- Among the seven neonates four were not tested for SARS-CoV-2, three were tested for SARS-CoV-2, and one neonate was tested positive for SARS-CoV-2 after 36 hours of birth
|
Zambrano et al. (40)
|
Research letter
|
Pregnant women with 31 weeks of gestation with COVID-19
|
- The initial presentation of the pregnant woman was fever, dry cough, myalgia, and headache. The patient also presented bilateral conjunctival hyperemia.
|
- There was no other clinical feature reported which was related to COVID-19
|
Zhu et al. (41)
|
Original article
|
Nine pregnant women were confirmed with COVID-19 (gestational age 31-39 weeks)
|
- In most of the cases, fever and cough were the onsets of symptoms, with only one patient having diarrhea.
|
- CT scan of the chest indicated viral pneumonia with bilateral ground-glass opacities with patchy lung consolidation and blurred borders of the lungs. After treatment, the lesions resolved significantly.
|
- Several prenatal complications were reported which includes intrauterine distress (six women), premature rupture of membranes (three women), abnormality of amniotic fluid (two women) and umbilical cord (two women), and placenta previa (one woman)
|
- Five women received antiviral therapy (oseltamivir) after delivery. Among them, one received oseltamivir and interferon combination
|
- Seven women underwent cesarean sections, and two had vaginal deliveries.
|
- Vertical transmission of SARS-CoV-2 was not reported for any newborns
|
- Several newborns presented gastrointestinal (gastric bleeding, refusal to feed, bloating and food intolerance) and respiratory symptoms (abnormalities in chest radiography, respiratory distress syndrome, and pneumothorax). Two children developed thrombocytopenia. One premature newborn died on the 9th day due to multiple organ failure, refractory shock, and disseminated intravascular coagulation
|