Is COVID-19 associated with more complications in pregnancy?

Submitted by: MChoi 148

There is no consensus in the literature on this question.
NOTE: New research on COVID-19 comes out nearly every day. The state of our knowledge may change quickly so take this answer with a grain of salt.
This short answer was generated by aggregating the answers that each of the 10 studies below gave to the question (as indicated by State of K members) and adjusting for source quality and other factors. If key studies are missing or the answers attributed to individual studies are incorrect, the above answer could be wrong. For medical questions, don't rely on the information here. Consult a medical professional.


Chart summary of 10 studies examining this question

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Literature Reviews
Although we recommend you consider all of the studies below, we believe the following study is a literature review, which surveys and evaluates many studies on this question:
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SUMMARIES OF STUDIES
Total studies in list: 10
Sorted by publication year
1
Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records
"BACKGROUND:Previous studies on the pneumonia outbreak caused by the 2019 novel coronavirus disease (COVID-19) were based on information from the general population. Limited data are available for pregnant women with COVID-19 pneumonia. This study aimed to evaluate the clinical characteristics of COVID-19 in pregnancy and the intrauterine vertical transmission potential of COVID-19 infection.METHODS:Clinical records, laboratory results, and chest CT scans were retrospectively reviewed for nine pregnant women with laboratory-confirmed COVID-19 pneumonia (ie, with maternal throat swab samples that were positive for severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) who were admitted to Zhongnan Hospital of Wuhan University, Wuhan, China, from Jan 20 to Jan 31, 2020. Evidence of intrauterine vertical transmission was assessed by testing for the presence of SARS-CoV-2 in amniotic fluid, cord blood, and neonatal throat swab samples. Breastmilk samples were also collected and tested from patients after the first lactation.FINDINGS:All nine patients had a caesarean section in their third trimester. Seven patients presented with a fever. Other symptoms, including cough (in four of nine patients), myalgia (in three), sore throat (in two), and malaise (in two), were also observed. Fetal distress was monitored in two cases. Five of nine patients had lymphopenia (<1·0 × 10⁹ cells per L). Three patients had increased aminotransferase concentrations. None of the patients developed severe COVID-19 pneumonia or died, as of Feb 4, 2020. Nine livebirths were recorded. No neonatal asphyxia was observed in newborn babies. All nine livebirths had a 1-min Apgar score of 8-9 and a 5-min Apgar score of 9-10. Amniotic fluid, cord blood, neonatal throat swab, and breastmilk samples from six patients were tested for SARS-CoV-2, and all samples tested negative for the virus.INTERPRETATION:The clinical characteristics of COVID-19 pneumonia in pregnant women were similar to those reported for non-pregnant adult patients who developed COVID-19 pneumonia. Findings from this small group of cases suggest that there is currently no evidence for intrauterine infection caused by vertical transmission in women who develop COVID-19 pneumonia in late pregnancy.FUNDING:Hubei Science and Technology Plan, Wuhan University Medical Development Plan."
AUTHORS
Luo F
Yu X
Wang C
Guo J
Chen H
Zhang W
PUBLISHED
2020 in The Lancet
High quality source
Yes
Yes
2
Coronavirus Disease 2019 (COVID-19) Pandemic and Pregnancy
"The current coronavirus disease 2019 (COVID-19) pneumonia pandemic, caused by the severe acute respiratory syndrome 2 (SARS-CoV-2) virus, is spreading globally at an accelerated rate, with a basic reproduction number (R0) of 2 – 2.5, indicating that 2 – 3 persons will be infected from an index patient. A serious public health emergency, it is particularly deadly in vulnerable populations and communities in which healthcare providers are insufficiently prepared to manage the infection. As of March 16, 2020, there are more than 180,000 confirmed cases of COVID-19 worldwide, with over 7,000 related deaths. The SARS-CoV-2 virus has been isolated from asymptomatic individuals, and affected patients continue to be infectious two weeks after cessation of symptoms. The substantial morbidity and socioeconomic impact have necessitated drastic measures across all continents, including nationwide lockdowns and border closures.Pregnant women and their fetuses represent a high-risk population during infectious disease outbreaks. To date, the outcomes of 55 pregnant women infected with COVID-19 and 46 neonates have been reported in the literature, with no definite evidence of vertical transmission. Physiological and mechanical changes in pregnancy increase susceptibility to infections in general, particularly when the cardiorespiratory system is affected, and encourage rapid progression to respiratory failure in the gravida. Furthermore, the pregnancy bias towards T-helper 2 (Th2) system dominance which protects the fetus, leaves the mother vulnerable to viral infections, which are more effectively contained by the Th1 system. These unique challenges mandate an integrated approach to pregnancies affected by SARS-CoV-2.Here we present a review of COVID-19 in pregnancy, bringing together the various factors integral to the understanding of pathophysiology and susceptibility, diagnostic challenges with real-time reverse transcriptase polymerase chain reaction (RT-PCR) assays, therapeutic controversies, intrauterine transmission and maternal-fetal complications. We discuss the latest options in antiviral therapy and vaccine development, including the novel use of chloroquine in the management of COVID-19. Fetal surveillance, in view of the predisposition to growth restriction and special considerations during labor and delivery are addressed. Additionally, we focus on keeping frontline obstetric care providers safe while continuing to provide essential services. Our clinical service model is built around the principles of workplace segregation, responsible social distancing, containment of cross-infection to healthcare providers, judicious use of personal protective equipment and telemedicine. Our aim is to share a framework which can be adopted by tertiary maternity units managing pregnant women in the flux of a pandemic while maintaining the safety of the patient and healthcare provider at its core."
AUTHORS
LL Min
LMX Karen
WJL Jeslyn
P Dashraath
PUBLISHED
2020 in American Journal of Obstetrics and Gynecology
High quality source
Couldn't Identify
Couldn't Identify
3
Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study
"BackgroundIn December, 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China. The number of affected pregnant women is increasing, but scarce information is available about the clinical features of COVID-19 in pregnancy. This study aimed to clarify the clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19.MethodsIn this retrospective, single-centre study, we included all pregnant women with COVID-19 who were admitted to Tongji Hospital in Wuhan, China. Clinical features, treatments, and maternal and fetal outcomes were assessed.FindingsSeven patients, admitted to Tongji Hospital from Jan 1, to Feb 8, 2020, were included in our study. The mean age of the patients was 32 years (range 29–34 years) and the mean gestational age was 39 weeks plus 1 day (range 37 weeks to 41 weeks plus 2 days). Clinical manifestations were fever (six [86%] patients), cough (one [14%] patient), shortness of breath (one [14%] patient), and diarrhoea (one [14%] patient). All the patients had caesarean section within 3 days of clinical presentation with an average gestational age of 39 weeks plus 2 days. The final date of follow-up was Feb 12, 2020. The outcomes of the pregnant women and neonates were good. Three neonates were tested for SARS-CoV-2 and one neonate was infected with SARS-CoV-2 36 h after birth.InterpretationThe maternal, fetal, and neonatal outcomes of patients who were infected in late pregnancy appeared very good, and these outcomes were achieved with intensive, active management that might be the best practice in the absence of more robust data. The clinical characteristics of these patients with COVID-19 during pregnancy were similar to those of non-pregnant adults with COVID-19 that have been reported in the literature."
AUTHORS
X Lin
S Wang
Z Xiong
Q Kang
W Li
N Yu
PUBLISHED
2020 in The Lancet Infectious Diseases
High quality source
No
No
4
Potential Maternal and Infant Outcomes from (Wuhan) Coronavirus 2019-nCoV Infecting Pregnant Women: Lessons from SARS, MERS, and Other Human Coronavirus Infections
"In early December 2019 a cluster of cases of pneumonia of unknown cause was identified in Wuhan, a city of 11 million persons in the People's Republic of China. Further investigation revealed these cases to result from infection with a newly identified coronavirus, termed the 2019-nCoV. The infection moved rapidly through China, spread to Thailand and Japan, extended into adjacent countries through infected persons travelling by air, eventually reaching multiple countries and continents. Similar to such other coronaviruses as those causing the Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), the new coronavirus was reported to spread via natural aerosols from human-to-human. In the early stages of this epidemic the case fatality rate is estimated to be approximately 2%, with the majority of deaths occurring in special populations. Unfortunately, there is limited experience with coronavirus infections during pregnancy, and it now appears certain that pregnant women have become infected during the present 2019-nCoV epidemic. In order to assess the potential of the Wuhan 2019-nCoV to cause maternal, fetal and neonatal morbidity and other poor obstetrical outcomes, this communication reviews the published data addressing the epidemiological and clinical effects of SARS, MERS, and other coronavirus infections on pregnant women and their infants. Recommendations are also made for the consideration of pregnant women in the design, clinical trials, and implementation of future 2019-nCoV vaccines."
AUTHORS
Schwartz DA
Graham AL
PUBLISHED
2020 in Viruses
High quality source
Couldn't Identify
Couldn't Identify
5
2019-nCoV epidemic: what about pregnancies?
"On Feb 3, 2020, WHO confirmed17 238 cases of novel coronavirus(2019-nCoV) infections in China.Among them, 2296 (13%) cases werereported as severe, and 361 deathswere declared (2%).1Members of the coronavirus familyresponsible for severe acute respiratorysyndrome (SARS-CoV) and Middle Eastrespiratory syndrome (MERS-CoV) areknown to be responsible for severecomplications during pregnancy.2,312 pregnant women were infectedwith SARS-CoV during the 2002–03pandemic.2 Four (57%) of sevenwomen in the first trimester had amiscarriage. In the second to thirdtrimester, two (40%) of five womenhad fetal growth restriction, andfour (80%) of five women had pretermbirth (one spontaneous; three inducedfor maternal condition). Three (25%)women died during pregnancy.In a review of 11 pregnant womeninfected with MERS-CoV,3 ten (91%)presented with adverse outcomes,six (55%) neonates required admissionto the intensive care unit, andthree (27%) died. Two neonates weredelivered prematurely for severematernal respiratory failure.Considering that the 2019-nCoVseems to have a similar pathogenicpotential as SARS-CoV and MERSCoV,4 pregnant women are atincreased risk of severe infections,there are no specific clinical signsof coronavirus infections precedingsevere complications,5 coronaviruseshave the potential to cause severematernal or perinatal adverseoutcomes, or both,2,3 and the currentlack of data on the consequencesof a 2019-nCoV infection duringpregnancy, we recommend systematicscreening of any suspected 2019-nCoVinfection during pregnancy. If2019-nCoV infection during preg-nancy is confirmed, extended followup should be recommended formothers and their fetuses."
AUTHORS
D Baud
D Musso
L Pomar
G Favre
PUBLISHED
2020 in The Lancet
High quality source
Yes
Yes
6
Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia
"BackgroundThe newly identified 2019-nCoV, which appears to have originated in Wuhan, the capital city of Hubei province in central China, is spreading rapidly nationwide. A number of cases of neonates born to mothers with 2019-nCoV pneumonia have been recorded. However, the clinical features of these cases have not been reported, and there is no sufficient evidence for the proper prevention and control of 2019-nCoV infections in neonates.MethodsThe clinical features and outcomes of 10 neonates (including 2 twins) born to 9 mothers with confirmed 2019-nCoV infection in 5 hospitals from January 20 to February 5, 2020 were retrospectively analyzed.ResultsAmong these 9 pregnant women with confirmed 2019-nCoV infection, onset of clinical symptoms occurred before delivery in 4 cases, on the day of delivery in 2 cases, and after delivery in 3 cases. In most cases, fever and a cough were the first symptoms experienced, and 1 patient also had diarrhea. Of the newborns born to these mothers, 8 were male and 2 were female; 4 were full-term infants and 6 were born premature; 2 were small-for-gestational-age (SGA) infants and 1 was a large-for-gestational-age (LGA) infant; there were 8 singletons and 2 twins. Of the neonates, 6 had a Pediatric Critical Illness Score (PCIS) score of less than 90. Clinically, the first symptom in the neonates was shortness of breath (n=6), but other initial symptoms such as fever (n=2), thrombocytopenia accompanied by abnormal liver function (n=2), rapid heart rate (n=1), vomiting (n=1), and pneumothorax (n=1) were observed. Up to now, 5 neonates have been cured and discharged, 1 has died, and 4 neonates remain in hospital in a stable condition. Pharyngeal swab specimens were collected from 9 of the 10 neonates 1 to 9 days after birth for nucleic acid amplification tests for 2019-nCoV, all of which showed negative results.ConclusionsPerinatal 2019-nCoV infection may have adverse effects on newborns, causing problems such as fetal distress, premature labor, respiratory distress, thrombocytopenia accompanied by abnormal liver function, and even death. However, vertical transmission of 2019-nCoV is yet to be confirmed."
AUTHORS
L Zhang
S Peng
C Fang
L Wang
H Zhu
PUBLISHED
2020 in Translational Pediatrics
Q3
Yes
Yes
7
Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know
"Coronavirus Disease 2019 (COVID-19) is an emerging disease with a rapid increase in cases and deaths since its first identification in Wuhan, China, in December 2019. Limited data are available about COVID-19 during pregnancy; however, information on illnesses associated with other highly pathogenic coronaviruses (i.e., severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS)) might provide insights into COVID-19’s effects during pregnancy."
AUTHORS
JA Lednicky
JC Smulian
SA Rasmussen
PUBLISHED
2020 in American Journal of Obstetrics and Gynecology
High quality source
No
No
8
Coronavirus Disease 2019 (COVID-19) During Pregnancy: A Case Series
"Background: Coronavirus disease 2019 (COVID-19) is a new viral respiratory disease and whether pregnant women are at increased risk of infection is unknown. Viral pneumonia is an important indirect cause of maternal death. Little is known about the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy. Objective: To describe the clinical characteristics of COVID-19 in pregnancy and their newborn infant, and we sought to explored whether the SARS-CoV-2 can be intrauterine vertically transmitted. Study Design: The study was a case series study conducted in the obstetric ward of Tongji Hospital affiliated to Huazhong University of science and technology, Wuhan, China. Demographic, clinical, laboratory and radiological profiles of the SARS-CoV-2 infection case series. A systematic testing procedure for SARS-CoV-2 infection using oropharyngeal swab, placenta tissue, vaginal mucus, and breast milk of mothers. and oropharyngeal swab, umbilical cord blood, and serum of newborns was conducted. Results: We have conducted the most thorough virological assessment to date, and we include a longer clinical observation in mother-infant dyads during hospitalization. The clinical course and outcomes of three pregnant women who acquired SARS-CoV-2 infection late pregnancy are described in mother-infant dyads. Two had caesarean delivery in their third trimester. All patients showed an uneventful perinatal course, and a successful outcome. No infants became infected by vertical transmission or during delivery. Conclusion: No evidence to suggest the potential risk of intrauterine vertical transmission in the case series and further in-depth study is needed. Both the pregnancy woman and infant showed fewer adverse maternal and neonatal outcomes."
AUTHORS
B Zhang
J Chen
L Chen
Q Zhang
Q Wang
W Liu
PUBLISHED
2020 in Preprints
Preprint
No
No
9
Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis.
"OBJECTIVE. The purpose of this study was to describe the clinical manifestations and CT features of coronavirus disease (COVID-19) pneumonia in 15 pregnant women and to provide some initial evidence that can be used for guiding treatment of pregnant women with COVID-19 pneumonia. MATERIALS AND METHODS. We reviewed the clinical data and CT examinations of 15 consecutive pregnant women with COVID-19 pneumonia in our hospital from January 20, 2020, to February 10, 2020. A semiquantitative CT scoring system was used to estimate pulmonary involvement and the time course of changes on chest CT. Symptoms and laboratory results were analyzed, treatment experiences were summarized, and clinical outcomes were tracked. RESULTS. Eleven patients had successful delivery (10 cesarean deliveries and one vaginal delivery) during the study period, and four patients were still pregnant (three in the second trimester and one in the third trimester) at the end of the study period. No cases of neonatal asphyxia, neonatal death, stillbirth, or abortion were reported. The most common early finding on chest CT was ground-glass opacity (GGO). With disease progression, crazy paving pattern and consolidations were seen on CT. The abnormalities showed absorptive changes at the end of the study period for all patients. The most common onset symptoms of COVID-19 pneumonia in pregnant women were fever (13/15 patients) and cough (9/15 patients). The most common abnormal laboratory finding was lymphocytopenia (12/15 patients). CT images obtained before and after delivery showed no signs of pneumonia aggravation after delivery. The four patients who were still pregnant at the end of the study period were not treated with antiviral drugs but had achieved good recovery. CONCLUSION. Pregnancy and childbirth did not aggravate the course of symptoms or CT features of COVID-19 pneumonia. All the cases of COVID-19 pneumonia in the pregnant women in our study were the mild type. All the women in this study-some of whom did not receive antiviral drugs-achieved good recovery from COVID-19 pneumonia."
AUTHORS
Yang L
Wu X
Zheng D
Zheng C
Wang J
Li L et al
PUBLISHED
2020 in American Journal of Roentgenology
High quality source
No
No
10
Risks of Novel Coronavirus Disease (COVID-19) in Pregnancy; a Narrative Review
"Introduction:The outbreak of the new Coronavirus in China in December 2019 and subsequently in various countries around the world has raised concerns about the possibility of vertical transmission of the virus from mother to fetus. The present study aimed to review published literature in this regard.Methods:In this narrative review, were searched for all articles published in various databases including PubMed, Scopus, Embase, Science Direct, and Web of Science using MeSH-compliant keywords including COVID-19, Pregnancy, Vertical transmission, Coronavirus 2019, SARS-CoV-2 and 2019-nCoV from December 2019 to March 18, 2020 and reviewed them. All type of articles published about COVID-19 and vertical transmission in pregnancy were included.Results:A review of 13 final articles published in this area revealed that COVID-19 can cause fetal distress, miscarriage, respiratory distress and preterm delivery in pregnant women but does not infect newborns. There has been no report of vertical transmission in pregnancy, and it has been found that clinical symptoms of COVID-19 in pregnant women are not different from those of non-pregnant women.Conclusion:Overall, due to lack of appropriate data about the effect of COVID-19 on pregnancy, it is necessary to monitor suspected pregnant women before and after delivery. For confirmed cases both the mother and the newborn child should be followed up comprehensively."
AUTHORS
S Pouy
M Amiri
L Panahi
PUBLISHED
2020 in Archives of Academic Emergency Medicine
UNRANKED SOURCE
Literature Review
Yes
Yes







ADDITIONAL STUDIES TO CONSIDER ADDING TO LIST
Total additional studies: 70
State of K's algorithms generated the list of studies below based on the studies that were added to the above list. Some of these studies may also examine: "Is COVID-19 associated with more complications in pregnancy?" If a study examines this question, add it to the list by pressing the button.

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Highly regarded source
An Analysis of 38 Pregnant Women with COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnancy Outcomes
" The emergence of a novel coronavirus, termed SARS-CoV-2, and the potentially life-threating respiratory disease that it can produce, COVID-19, has rapidly spread across the globe creating a massive public health problem. Previous epidemics of many emerging viral infections have typically resulted in poor obstetrical outcomes including maternal morbidity and mortality, maternal-fetal transmission of the virus, and perinatal infections and death. This communication reviews the effects of two previous coronavirus infections - severe acute respiratory syndrome (SARS) caused by SARS-CoV and Middle East respiratory syndrome (MERS) caused by MERS-CoV - on pregnancy outcomes. In addition, it analyzes literature describing 38 pregnant women with COVID-19 and their newborns in China to assess the effects of SARS-CoV-2 on the mothers and infants including clinical, laboratory and virologic data, and the transmissibility of the virus from mother to fetus. This analysis reveals that unlike coronavirus infections of pregnant women caused by SARS and MERS, in these 38 pregnant women COVID-19 did not lead to maternal deaths. Importantly, and similar to pregnancies with SARS and MERS, there were no confirmed cases of intrauterine transmission of SARS-CoV-2 from mothers with COVID-19 to their fetuses. All neonatal specimens tested, including in some cases placentas, were negative by rt-PCR for SARS-CoV-2. At this point in the global pandemic of COVID-19 infection there is no evidence that SARS-CoV-2 undergoes intrauterine or transplacental transmission from infected pregnant women to their fetuses. Analysis of additional cases is necessary to determine if this remains true. "
AUTHOR
David A. Schwartz
PUBLISHED
2020 in Archives of Pathology & Laboratory Medicine

Add to List
Highly regarded source
An Analysis of 38 Pregnant Women with COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnancy Outcomes
"The emergence of a novel coronavirus, termed SARS-CoV-2, and the potentially life-threatening respiratory disease that it can produce, COVID-19, has rapidly spread across the globe creating a massive public health problem. Previous epidemics of many emerging viral infections have typically resulted in poor obstetrical outcomes including maternal morbidity and mortality, maternal-fetal transmission of the virus, and perinatal infections and death. This communication reviews the effects of two previous coronavirus infections - severe acute respiratory syndrome (SARS) caused by SARS-CoV and Middle East respiratory syndrome (MERS) caused by MERS-CoV - on pregnancy outcomes. In addition, it analyzes literature describing 38 pregnant women with COVID-19 and their newborns in China to assess the effects of SARS-CoV-2 on the mothers and infants including clinical, laboratory and virologic data, and the transmissibility of the virus from mother to fetus. This analysis reveals that unlike coronavirus infections of pregnant women caused by SARS and MERS, in these 38 pregnant women COVID-19 did not lead to maternal deaths. Importantly, and similar to pregnancies with SARS and MERS, there were no confirmed cases of intrauterine transmission of SARS-CoV-2 from mothers with COVID-19 to their fetuses. All neonatal specimens tested, including in some cases placentas, were negative by rt-PCR for SARS-CoV-2. At this point in the global pandemic of COVID-19 infection there is no evidence that SARS-CoV-2 undergoes intrauterine or transplacental transmission from infected pregnant women to their fetuses. Analysis of additional cases is necessary to determine if this remains true."
AUTHOR
Schwartz DA
PUBLISHED
2020 in Archives of Pathology & Laboratory Medicine

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Sitagliptin: a potential drug for the treatment of SARS-CoV-2?
"Recently, an outbreak of fatal coronavirus, SARS-CoV-2, has emerged from China and is rapidly spreading worldwide. As the coronavirus pandemic rages, drug discovery and development become even more challenging. Drug repurposing of the antimalarial drug chloroquine and its hydroxylated form had demonstrated apparent effectiveness in the treatment of COVID-19 associated pneumonia in clinical trials. SARS-CoV-2 spike protein shares 31.9% sequence identity with the spike protein presents in the Middle East Respiratory Syndrome Corona Virus (MERS-CoV), which infects cells through the interaction of its spike protein with the DPP4 receptor found on macrophages. Sitagliptin, a DPP4 inhibitor, that is known for its antidiabetic, immunoregulatory, anti-inflammatory, and beneficial cardiometabolic effects has been shown to reverse macrophage responses in MERS-CoV infection and reduce CXCL10 chemokine production in AIDS patients. We suggest that Sitagliptin may be beneficial alternative for the treatment of COVID-19 disease especially in diabetic patients and patients with preexisting cardiovascular conditions who are already at higher risk of COVID-19 infection."
AUTHOR
Sanaa Bardaweel
PUBLISHED
2020 in Center for Open Science

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Sitagliptin: a potential drug for the treatment of SARS-CoV-2?
"Recently, an outbreak of fatal coronavirus, SARS-CoV-2, has emerged from China and is rapidly spreading worldwide. As the coronavirus pandemic rages, drug discovery and development become even more challenging. Drug repurposing of the antimalarial drug chloroquine and its hydroxylated form had demonstrated apparent effectiveness in the treatment of COVID-19 associated pneumonia in clinical trials. SARS-CoV-2 spike protein shares 31.9% sequence identity with the spike protein presents in the Middle East Respiratory Syndrome Corona Virus (MERS-CoV), which infects cells through the interaction of its spike protein with the DPP4 receptor found on macrophages. Sitagliptin, a DPP4 inhibitor, that is known for its antidiabetic, immunoregulatory, anti-inflammatory, and beneficial cardiometabolic effects has been shown to reverse macrophage responses in MERS-CoV infection and reduce CXCL10 chemokine production in AIDS patients. We suggest that Sitagliptin may be beneficial alternative for the treatment of COVID-19 disease especially in diabetic patients and patients with preexisting cardiovascular conditions who are already at higher risk of COVID-19 infection."
AUTHOR
Sanaa Bardaweel
PUBLISHED
2020 in Center for Open Science

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Lactoferrin as potential preventative and treatment for COVID-19
"The novel coronavirus 2019 (COVID-19) pandemic is rapidly advancing across the globe despite public and personal health measures. Antivirals and nutritional supplements have been proposed as potentially useful against SARS-CoV-2 (virus that causes COVID-19), but few have been clinically established. Lactoferrin (Lf) is a naturally occurring and non-toxic glycoprotein that is orally available as a nutritional supplement and has established in vitro anti-viral efficacy against a wide range of virus including SARS-CoV, a closely related corona virus to SARS-CoV-2 (virus that causes COVID-19). Furthermore, Lf possesses unique immunomodulatory and anti-inflammatory effects that maybe especially relevant to the pathophysiology of severe COVID-19 cases. We review the underlying biological mechanisms of Lf as antiviral and immune regulator, and propose its unique potential as preventative and adjunct treatment for COVID-19. We hope that further research and development of Lf nutritional supplementation would establish its role for COVID-19."
AUTHORS
Wei-Zen Sun
Raymond Chang
Tzi Bun Ng
PUBLISHED
2020 in Center for Open Science

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When Darkness Becomes a Ray of Light in the Dark Times: Understanding the COVID-19 via the Comparative Analysis of the Dark Proteomes of SARS-CoV-2, Human SARS and Bat SARS-Like Coronaviruses
"AbstractRecently emerged coronavirus designated as SARS-CoV-2 (also known as 2019 novel coronavirus (2019-nCoV) or Wuhan coronavirus) is a causative agent of coronavirus disease 2019 (COVID-19), which is rapidly spreading throughout the world now. More than 9,00,000 cases of SARS-CoV-2 infection and more than 47,000 COVID-19-associated mortalities have been reported worldwide till the writing of this article, and these numbers are increasing every passing hour. World Health Organization (WHO) has declared the SARS-CoV-2 spread as a global public health emergency and admitted that the COVID-19 is a pandemic now. The multiple sequence alignment data correlated with the already published reports on the SARS-CoV-2 evolution and indicated that this virus is closely related to the bat Severe Acute Respiratory Syndrome-like coronavirus (bat SARS-like CoV) and the well-studied Human SARS coronavirus (SARS CoV). The disordered regions in viral proteins are associated with the viral infectivity and pathogenicity. Therefore, in this study, we have exploited a set of complementary computational approaches to examine the dark proteomes of SARS-CoV-2, bat SARS-like, and human SARS CoVs by analysing the prevalence of intrinsic disorder in their proteins. According to our findings, SARS-CoV-2 proteome contains very significant levels of structural order. In fact, except for Nucleocapsid, Nsp8, and ORF6, the vast majority of SARS-CoV-2 proteins are mostly ordered proteins containing less intrinsically disordered protein regions (IDPRs). However, IDPRs found in SARS-CoV-2 proteins are functionally important. For example, cleavage sites in its replicase 1ab polyprotein are found to be highly disordered, and almost all SARS-CoV-2 proteins were shown to contain molecular recognition features (MoRFs), which are intrinsic disorder-based protein-protein interaction sites that are commonly utilized by proteins for interaction with specific partners. The results of our extensive investigation of the dark side of the SARS-CoV-2 proteome will have important implications for the structural and non-structural biology of SARS or SARS-like coronaviruses.SignificanceThe infection caused by a novel coronavirus (SARS-CoV-2) that causes severe respiratory disease with pneumonia-like symptoms in humans is responsible for the current COVID-19 pandemic. No in-depth information on structures and functions of SARS-CoV-2 proteins is currently available in the public domain, and no effective anti-viral drugs and/or vaccines are designed for the treatment of this infection. Our study provides the first comparative analysis of the order- and disorder-based features of the SARS-CoV-2 proteome relative to human SARS and bat CoV that may be useful for structure-based drug discovery."
AUTHORS
Rajanish Giri
Christopher J. Oldfield
Kundlik Gadhave
Bhuvaneshwari R. Gehi
Meenakshi Shegane
Taniya Bhardwaj et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Kebijakan Pemberlakuan Lock Down Sebagai Antisipasi Penyebaran Corona Virus Covid-19
"Abstract2020 is a worrying year for all countries, including Indonesia. This is due to the emergence of the Corona virus outbreak, which originated in Wuhan City of China, and spread throughout the world. Initially the government did not follow the method used by several other countries related to information provided about the corona covid-19 virus, namely by conducting a quick reaction of prevention socialization. The reason is so that the Indonesian people are not worried about issues that are worrying, other than to minimize the existence of Hoax news from a handful of irresponsible people. Finally the covid-19 outbreak also became a concern for the community, because many Indonesians were affected by the transmission of this virus. Therefore, the government took the initiative to take a lockdown policy for 14 days to anticipate the transmission of this corona outbreak. The study uses qualitative research methods with a literary and empirical approach. The data obtained comes from several regulations, such as the Governor of DKI Jakarta and several other regulations and policies, as well as phenomena that occur in the field. The results of the study stated that Indonesia had experienced a condition where the community's concern about Covid-19 was quite large, so that a government policy to lockdown was needed, as an effort to break the chain of the spread of the Corona Covid-19 virus.Keywords: Corona Virus, Lock Down, Government Policy AbstrakTahun 2020 merupakan tahun yang mengkhawatirkan seluruh negara, tanpa terkecuali negara Indonesia. Hal itu disebabkan munculkan wabah virus Corona, yang bermula dari Kota Wuhan China, dan menyebar ke seluruh penjuru dunia. Awalnya pemerintah tidak mengikuti cara yang digunakan oleh beberapa negara lainnya terkait informasi yang diberikan mengenai virus corona covid-19, yaitu dengan melakukan reaksi cepat sosialisasi pencegahan. Penyebabnya, agar masyarakat Indonesia  tidak khawatir dengan isu yang mengkhawatirkan, selain untuk meminimalisir adanya berita Hoax dari segelintir orang yang tidak bertanggung jawab. Akhirnya wabah covid-19 ini juga menjadi hal yang mengkhawatirkan bagi masyarakat, karena banyak warga Indonesia yang terkena dampak penularan virus ini. Oleh karenanya, pemerintah berinisiatif untuk mengambil kebijakan lockdown selama 14 hari guna mengantisipasi penularan wabah corona ini. Penelitian menggunakan metode penelitian kualitatif dengan pendekatan literatur dan empiris. Data yang didapat berasal dari beberapa Peraturan, seperti Peraturan Gubernur DKI Jakarta dan beberapa peraturan dan kebijakan lainnya, serta fenomena yang terjadi di lapangan. Hasil penelitian menyatakan bahwa Indonesia sudah mengalami kondisi dimana kekhawatiran masyarakat terhadap covid-19 cukup besar, sehingga diperlukan kebijakan pemerintah untuk melakukan Lockdown, sebagai upaya memutus mata rantai penyebaran virus corona Covid-19Kata kunci : Virus Corona, Lock Down, Kebijakan Pemerintah"
AUTHORS
Nur Rohim Yunus
Annissa Rezki
PUBLISHED
2020 in SALAM: Jurnal Sosial dan Budaya Syar-i

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Ayurveda’s Holistic Lifestyle Approach for the Management of Coronavirus disease (COVID-19): Possible Role of Tulsi
"Coronavirus disease COVID-19 is caused by the recently discovered corona virus that can spread between animals and humans. The outbreak of the corona virus was begun in Wuhan, China, in December 2019. The most common symptoms are fever, tiredness, and dry cough. Some individuals also develop aches and pains, nasal congestion, runny nose, sore throat, or diarrhea. It was reported that traditional remedies may alleviate the symptoms of COVID-19. Ayurveda is the world's oldest medical system that can manage any disease without side effects. Ayurveda is equipped with varieties of treatment modalities to handle with any type of deadly diseases. However, a major drawback is a lack of adequate scientific basis. Tulsi has multi-modal therapeutic effects, we hypothesize that tulsi may be effective in the prevention and management of COVID-19. Though the existing literature supports the management of symptoms of COVID-19 using tulsi, a lack of standard formulation limits its use. This is the need of time to start with translational research to provide scientific evidence for the efficacy and to establish the standard formulation of tulsi in the management of COVID-19."
AUTHORS
Sai Sailesh Kumar Goothy Srilatha Goothy Anita Choudhary Potey G G Hirok Chakraborty Arun HS Kumar
Sai Sailesh Kumar Goothy Srilatha Goothy Anita Choudhary Potey G G Hirok Chakraborty
Sai Sailesh Kumar Goothy Srilatha Goothy Anita Choudhary Potey G G
Sai Sailesh Kumar Goothy Srilatha Goothy Anita Choudhary
Sai Sailesh Kumar Goothy Srilatha Goothy
Sai Sailesh Kumar Goothy et al
PUBLISHED
2020 in International Journal of Research in Pharmaceutical Sciences

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Corona Virus (COVID – 19)
"It is difficult while writing an editorial, at this time, to ignore the extensive impact of the Corona virus (COVID-19) and it is probably important for us, as health professionals to give it some considered thought, outside the immediacy of current activity. I say this as someone recently returned from work related overseas travel, with my travel not meeting the government-imposed return deadline by some seven hours. This required my quarantine and/or isolation for some two weeks. After my first week of exclusion from most of my family, friends and working remotely and online it seems that the rest of Australia has caught up with my circumstance, many stood down from work, many businesses closed, a massive effort by the health system and economic rescue or support packages being implemented by government. It seems that I will have little opportunity to relax and celebrate with others at the end of this week....."
AUTHOR
David Briggs
PUBLISHED
2020 in Asia-Pacific Journal of Health Management

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Cardiovascular Vulnerability to COVID-19 in Cancer Survivors
"Coronavirus disease 2019 (COVID-19) has been declared a global pandemic by the World Health Organization on March 11, 2020. COVID-19 is caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-Cov-2). Although primarily a respiratory disease, cardiovascular complications of COVID-19 have been increasingly recognized. In addition, higher fatality has been reported in COVID-19 patients with underlying cardiovascular diseases. Cancer survivors have a considerably increased risk for premature cardiovascular diseases, mainly due to cardiotoxic cancer treatments. Therefore, it is foreseeable that cancer survivors will be more vulnerable to cardiovascular complications caused by COVID-19. In this review, three scenarios for increased cardiovascular complications of COVID-19 in cancer patients are proposed. In the first scenario, cardiotoxic cancer treatment and COVID-19 synergize to exacerbate direct myocardial damage. In the second scenario, cardiotoxic cancer treatment leads to a reduced cardiac reserve in cancer survivors, making them more vulnerable to COVID-19 in a “two-hit” model. The third scenario suggests that several shared risk factors may aggravate cardiovascular complications caused by both cancer treatment and COVID-19. Taken together, cancer survivors may be more vulnerable to cardiovascular complications when challenged by the COVID-19, and special cardiovascular care should be given to these patients."
AUTHOR
Beshay Zordoky
PUBLISHED
2020 in MDPI AG

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Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: a case-control study
"Abstract

Background
The ongoing epidemics of coronavirus disease 2019 (COVID-19) have caused serious concerns about its potential adverse effects on pregnancy. There are limited data on maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia.


Methods
We conducted a case-control study to compare clinical characteristics, maternal and neonatal outcomes of pregnant women with and without COVID-19 pneumonia.


Results
During January 24 to February 29, 2020, there were sixteen pregnant women with confirmed COVID-19 pneumonia and eighteen suspected cases who were admitted to labor in the third trimester. Two had vaginal delivery and the rest took cesarean section. Few patients presented respiratory symptoms (fever and cough) on admission, but most had typical chest CT images of COVID-19 pneumonia. Compared to the controls, COVID-19 pneumonia patients had lower counts of white blood cells (WBC), neutrophils, C-reactive protein (CRP), and alanine aminotransferase (ALT) on admission. Increased levels of WBC, neutrophils, eosinophils, and CRP were found in postpartum blood tests of pneumonia patients. There were three (18.8%) and three (16.7%) of the mothers with confirmed or suspected COVID-19 pneumonia had preterm delivery due to maternal complications, which were significantly higher than the control group. None experienced respiratory failure during hospital stay. COVID-19 infection was not found in the newborns and none developed severe neonatal complications.


Conclusion
Severe maternal and neonatal complications were not observed in pregnant women with COVID-19 pneumonia who had vaginal delivery or caesarean section. Mild respiratory symptoms of pregnant women with COVID-19 pneumonia highlight the need of effective screening on admission.
"
AUTHORS
Linli Yue
Yin Ouyang
Yuxia Lv
Lefei Han
Guoqiang Sun
Lin Chen et al
PUBLISHED
2020 in Clinical Infectious Diseases

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Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: a case-control study
"Background
The ongoing epidemics of coronavirus disease 2019 (COVID-19) have caused serious concerns about its potential adverse effects on pregnancy. There are limited data on maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia.
Methods
We conducted a case-control study to compare clinical characteristics, maternal and neonatal outcomes of pregnant women with and without COVID-19 pneumonia.
Results
During January 24 to February 29, 2020, there were sixteen pregnant women with confirmed COVID-19 pneumonia and eighteen suspected cases who were admitted to labor in the third trimester. Two had vaginal delivery and the rest took cesarean section. Few patients presented respiratory symptoms (fever and cough) on admission, but most had typical chest CT images of COVID-19 pneumonia. Compared to the controls, COVID-19 pneumonia patients had lower counts of white blood cells (WBC), neutrophils, C-reactive protein (CRP), and alanine aminotransferase (ALT) on admission. Increased levels of WBC, neutrophils, eosinophils, and CRP were found in postpartum blood tests of pneumonia patients. There were three (18.8%) and two (10.5%) of the mothers with confirmed or suspected COVID-19 pneumonia had preterm delivery due to maternal complications, which were significantly higher than the control group. None experienced respiratory failure during hospital stay. COVID-19 infection was not found in the newborns and none developed severe neonatal complications.
Conclusion
Severe maternal and neonatal complications were not observed in pregnant women with COVID-19 pneumonia who had vaginal delivery or caesarean section. Mild respiratory symptoms of pregnant women with COVID-19 pneumonia highlight the need of effective screening on admission."
AUTHORS
Linli Yue
Yin Ouyang
Yuxia Lv
Lefei Han
Guoqiang Sun
Lin Chen et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province
"Objective: To study the effect of COVID-19 on pregnancy outcomes and neonatal prognosis in Hubei Province. Methods: A retrospective comparison of the pregnancy outcomes was done between 16 women with COVID-19 and 45 women without COVID-19. Also, the results of laboratory tests, imaging examinations, and the 2019-nCoV nucleic acid test were performed in 10 cases of neonatal deliverd from women with COVID-19. Results: (1) Of the 16 pregnant women with COVID-19, 15 cases were ordinary type and 1 case was severe type. No one has progressed to critical pneumonia. The delivery method of the two groups was cesarean section, and the gestational age were (38.7±1.4) and (37.9±1.6) weeks, there was no significant difference between the two groups (P> 0.05). Also, there wee no significant differences in the intraoperative blood loss and birth weight of the newborn between the two groups (all P>0.05). (2) Ten cases of neonates delivered from pregnant women with COVID-19 were collected. The 2019-nCoV nucleic acid test were all negative. There were no significant differences in fetal distress, meconium-stained amniotic fluid, preterm birth, and neonatal asphyxia between the two groups (all P>0.05). (3) In the treatment of uterine contraction fatigue, carbetocin or carboprost tromethamine was used more in cesarean section for pregnant women with COVID-19 (1.3±0.6), compared with Non-COVID-19 group (0.5±0.7), the difference was statistically significant (P=0.001). Conclusions: If there is an indication for obstetric surgery or critical illness of COVID-19 in pregnant women, timely termination of pregnancy will not increase the risk of premature birth and asphyxia of the newborn, but it is beneficial to the treatment and rehabilitation of maternal pneumonia. Preventive use of long-acting uterotonic agents could reduce the incidence of postpartum hemorrhage during surgery. 2019-nCoV infection has not been found in neonates deliverd from pregnant women with COVID-19."
AUTHORS
Wei M
Jiang Y
Zhang L
LI Ji
Zhou XC
Cheng BH
PUBLISHED
2020 in Chinese Medical Association

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Literature review
SARS-CoV-2 Infection in Pregnancy – a Review of the Current Literature and Possible Impact on Maternal and Neonatal Outcome
"AbstractIn December 2019, cases of pneumonia of unknown cause first started to appear in Wuhan in China; subsequently, a new coronavirus was soon identified as the cause of the illness, now known as Coronavirus Disease 2019 (COVID-19). Since then, infections have been confirmed worldwide in numerous countries, with the number of cases steadily rising. The aim of the present review is to provide an overview of the new severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2) and, in particular, to deduce from it potential risks and complications for pregnant patients. For this purpose, the available literature on cases of infection in pregnancy during the SARS epidemic of 2002/2003, the MERS (Middle East respiratory syndrome) epidemic ongoing since 2012, as well as recent publications on cases infected with SARS-CoV-2 in pregnancy are reviewed and reported. Based on the literature available at the moment, it can be assumed that the clinical course of COVID-19 disease may be complicated by pregnancy which could be associated with a higher mortality rate. It may also be assumed at the moment that transmission from mother to child in utero is unlikely. Breastfeeding is possible once infection has been excluded or the disease declared cured."
AUTHORS
Adriana Titzmann
Florian M. Stumpfe
Michael O. Schneider
Peter A. Fasching
Matthias W. Beckmann
Sven Kehl et al
PUBLISHED
2020 in Geburtshilfe und Frauenheilkunde

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Clinical features and the maternal and neonatal outcomes of pregnant women with coronavirus disease 2019
"BACKGROUND
There is little information about the coronavirus disease 2019 (Covid-19) during pregnancy. This study aimed to determine the clinical features and the maternal and neonatal outcomes of pregnant women with Covid-19.

METHODS
In this retrospective analysis from five hospitals, we included pregnant women with Covid-19 from January 1 to February 20, 2020. The primary composite endpoints were admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Secondary endpoints included the clinical severity of Covid-19, neonatal mortality, admission to neonatal intensive care unit (NICU), and the incidence of acute respiratory distress syndrome (ARDS) of pregnant women and newborns.

RESULTS
Thirty-three pregnant women with Covid-19 and 28 newborns were identified. One (3%) pregnant woman needed the use of mechanical ventilation. No pregnant women admitted to the ICU. There were no moralities among pregnant women or newborns. The percentages of pregnant women with mild, moderate, and severe symptoms were 13 (39.4%),19(57.6%), and 1(3%). One (3.6%) newborn developed ARDS and was admitted to the NICU. The rate of perinatal transmission of SARS-CoV-2 was 3.6%.

CONCLUSIONS
This report suggests that pregnant women are not at increased risk for severe illness or mortality with Covid-19 compared with the general population. The SARS-CoV-2 infection during pregnancy might not be associated with as adverse obstetrical and neonatal outcomes that are seen with the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) infection during pregnancy. (Funded by the National Key Research and Development Program.)"
AUTHORS
Qiong Yang
Ling Feng
Wen-cong He
Cui-fang Fan
Yu-ling Liu
Kutluk Oktay et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Literature review
Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis
"Background:
Coronavirus disease 2019 (COVID-19) is an evolving infectious disease that dramatically spread all over the world in the early part of 2020. No studies have yet summarised the potential severity and mortality risks caused by COVID-19 in patients with chronic obstructive pulmonary disease (COPD), and we update information in smokers.
Methods:
We systematically searched electronic databases from inception to March 24, 2020. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Study quality was assessed using a modified version of the Newcastle Ottawa Scale. We synthesised a narrative from eligible studies and conducted a meta-analysis using a random-effects model to calculate pooled prevalence rates and 95% confidence intervals (95%CI).
Results:
In total, 123 abstracts were screened and 61 full-text manuscripts were reviewed. A total of 15 studies met the inclusion criteria, which included a total of 2473 confirmed COVID-19 patients. All studies were included in the meta-analysis. The crude case fatality rate of COVID-19 was 6.4%. The pooled prevalence rates of COPD patients and smokers in COVID-19 cases were 2% (95% CI, 1%-3%) and 9% (95% CI, 4%-14%) respectively. COPD patients were at a higher risk of more severe disease (risk of severity = 63%, (22/35) compared to patients without COPD 33.4% (409/1224) [calculated RR, 1.88 (95% CI, 1.4-2.4)]. This was associated with higher mortality (60%). Our results showed that 22% (31/139) of current smokers and 46% (13/28) of ex-smokers had severe complications. The calculated RR showed that current smokers were 1.45 times more likely [95% CI: 1.03-2.04] to have severe complications compared to former and never smokers. Current smokers also had a higher mortality rate of 38.5%.
Conclusion:
Although COPD prevalence in COVID-19 cases was low in current reports, COVID-19 infection was associated with substantial severity and mortality rates in COPD. Compared to former and never smokers, current smokers were at greater risk of severe complications and higher mortality rate. Effective preventive measures are required to reduce COVID-19 risk in COPD patients and current smokers."
AUTHORS
Abdullah S Alqahtani
Mater Almehmadi
Saeed M Alghamdi
Abdulelah M Aldhahir
Tope Oyelade
Jaber S Alqahtani et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Anaesthetic managment and clinical outcomes of parturients with COVID-19: a multicentre, retrospective, propensity score matched cohort study
"Objective:To analyse the clinical features of COVID−19 parturients, and to compare anaesthetic regimen and clinical outcomes in parturients with or without COVID−19 undergoing cesarean delivery.Methods: Data were extracted from the electronic medical record of 3 medical institutions in Hubei Province, China, from June 1, 2019 to March 20, 2020 according to inclusion and exclusion criteria. After propensity score matching with demographics, the clinical and laboratory characteristics of parturients with or without COVID−19 were analysed. The anaesthetic regimen and clinical outcomes of themselves and their infants were compared in these two groups of parturients. Results: A total of 1,588 patients without SARS−CoV−2 infection undergoing cesarean delivery were retrospectively included. After achieving a balanced cohort through propensity score matching, 89 patients (COVID−19 group), who were diagnosed with COVID−19 by SARS−CoV−2 nucleic acid test and CT scan matched with 173 patients without COVID−19 (Control group). The SARS−CoV−2 infected parturients in the early stages of COVID−19 outbreak was much more than during the later stage. The main clinical characteristics of parturients with COVID−19 were fever (34.8%), cough (33.7%), an increased plasma CRP (52.8%) and a decreased lymphocyte counting (33.7%). A high rate of emergency and a high incidence of anaesthesia-related complications, such as pharyngalgia, multiple puncture, intraoperative hypotension, nausea, vomiting, vertigo and chills in the COVID−19 parturients. In addition, the parturients with COVID−19 had a long duration of operation and hospital stay, and an increased intraoperative oxytocin utilization and postoperative oxygen therapy. The newborns from the SARS−CoV−2 infected mothers, who received general anaesthesia, had a high risk of Apgar score ≤8 at 1 and 5 minutes after delivery and a higher rate of neonatal intensive care unit (NICU) admission. Conclusions: Anaesthesia−related complications occur more frequently in the COVID−19 parturients and their newborns have a high risk of distress."
AUTHORS
Jie Wang
Daqing Ma
Qin Zhou
Xiangdong Chen
Rong Chen
Qing-tao Meng et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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“The COVID-19 Generation”: A Cautionary Note
"With COVID-19 presenting as a global pandemic, we have noticed an emerging rhetoric concerning “the COVID-19 Generation,” both anecdotally and across various media outlets. The narratives advanced to support such rhetoric have distinct implications for the study of work, aging, and retirement. In this commentary, we review this emerging issue and present evidence against attempts to define “the COVID-19 Generation” as a new construct along conceptual, methodological, as well as practical lines, with a specific focus on identifying real dangers associated with investigating and potentially managing a new generation associated with this pandemic. We strongly caution against the adoption of “the COVID-19 Generation” as a concept of study and instead offer several suggestions to researchers, organizations, and practitioners seeking answers to complicated questions about links between COVID-19 and various processes relevant to work, aging, and retirement during this time of uncertainty."
AUTHORS
Cort Rudolph
Hannes Zacher
PUBLISHED
2020 in Center for Open Science

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Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2) infection during late pregnancy: A Report of 18 patients from Wuhan, China
"Abstract

Background Compared with Severe Acute Respiratory Syndrome(SARS) and Middle East Respiratory Syndrome(MESR), Corona Virus Disease 2019(COVID-19) spread more rapidly and widely. The population was generally susceptible. However, reports on pregnant women infected with SARS-CoV-2 were very limited. By sharing the clinical characteristics, treatments and outcomes of 18 patients with COVID-19 during late pregnancy, we hoped to provide some references for obstetric treatment and management. Methods: A total of 18 patients with COVID-19 treated in Renmin Hospital of Wuhan University were collected. The epidemiological characteristics, clinical manifestations, laboratory tests, chest CT and pregnancy outcomes were performed for analysis. Results: 1.18 cases of late pregnancy infected with SARS-CoV-2 pneumonia were delivered at 35 + 5 weeks to 41 weeks. According to the clinical classification of COVID-19, 1 case was mild type, 16 cases were ordinary type, and 1 case was severe type. 2 . According to Imaging examinations: 15 (83%) cases showed unilateral or bilateral pneumonia, 2 (11%) cases had pulmonary infection with pleural effusion, and 1(6%) case had no abnormal imaging changes. 3. Among the 18 newborns, there were 3 (17%) premature infants, 1 (6%) case of mild asphyxia, 5 (28%) cases of bacterial pneumonia, 1 (6%) case of gastrointestinal bleeding, 1 (6%) case of necrotizing enteritis, 2 (11%) cases of hyperbilirubinemia and 1 (6%) case of diarrhea. All the newborns were negative for the first throat swab test of SARS-CoV-2 after birth. 4. Follow-up to Mar 7, 2020, no maternal and neonatal deaths occurred. Conclusions: The majority of patients in late term pregnancy with COVID-19 were of ordinary type, and they less likely developed into critical pneumonia after early isolation and antiviral treatment. Vertical transmission of SARS-CoV-2 was not detected, but the proportion of neonatal bacterial pneumonia was higher than other neonatal diseases in newborns.
"
AUTHORS
Lu Zhang
Jing Yang
Lei Ming
Jun Li
Min Wei
Lan Dong et al
PUBLISHED
2020 in Research Square

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Literature review
Konsep Tafakkur Dalam Alquran Dalam Menyikapi Coronavirus Covid-19
"Abstract:Tafakkur in Arabic is interpreted as an act of thinking to bridge the perceptions and conceptions of this world life to the afterlife, and from creatures to their Creator, namely Allah. Tafakkur goes beyond this life to a wider region, the hereafter, and transcends the superficiality of materialism to a deeper horizon, that is "spirit" which can motivate all external and internal activities of Muslims. According to Ibn Khaldun in the book Mukadimmah has a fairly broad understanding. Education is not only a teaching and learning process that is limited by four walls, but education is a process in which humans consciously capture, absorb, and experience natural events throughout the ages. This study aims to treat the epidemic of the Covid 19 virus corona with an Islamic Education perspective approach. This research is a qualitative research with a literature review approach. The results found that the tafakkur corona Covid 19 virus in the perspective of the Islamic religion produced findings through, namely; first, quarantine, namely isolating the area affected by the plague is an appropriate action; Second, be patient; Third, be kind and work hard; Fourth, pray a lot.Keywords: Tafakkur, Islamic Religious Education, Corona virus Covid 19 AbstrakTafakkur dalam bahasa Arab diartikan sebagai tindakan berpikir untuk menjembatani persepsi dan konsepsi dari kehidupan dunia ini ke kehidupan akhirat, dan dari makhluk ke Penciptanya, yaitu Allah Swt. Tafakkur melampaui hidup ini ke wilayah lebih luas, akhirat, dan melampaui kedangkalan materialisme menuju horizon lebih dalam, yaitu “ruh” yang dapat memotivasi seluruh aktivitas eksternal dan internal kaum muslim. Menurut Ibn Khaldun di dalam buku Mukadimmah mempunyai pengertian yang cukup luas. Pendidikan bukan hanya merupakan proses belajar mengajar yang dibatasi oleh empat dinding, tetapi pendidikan adalah suatu proses dimana manusia secara sadar menangkap, menyerap, dan menghayati peristiwa-peristiwa alam sepanjang zaman. Penelitian ini bertujuan untuk men-tafakkuri wabah corona virus Covid 19 dengan pendekatan perspektif Pendidikan Islam. Penelitian ini merupakan penelitian kualitatif dengan pendekatan literature review. Hasil penelitian menemukan bahwa tafakkur corona virus Covid 19 dalam perspektif Agama Islam menghasilkan temuan melalui, yaitu; pertama, karantina yaitu mengisolasi daerah yang terkena wabah adalah sebuah tindakan yang tepat; Kedua, bersabar; Ketiga, berbaik sangka dan berikhtiarlah; Keempat, banyak berdoalah.Kata Kunci: Tafakkur, Pendidikan Agama Islam, Coronavirus Covid 19"
AUTHOR
Indriya Indriya
PUBLISHED
2020 in SALAM: Jurnal Sosial dan Budaya Syar-i

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Literature review
Konsep Tafakkur Dalam Alquran Dalam Menyikapi Coronavirus Covid-19
"Abstract:Tafakkur in Arabic is interpreted as an act of thinking to bridge the perceptions and conceptions of this world life to the afterlife, and from creatures to their Creator, namely Allah. Tafakkur goes beyond this life to a wider region, the hereafter, and transcends the superficiality of materialism to a deeper horizon, that is "spirit" which can motivate all external and internal activities of Muslims. According to Ibn Khaldun in the book Mukadimmah has a fairly broad understanding. Education is not only a teaching and learning process that is limited by four walls, but education is a process in which humans consciously capture, absorb, and experience natural events throughout the ages. This study aims to treat the epidemic of the Covid 19 virus corona with an Islamic Education perspective approach. This research is a qualitative research with a literature review approach. The results found that the tafakkur corona Covid 19 virus in the perspective of the Islamic religion produced findings through, namely; first, quarantine, namely isolating the area affected by the plague is an appropriate action; Second, be patient; Third, be kind and work hard; Fourth, pray a lot.Keywords: Tafakkur, Islamic Religious Education, Corona virus Covid 19 AbstrakTafakkur dalam bahasa Arab diartikan sebagai tindakan berpikir untuk menjembatani persepsi dan konsepsi dari kehidupan dunia ini ke kehidupan akhirat, dan dari makhluk ke Penciptanya, yaitu Allah Swt. Tafakkur melampaui hidup ini ke wilayah lebih luas, akhirat, dan melampaui kedangkalan materialisme menuju horizon lebih dalam, yaitu “ruh” yang dapat memotivasi seluruh aktivitas eksternal dan internal kaum muslim. Menurut Ibn Khaldun di dalam buku Mukadimmah mempunyai pengertian yang cukup luas. Pendidikan bukan hanya merupakan proses belajar mengajar yang dibatasi oleh empat dinding, tetapi pendidikan adalah suatu proses dimana manusia secara sadar menangkap, menyerap, dan menghayati peristiwa-peristiwa alam sepanjang zaman. Penelitian ini bertujuan untuk men-tafakkuri wabah corona virus Covid 19 dengan pendekatan perspektif Pendidikan Islam. Penelitian ini merupakan penelitian kualitatif dengan pendekatan literature review. Hasil penelitian menemukan bahwa tafakkur corona virus Covid 19 dalam perspektif Agama Islam menghasilkan temuan melalui, yaitu; pertama, karantina yaitu mengisolasi daerah yang terkena wabah adalah sebuah tindakan yang tepat; Kedua, bersabar; Ketiga, berbaik sangka dan berikhtiarlah; Keempat, banyak berdoalah.Kata Kunci: Tafakkur, Pendidikan Agama Islam, Coronavirus Covid 19"
AUTHOR
Indriya Indriya
PUBLISHED
2020 in SALAM: Jurnal Sosial dan Budaya Syar-i

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No SARS-CoV-2 in expressed prostatic secretion of patients with coronavirus disease 2019: a descriptive multicentre study in China
"Abstract
Purpose: The aim of the present study was to assess whether SARS-CoV-2 can be detected in the expressed prostatic secretion (EPS) of patients with corona virus disease 2019 (COVID-19).
Methods: 18 cases of COVID-19, and 5 suspected cases, were selected from three medical centers to detect the RNA expression of SARS-CoV-2 in their EPS with RT-PCR.
Results: Results were negative in all EPS samples for SARS-CoV-2 of suspected and confirmed patients.
Conclusions: No SARS-CoV-2 was expressed in EPS of patients with COVID-19."
AUTHORS
jinfei tian
qingyou zheng
weihe quan
yong zhao
haijia xu
hao chu et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Risk Factors of Healthcare Workers with Corona Virus Disease 2019: A Retrospective Cohort Study in a Designated Hospital of Wuhan in China
"Abstract
Corona Virus Disease 2019 (COVID-19) originated in Wuhan, China has caused many healthcare workers (HCWs) infected. Seventy-two HCWs manifested with acute respiratory illness were retrospectively enrolled to analyze the risk factors. The high-risk department, longer duty hours, and suboptimal hand hygiene after contacting with patients were linked to COVID-19."
AUTHORS
Xiaodong Tan
Ling Zhang
Li Ran
Wenwen Wu
Ying Wang
Xuyu Chen
PUBLISHED
2020 in Clinical Infectious Diseases

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In silico Screening of Food Bioactive Compounds to Predict Potential Inhibitors of COVID-19 Main protease (Mpro) and RNA-dependent RNA polymerase (RdRp)
"&lt;p&gt;As novel corona virus (COVID-19) infections has spread throughout the
world, world health organization (WHO) has announced COVID-19 as a pandemic
infection. Henceforth investigators are conducting extensive research to find possible
therapeutic agents against COVID-19. Main protease (Mpro) that plays an
essential role in processing the polyproteins that are translated from the
COVID-19 RNA becomes and RNA-dependent RNA polymerase (RdRp) that catalyzes the
replication of RNA from RNA template as a potential targets for in silico
screening of effective therapeutic compounds to COVID-19. In this study we used
COVID-19 Docking Server to predict potential food bioactive compounds to inhibit
Mpro and RdRp. The results showed that Phycocyanobilin, Riboflavin, Cyanidin, Daidzein, Genistein
are potent inhibitor bioactive compounds to Mpro and RdRp in comparison to antiviral drugs. Though, further in
vitro and/or in vivo research is required to validate the docking results. &lt;br&gt;&lt;/p&gt;"
AUTHORS
Brahmaiah Pendyala
Ankit Patras
PUBLISHED
2020 in American Chemical Society (ACS)

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Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records
FUNDERS
Hubei Science and Technology Plan , Wuhan University Medical Development Plan
You can view the abstract at: https://doi.org/10.1016/s0140-6736(20)30360-3
AUTHORS
Wei Hou
Qing Gong
Dan Xu
Huijun Chen
Fan Luo
Huixia Yang et al
PUBLISHED
2020 in The Lancet

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Literature review
Assessment of the possibility of vertical transmission of COVID-19: A systematic review and meta-analysis protocol
"Abstract

BackgroundThe novel coronavirus 2019 (COVID-19) outbreak has put a great burden on global health and healthcare systems. One of the vulnerable groups to COVID-19 infection and complications is the pregnant women. There is controversy regarding the possibility of vertical transmission of COVID-19 from mother to infant. The aim of this systematic review and meta-analysis was to assess the possibility of vertical transmission of COVID-19 based on currently published literature including observational studies. All published articles including case reports, case series,MethodsThis study will be conducted on all published observational studies, including cross-sectional studies, cohort, case-control, case reports, and case series, in peer reviewed journals in any language until the end of March 2020. Editorials, commentaries and letter to editors will be excluded from the review. Search will be conducted in international bibliographic databases including PubMed, Embase, and Web of Science based on preferred reporting items for systematic reviews and meta-analysis (PRISMA) checklist. Primary search will be performed in PubMed and Embase using the Coronavirus 2019 and vertical transmission keywords based on medical subject heading (MeSH) terms along with free text searching in combination with Boolean operations. The search strategy will be improved and finalized based on the results of the primary search. The World Health Organization (WHO) and google scholar websites will be searched as grey literature. Articles will be reviewed by two authors independently for the relevance of titles and abstracts. Data extraction of the included articles will be performed by two researchers using the Zotero and review manager (revMan) software. Heterogeneity of the articles will be assessed using DerSimonian &amp; Laird Q test and I 2 statistic. The pooled estimated prevalence of vertical transmission of COVID-19 will be performed using the Metaprop command. Publication bias will be assessed using the Begg's rank correlation and the Egger weighted regression methods.DiscussionThe findings of this systematic review and meta-analysis will help practitioners and health care providers in decision making for the care and management of COVID-19 infected pregnant women. Systematic review registration In process
"
AUTHORS
Tahereh Fathi Najafi
Sareh Dashti
Narjes Bahri
Hamid Reza Tohidinik
PUBLISHED
2020 in Research Square

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Infection with SARS-CoV-2 in pregnancy. Information and proposed care. CNGOF
"A new coronavirus (SARS-CoV-2) highlighted at the end of 2019 in China is spreading across all continents. Most often at the origin of a mild infectious syndrome, associating mild symptoms (fever, cough, myalgia, headache and possible digestive disorders) to different degrees, SARS-Covid-2 can cause serious pulmonary pathologies and sometimes death.Data on the consequences during pregnancy are limited. The first Chinese data published seem to show that the symptoms in pregnant women are the same as those of the general population. There are no cases of intrauterine maternal-fetal transmission, but cases of newborns infected early suggest that there could be vertical perpartum or neonatal transmission. Induced prematurity and cases of respiratory distress in newborns of infected mothers have been described.Pregnancy is known as a period at higher risk for the consequences of respiratory infections, as for influenza, so it seems important to screen for Covid-19 in the presence of symptoms and to monitor closely pregnant women.In this context of the SARS-Covid-2 epidemic, the societies of gynecology-obstetrics, infectious diseases and neonatalogy have proposed a French protocol for the management of possible and proven cases of SARS-Covid-2 in pregnant women. These proposals may evolve on a daily basis with the advancement of the epidemic and knowledge in pregnant women. Subsequently, an in-depth analysis of cases in pregnant women will be necessary in order to improve knowledge on the subject."
AUTHORS
Lucet JC
Lescure X
Huissoud C
Deruelle P
Sibiude J
Peyronnet V
PUBLISHED
2020 in Gynécologie Obstétrique Fertilité & Sénologie

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Anaesthesia and infection control in cesarean section of pregnant women with coronavirus disease 2019 (COVID-19)
"Background The coronavirus disease 2019 (COVID-19) first emerged in Wuhan, China, and soon caused an ongoing pandemic globally. In this study we conducted a retrospective study to evaluate the safety and efficacy of combined spinal-epidural anaesthesia (CSEA) and infection control measures on perinatal care quality of 30 pregnant women with confirmed and suspected COVID-19.
Methods Individual demographic data, clinical outcomes, laboratory investigations of pregnant women and their newborns were collected from electronic medical records of the Maternal and Children Health Hospital of Hubei Province, during January 24 to February 29, 2020. Anaesthesia and surgery results were compared between pregnant women with confirmed and suspected COVID-19 infection.
Results Using CSEA in cesarean section was effective and safe for pregnant women with confirmed and suspected COVID-19 infection. Administration of dezocine and morphine was effective as postoperative analgesia, and well tolerated in COVID-19 patients. The assessment of surgery outcomes also showed similar results in both confirmed and suspected cases. No respiratory failure nor distress were found in the mothers with confirmed COVID-19 infection and their neonates. None of these patients experienced severe obstetric complications related to anaesthesia and surgeries. No COVID-19 infection was reported in the neonates born to the mothers with confirmed COVID-19 infection and healthcare workers in these operations.
Conclusions In cesarean section for pregnant women with COVID-19 infection, CSEA was safe and efficient in achieving satisfactory obstetrical anaesthesia and postoperative analgesia. No cross-infection occurred in the HCWs working in these operations."
AUTHORS
Linli Yue
Lefei Han
Min Zhong
Zhenzhen Wan
Caijuan Chu
Jun Wang et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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A Case of COVID-19 Pneumonia in a Young Male with Full Body Rash as a Presenting Symptom
"Background: In December 2019 the coronavirus disease of 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2, was identified in Wuhan, China. In the ensuing months, the COVID-19 pandemic has spread globally and case load is exponentially increasing across the United States. Emergency departments have adopted screening and triage procedures to identify potential cases and isolate them during evaluation.

Case Presentation: We describe a case of COVID-19 pneumonia requiring hospitalization that presented with fever and extensive rash as the primary presenting symptoms. Rash has only been rarely reported in COVID-19 patients, and has not been previously described."
AUTHORS
Christian Koziatek
Madison Hunt
PUBLISHED
2020 in Clinical practice and cases in emergency medicine

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Prediction of Number of Cases of 2019 Novel Coronavirus (COVID-19) Using Social Media Search Index
"Predicting the number of new suspected or confirmed cases of novel coronavirus disease 2019 (COVID-19) is crucial in the prevention and control of the COVID-19 outbreak. Social media search indexes (SMSI) for dry cough, fever, chest distress, coronavirus, and pneumonia were collected from 31 December 2019 to 9 February 2020. The new suspected cases of COVID-19 data were collected from 20 January 2020 to 9 February 2020. We used the lagged series of SMSI to predict new suspected COVID-19 case numbers during this period. To avoid overfitting, five methods, namely subset selection, forward selection, lasso regression, ridge regression, and elastic net, were used to estimate coefficients. We selected the optimal method to predict new suspected COVID-19 case numbers from 20 January 2020 to 9 February 2020. We further validated the optimal method for new confirmed cases of COVID-19 from 31 December 2019 to 17 February 2020. The new suspected COVID-19 case numbers correlated significantly with the lagged series of SMSI. SMSI could be detected 6–9 days earlier than new suspected cases of COVID-19. The optimal method was the subset selection method, which had the lowest estimation error and a moderate number of predictors. The subset selection method also significantly correlated with the new confirmed COVID-19 cases after validation. SMSI findings on lag day 10 were significantly correlated with new confirmed COVID-19 cases. SMSI could be a significant predictor of the number of COVID-19 infections. SMSI could be an effective early predictor, which would enable governments’ health departments to locate potential and high-risk outbreak areas."
AUTHORS
Qiang Sun
Mingchih Chen
Szu-Yuan Wu
Yidan Wang
Ke-Fei Wu
Ben-Chang Shia et al
PUBLISHED
2020 in International Journal of Environmental Research and Public Health

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Literature review
Update on the SARS-CoV-2 (COVID-19) Outbreak: A Global Pandemic Challenge
"The 2019 novel coronavirus (previously 2019-nCoV) or coronavirus infectious disease 2019 (COVID-19) outbreak has been summarized as on March 29, 2020. COVID-19 is a highly transmittable and pathogenic viral infection caused by severe acute respiratory syndrome coronavirus 2 (SERS-CoV-2). The disease was first seen during an outbreak in Wuhan, China and continuous spreading from human to human around the sphere. The disease is uncontrolled and increasing the death toll through. The world is facing a global challenge to protect human lives caused by coronavirus outbreak. The number of infected patients is increasing day by day due to COVID-19 as a pandemic. The world health organization (WHO) has declared global public health emergency on January 30, 2020. The disease has been spread around 201 countries with total confirmed cases 634835 and death cases 29891 as on March 29, 2020. The goal of this review to summaries and update the clinical/medical features and suggestions for diagnosis of the COVID-19 as a pandemic. The discussion of the various therapeutic algorithms, risk, prevention and control based on the latest reports has been provided."
AUTHOR
Abhishek Kumar Soni
PUBLISHED
2020 in MDPI AG

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A novel coronavirus transmission from China to Pakistan via different countries; A review.
"A review of novel coronavirus transmission from China to globally is a serious illness or just a thread to world population. In the beginning cases of novel coronavirus (COVID-19), were found with infected pneumonia (NCIP) in Wuhan city, China, during December 2019 and January 2020. An outbreak of 2019 novel coronavirus diseases (COVID-19) in Wuhan, China has spread quickly national and international wide through transportation and travelling of people. Covid-19 outbreak was idiopathic, and it got attention not only nationally but internationally. Health authorities got activated and they took immediate actions for prevention, diagnosis, and treatment of the condition. They use precaution by isolating the people infected with it even who were suspected, did close monitoring of the patients and discovered different treatment procedures and diagnostic tests to combat the disease. Electronic articles search and data collected were done through PubMed, Google Scholar and Medline, using the following keywords: coronavirus, coronavirus transmission and outbreak, and coronavirus review. All types of articles were included to discuss Covid-19 transmission national as well as international included Pakistan."
AUTHORS
Jais Kumar
Syed Ali Naqi
Naveed Arshad
PUBLISHED
2020 in The Professional Medical Journal

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COVID-19, Australia: Epidemiology Report 3: Reporting week ending 19:00 AEDT 15 February 2020
"This is the third epidemiological report for coronavirus disease 2019 (COVID-19), previously known as novel coronavirus (2019-nCoV), from the virus now known as SARS-CoV-2, reported in Australia as at 19:00 Australian Eastern Daylight Time [AEDT] 15 February 2020. It includes data on the COVID-19 Australian cases, the international situation and current information on the severity, transmission and spread."
AUTHORS
Malinda Chea
Malinda Chea
PUBLISHED
2020 in Communicable Diseases Intelligence

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COVID-19, Australia: Epidemiology Report 2: Reporting week ending 19:00 AEDT 8 February 2020
"This is the second epidemiological report for coronavirus disease (COVID-19), previously known as novel coronavirus (2019-nCoV), reported in Australia as at 19:00 Australian Eastern Daylight Time [AEDT] 8 February 2020. It includes data on Australian cases notified during the week ending 19:00 AEDT 8 February 2020, the international situation and current information on the severity, transmission and spread of the COVID-19 infection."
AUTHOR
Liz J Walker
PUBLISHED
2020 in Communicable Diseases Intelligence

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Role of Vitamin D in Pathogenesis and Severity of COVID-19 Infection
"Coronavirus disease (COVID-19) is an infectious disease caused by a new virus which causes respiratory illness. Older adults and people who have previous chronic medical conditions are at higher risk for more serious complications from COVID-19.Hypovitaminosis D is attributed to the increased risk of lung injury and acute respiratory distress syndrome (ARDS) as well as diabetes, Cardiovascular event and associated comorbidities, which are the main causes of severe clinical problem in COVID-19 patients. Considering the protective role of vitamin D through modulating the innate and adaptive immune system as well as inhibition of Renin Angiotensin System (RAS), vitamin D supplementation might boost the immune system of COVID-19 patients and reduce severity of the disease in vitamin D deficient individuals."
AUTHORS
Mohammad E. Khamseh
Maryam Ghavideldarestani
Maryam Honardoost
PUBLISHED
2020 in MDPI AG

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Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection During Pregnancy In China: A Retrospective Cohort Study
"Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been identified as the cause of the ongoing worldwide epidemic of Coronavirus Disease 2019 (COVID-19) in China and worldwide. However, there were few studies about the effects of SARS-CoV-2 infection on pregnant women.
Methods In this retrospective cohort study, we enrolled 31 pregnant women and 35 non-pregnant women from Jan 28 to Feb 28, 2020 to evaluate the effects of SARS-CoV-2 infection during pregnancy. Inflammatory indices were used to assess the severity of COVID-19. Evidence of vertical transmission was determined by laboratory confirmation of SARS-CoV-2 in amniotic fluid, placenta, neonatal throat and anal swab and breastmilk samples.
Findings Compared with non-pregnant women, pregnant women had a significantly lower proportion of fever (54.8% vs. 87.5%, p= 0.006), a shorter average interval from onset to hospitalization, and a higher proportion of severe or critical COVID-19 (32.3% vs. 11.4%, p=0.039). Neutrophil-to-lymphocyte ratio (NLR) and systematic immune-inflammation-based prognostic index (SII) were significantly higher on admission in severe/critical pneumonia group than moderate pneumonia group. We could not detect the presence of SARS-CoV-2 by RT-PCR in amniotic fluid, placenta, neonatal throat and anal swab and breastmilk samples.
Conclusions The clinical symptoms of COVID-19 in pregnant women were insidious and atypical, compared with those in non-pregnant patients. SII and NLR could be a useful marker to evaluate the severity of COVID-19. There was no evidence of vertical transmission during pregnancy with SARS-CoV-2 infection."
AUTHORS
Shihuan Yu
Min Wu
Dujuan Yao
Hongyin Sun
Chaofei Han
Qingqing Luo et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Literature review
Pregnancy during the evolving pandemic Coronavirus Disease 2019 (COVID-19): A rapid scoping review of evidence in the published literature
"Abstract
BackgroundWith more than 1 million confirmed cases of coronavirus disease 2019 (COVID-19) worldwide and more than 50,000 deaths, the pandemic of Severe Acute Respiratory Syndrome CoV (SARS-CoV-2) is rapidly evolving. SARS-CoV-2 can also pose a higher risk to pregnant women, due to their immunosuppression during pregnancy. This study investigates the emerging and most UpToDate published scientific literature on the clinical feature and management recommendations for pregnant women with COVID-19.MethodA wide range of published scientific literature was systematically searched from PubMed, Embase, Scopus, Web of Science, and “Global research on coronavirus disease (COVID-19)” managed by the World Health Organization, published between 1 January 2019 to 27 March 2020. No limitations were used for geographical location, and articles published in English were included in the review. Results for the eligible studies were charted, analyzed, and presented in a narrative format. ResultOur study identified 52 unique articles, and 29 of those articles were included in this review after fulltext screening. Participants were mostly in their third trimester and presented with fever, dry cough, myalgia, shortness, and difficulty in breathing. Ground-glass opacity in the computerized tomography scan of the chest was the cardinal feature of COVID-19 pneumonia. Except for two participants, severe pneumonia did not occur among pregnant women. Pregnant women with COVID-19 were treated with a wide range of antiviral drugs. Higher episodes of preterm birth and cesarean delivery were observed; however, it cannot be explicitly attributed to the SARS-CoV-2. There is no published evidence on the vertical transmission of SARS-CoV-2. Pregnancy with COVID-19 infection must be managed by a collaborative team of healthcare professionals during antenatal, delivery, or postnatal stage. Detailed contact tracing, investigating travel history, radiological assessment, and laboratory tests with regular fetal health monitoring must be done. ConclusionThe emerging evidence of higher perinatal complications puts pregnant women in a further vulnerable condition. Cautiousness is imperative during the clinical management of pregnant women with COVID-19, as there is no approved treatment regime available at this moment. More research is necessary to fill the gaps in the knowledge of the clinical spectrum of COVID-19 among pregnant women."
AUTHORS
Tasmeer Alam
Gulam Muhammed Al Kibria
Md Zabir Hasan
PUBLISHED
2020 in Research Square

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Literature review
Pregnancy outcomes, Newborn complications and Maternal-Fetal Transmission of SARS-CoV-2 in women with COVID-19: A systematic review
"Abstract
Objective: The aim of this systematic review was to examine published and preprint reports for maternal and fetal outcomes in pregnant women with COVID-19 and also assess the incidence of maternal-fetal transmission of SARS CO-V-2 infection.
Design : Systematic review
Data sources:We searched PUMBED. Medline, Embase, MedRxiv and bioRxiv databases upto 31st March 2020 utilizing combinations of word variants for &amp;#34 coronavirus &amp;#34 or &amp;#34
COVID-19 &amp;#34 or &amp;#34 severe acute respiratory syndrome &amp;#34 or &amp;#34 SARS-COV-2 &amp;#34 and &amp;#34 pregnancy &amp;#34 . We also included data from preprint articles.
Study selection : Original case reports and case series on pregnant women with a confirmed diagnosis of SARS-CoV-2 infection.
Data extraction : We included 23 studies [China (20), USA (01), Republic of Korea (01) and Honduras, Central America (01) reporting the information on 172 pregnant women and 162 neonates. The primary outcome measures were maternal health characteristics and adverse pregnancy outcomes, neonatal outcomes and SARS-CoV-2 infection in neonates was extracted. Treatments given to pregnant women with COVID-19 were also recorded.
Results: Out of 172 women affected by COVID-19 in pregnancy, 160 women had delivered 162 newborns (2 set of twins, 12 ongoing pregnancies). In pregnant women with COVID-19, the most common symptoms were fever (54%), cough (35%), myalgia (17%), dyspnea (12%) and diarrhea (4%). Pneumonia was diagnosed by CT scan imaging in 100 % of COVID-19 pregnant women. Pregnancy complications included delivery by cesarean section (89%), preterm labor (21%), fetal distress (9%) and premature rupture of membranes (8%). The most common co-morbidities associated with pregnant women with COVID-19 were diabetes (11%), hypertensive disorders (9%), placental disorders (5%), co-infections (6%), scarred uterus (5%), hypothyroidism (5%) and anemia (4%). Amongst the neonates of COVID-19 mothers, preterm birth (23%), respiratory distress syndrome (14%), pneumonia (14%) low birth weight (11%), small for gestational age (3%) were reported. There was one still birth and one neonatal death reported. Vertical transmission rate of SARS-CoV-2 is estimated to be 11%.
Conclusion
In pregnant women with COVID-19, diabetes and hypertensive disorders are common co-morbidities and there is a risk of preterm delivery. Amongst the neonates born to mothers with COVID-19, respiratory distress syndrome and pneumonia are common occurrence. There is an evidence of vertical transmission of SARS-CoV-2 infection in women with COVID-19."
AUTHORS
Deepak Modi
Smita Mahale
Rahul Gajbhiye
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Literature review
Outcome of Coronavirus spectrum infections (SARS, MERS, COVID 1 -19) during pregnancy: a systematic review and meta-analysis
"Objective: The aim of this systematic review was to report pregnancy and perinatal outcomes of Coronavirus (CoV) spectrum infections, and particularly COVID-19 disease due to SARS-COV-2 infection during pregnancy.

Data Sources: Medline, Embase, Cinahl and Clinicaltrials.gov databases were searched electronically utilizing combinations of word variants for "coronavirus" or "severe acute respiratory syndrome" or "SARS" or "Middle East respiratory syndrome" or "MERS" or "COVID-19" and "pregnancy". The search and selection criteria were restricted to English language.

Study Eligibility Criteria: Inclusion criteria were pregnant women with a confirmed Coronavirus related illness, defined as either SARS, MERS or COVID-19.

Study Appraisal And Synthesis Methods: We used meta-analyses of proportions to combine data and reported pooled proportions. The pregnancy outcomes observed included miscarriage, preterm birth, pre-eclampsia, preterm prelabor rupture of membranes, fetal growth restriction, and mode of delivery. The perinatal outcomes observed were fetal distress, Apgar score < 7 at five minutes, neonatal asphyxia, admission to neonatal intensive care unit, perinatal death, and evidence of vertical transmission.

Results: 19 studies including 79 women were eligible for this systematic review: 41 pregnancies (51.9%) affected by COVID-19, 12 (15.2%) by MERS, and 26 (32.9%) by SARS. An overt diagnosis of pneumonia was made in 91.8% and the most common symptoms were fever (82.6%), cough (57.1%) and dyspnea (27.0%). For all CoV infections, the rate of miscarriage was 39.1% (95% CI 20.2-59.8); the rate of preterm birth < 37 weeks was 24.3% (95% CI 12.5-38.6); premature prelabor rupture of membranes occurred in 20.7% (95% CI 9.5-34.9), preeclampsia in 16.2% (95% CI 4.2-34.1), and fetal growth restriction in 11.7% (95% CI 3.2-24.4); 84% were delivered by cesarean; the rate of perinatal death was 11.1% (95% CI 84.8-19.6) and 57.2% (95% CI 3.6-99.8) of newborns were admitted to the neonatal intensive care unit. When focusing on COVID-19, the most common adverse pregnancy outcome was preterm birth < 37 weeks, occurring in 41.1% (95% CI 25.6-57.6) of cases, while the rate of perinatal death was 7.0% (95% CI 1.4-16.3). None of the 41 newborns assessed showed clinical signs of vertical transmission.

Conclusion: In mothers infected with coronavirus infections, including COVID-19, >90% of whom also had pneumonia, PTB is the most common adverse pregnancy outcome. Miscarriage, preeclampsia, cesarean, and perinatal death (7-11%) were also more common than in the general population. There have been no published cases of clinical evidence of vertical transmission. Evidence is accumulating rapidly, so these data may need to be updated soon. The findings from this study can guide and enhance prenatal counseling of women with COVID-19 infection occurring during pregnancy.

"
AUTHORS
Danilo Buca
Daniele Di Mascio
Giovanni Scambia
Vincenzo Berghella
Asma Khalil
Gabriele Saccone et al
PUBLISHED
2020 in American Journal of Obstetrics & Gynecology MFM

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Assessing the Awareness of the Novel Coronavirus (COVID-19) in Germany: A Google Trends Analysis (Preprint)
"
UNSTRUCTURED
On March 11, 2020 the World Health Organization characterized the novel Coronavirus (COVID-19) a pandemic. In this situation, evaluating a country’s awareness of a disease is crucial. Using online surveillance, we aimed to assess when and how the German population became aware about COVID-19.
We conducted a search on Google Trends from December 3, 2019 to March 20, 2020 using 5 keywords: Corona, Coronavirus, Corona symptome (corona symptoms), hände waschen (hand washing), gesichtsmaske (face mask). The data were collected for searches in Germany, and compared with the German COVID-19 incidence; Spearman's rank correlation coefficient and a time-lag was used for analysis.
We found a strong correlation between online search trends and the incidence of COVID-19 in Germany for the following search terms: Corona (r&gt;0.8), Coronavirus (r&gt;0.8), hand washing (r&gt;0.7) and Coronavirus symptoms (r&gt;0.8). For these searches, online searches preceded the actual outbreak of COVID-19 from 1 to 6 days.
The increasing incidence of COVID-19 in Germany correlated with people searching about that disease and related terms online. Google Trends may be a low-cost tool for monitoring the awareness of the COVID-19 outbreak and other diseases in the future.
"
AUTHORS
Shan Ali
Ahmed Ali
Mohammed Alradhi
Emad Almohisin
Zahraa Al-Hakeem
Tomasz Szmuda et al
PUBLISHED
2020 in JMIR Publications Inc.

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A Mathematical Model of the Covid-19 Cases in Indonesia (Under and Without Lockdown Enforcement)
"COVID-19 stands for Corona (CO), Virus (VI), Disease (D) and year 2019 (19), which is COVID-19 first appeared in 2019. Mathematical model of covid deployment in Indonesia under and without lockdown case uses the SIRV model, such as Susceptible, Infected, Recovery, and Virus. The results of this model state that under lockdown the spread of COVID-19 could be stopped. If it were not under lockdown it can multiply 1,276 times higher over two months."
AUTHORS
Muchammad Abrori
Sugiyanto Sugiyanto
PUBLISHED
2020 in Biology, Medicine, & Natural Product Chemistry

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New Corona Virus (COVID-19) Management in Pregnancy and Childbirth
You can view the abstract at: https://doi.org/10.5812/archcid.102938
AUTHORS
Razieh Sadat Tabatabaei
Maryam Mohammadi
Hadiseh Safi Nejad
Leila Asadi
PUBLISHED
2020 in Archives of Clinical Infectious Diseases

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First case of placental infection with SARS-CoV-2
"Background: The effects of Covid-19 in pregnancy remain relatively unknown. We present a case of second trimester pregnancy with symptomatic Covid-19 complicated by severe preeclampsia and placental abruption.
Methods: We analyzed placenta for the presence of SARS-CoV-2 through molecular and immunohistochemical assays and by and electron microscopy, and we measured the maternal antibody response in blood to this infection.
Results: SARS-CoV-2 localized predominantly to syncytiotrophoblast cells at the maternal-fetal interface of the placenta. Histological examination of the placenta revealed a dense macrophage infiltrate, but no evidence for vasculopathy typically associated with preeclampsia.
Conclusion: This case demonstrates, for the first time, SARS-CoV-2 invasion of the placenta, highlighting the potential for severe morbidity among pregnant women with Covid-19."
AUTHORS
Alice Lu-Culligans
Shelli Farhadian
Uma Deshmukh
Raffaella Morotti
Christopher Larsen
Hillary Hosier et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Literature review
COVID-19, septic shock and syndrome of disseminated intravascular coagulation syndrome. Part 2
"The article discusses the issues of hemostatic system disorders in patients with COVID-19. Strengthening the coagulopathy characteristic of DIC-syndrome, is a key sign of deterioration and an unfavorable prognosis in COVID-19 patients. Data obtained by Chinese colleagues demonstrates that a significantly increased level of D-dimer is one of the predictors of death. The article also highlights the preliminary recommendations of the International society of Thrombosis and Hemostasis (ISTH, 2020) to identify markers such as D-dimer, prothrombin time and platelet count as significant predictive markers in severe COVID-19 patients. The necessity of anticoagulant therapy in hospitalized patients is justified.&#x0D;
The article discusses the features of sepsis in pregnant women. Data from a meta-analysis of 19 studies evaluating pregnancy complications and outcomes in patients with various coronavirus infections are presented. Despite the complicated course of pregnancy, there were no cases of vertical transmission of viral infection.&#x0D;
In the pathogenesis of severe COVID-19 complications with the formation of severe acute respiratory distress syndrome, multi-organ dysfunction, super inflammation and cytokine storm play a leading role. In connection with viral sepsis, the article discusses the role of hemophagocytic lymphohistiocytosis as a hyperinflammatory syndrome characterized by fulminant and fatal hypercytokinemia with multiple organ failure, the role of hyperferritinemia in predicting the outcomes of severe sepsis. Groups of patients at high risk of death are discussed, as well as the need for anticoagulant and anti-cytokine therapy in patients with COVID-19."
AUTHORS
Giuseppe Rizzo
Maria Tretyakova
Ekaterina V Slukhanchuk
Alexander Makatsariya
Jamilya Kh. Khizroeva
Victoria O. Bitsadze et al
PUBLISHED
2020 in Annals of the Russian academy of medical sciences

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Literature review
The impact of COVID-19 on pregnancy and neonatal health: a systematic review
"Abstract
Background: In December 2019, a novel coronavirus disease (COVID-19) emerged in Wuhan, China. With an incredible rate of contagion, it has reached all over the world, with more than 2 million confirmed cases at the mid of April. However, the vertical transmission of COVID-19 is uncertain. This is a systematic review of published studies concerning pregnant women with confirmed COVID-19 and their neonates.Methods: We performed a systematic search in Pubmed, Web of Sciences, Google Scholar, Scopus, and World Health Organization (WHO) COVID-19 database to find articles reporting clinical data of COVID-19-positive pregnant women and their neonates.Results: 37 articles, involving 364 pregnant women with COVID-19 and 302 neonates, were included. The vast majority of pregnant patients were in their third trimester of pregnancy, and only 45 cases were in the first or second trimester (12.4%). Most mothers described mild to moderate manifestations of COVID-19. Of 364 pregnant women, 25 were asymptomatic at the time of admission. The most common symptoms were fever (62.4%) and cough (45.3%). Two maternal deaths occurred. Some pregnant patients (12.1%) had a negative SARS‐CoV‐2 test but displayed clinical manifestations and abnormalities in computed tomography (CT) scan related to COVID‐19. Twenty‐two (6.0%) pregnant patients developed severe pneumonia. Two maternal deaths occurred from severe pneumonia and multiple organ dysfunction. Studies included a total of 302 neonates from mothers with COVID‐19. Of the studies that provided data on the timing of birth, there were 65 (23.6%) preterm neonates. One baby was born dead from a mother who also died from COVID-19. Of the babies born alive from mothers with COVID‐19, five newborns faced critical conditions, and two of which later died. A total of 219 neonates underwent nasopharyngeal specimen collection for SARS‐CoV‐2, of which 11 tested positive (5%). Seventeen studies examined samples of the placenta, breast milk, umbilical cord, and amniotic fluid, and all tested negative except one amniotic fluid sample.Conclusions: A systematic review of published studies confirm that the course of COVID-19 in pregnant women resembles that of other populations. However, there is not sufficient evidence to establish an idea that COVID-19 would not complicate pregnancy."
AUTHORS
Nima Rezaei
Mona Mirbeyk
PUBLISHED
2020 in Research Square

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Literature review
Neurological manifestations associated with COVID19: a review and a call for action
"Abstract
While the epidemics of Coronavirus disease 2019 (COVID-19) continues to spread globally, more and more evidence is collected about the presence of neurological manifestations and symptoms associated with it. A systematic review has been performed of papers published until 5 April 2020. 29 papers related to neurological manifestations associated with COVID-19 were examined. The results show presence of central and peripheral nervous system manifestations related to coronavirus. Neurological manifestations or NeuroCOVID are part of the COVID-19 clinical picture, but questions remain regarding the frequency and severity of CNS symptoms, the mechanism of action underlying neurological symptoms, and the relationship of symptoms with the course and severity of COVID-19. Further clinical, epidemiological, and basic science research is urgently needed in order to understand and address neurological sequalae of COVID-19. Concomitant risk factors or determinants (e.g. demographic factors, comorbidities, or available biomarkers) that may predispose a person with COVID-19 to neurological manifestations also need to be identified. The review shows that although more and more papers are reporting neurological manifestations associated with COVID19, however many items remain unclear and this uncertainty calls for a global action that requires close coordination and open-data sharing between hospitals, academic institutions and the fast establishment of harmonised research priorities and research consortia to face the NeuroCOVID19 complications."
AUTHORS
Matilde Leonardi
Justin Charles McArthur
Alessandro Padovani
PUBLISHED
2020 in Research Square

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Neonatal Late Onset Infection with Severe Acute Respiratory Syndrome Coronavirus 2
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Objective To date, no information on late-onset infection in newborns to mother with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contracted in pregnancy are available. This study aimed to evaluate postdischarge SARS-CoV-2 status of newborns to mothers with COVID-19 in pregnancy that, at birth, were negative to SARS-CoV-2.
Study Design This is an observational study of neonates born to mothers with coronavirus disease 2019 (COVID-19).
Results Seven pregnant women with documented SARS-CoV-2 infection have been evaluated in our institution. One woman had a spontaneous abortion at 8 weeks of gestational age, four women recovered and are still in follow-up, and two women delivered. Two newborns were enrolled in the study. At birth and 3 days of life, newborns were negative to SARS-CoV-2. At 2-week follow-up, one newborn tested positive although asymptomatic.
Conclusion Our findings highlight the importance of follow-up of newborns to mothers with COVID-19 in pregnancy, since they remain at risk of contracting the infection in the early period of life and long-term consequences are still unknown.
Key Points
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AUTHORS
Simonetta Costa
Maurizio Sanguinetti
Antonio Lanzone
Brunella Posteraro
Piero Valentini
Danilo Buonsenso et al
PUBLISHED
2020 in American Journal of Perinatology

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Effects of SARS-CoV-2 infection on pregnant women and their infants: A retrospective study in Wuhan, China
" Context: The pandemic of a novel coronavirus, termed SARS-CoV-2, has created an unprecedented global health burden. Objective: To investigate the effect of the SARS-CoV-2 infection on maternal, fetal, and neonatal morbidity and other poor obstetrical outcomes. Design: All suspected cases of pregnant women with Coronavirus Disease 2019 (COVID-19) admitted into one center of Wuhan from Jan 20, 2020 to March 19, 2020 were included. Detailed clinical data of those pregnancies with COVID-19 were retrospectively collected and analyzed. Results: Twenty-seven laboratory or clinically confirmed SARS-CoV-2 infection pregnant women (4 early pregnancies included) and 24 neonates born to the 23 late pregnant mothers were analyzed. On admission, 46.2% (13/27) of the patients had symptoms, including fever (11/27), cough (9/27) and vomiting (1/27). Decreased total lymphocytes count was observed in 81.6% (22/27) patients. Twenty-six patients showed typical viral pneumonia by chest computed tomography (CT) scan, while one patient confirmed with COVID-19 infection showed no abnormality on chest CT. One mother developed severe pneumonia three days after her delivery. No maternal and perinatal death occurred. Moreover, one early preterm newborn, born to a mother with complication of premature rupture of fetal membranes, highly suspected with SARS-CoV-2 infection, was SARS-CoV-2 negative after repeated real-time reverse transcriptase polymerase chain reaction testing. Statistical difference was observed between the groups of early pregnant and late pregnant women with COVID-19 in the occurrence of lymphopenia and thrombocytopenia. Conclusions: No major complication were reported among the studied cohort, though one serious case and one perinatal infection were observed. Much effort should be done to reduce the pathogenic effect of COVID-19 infection in pregnancies. "
AUTHORS
Li-ye Yang
Sudong Zhan
Guoping Xiong
Hui Yang
Bin Hu
PUBLISHED
2020 in Archives of Pathology & Laboratory Medicine

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COVID-19 and pregnancy – where are we now? A review
"AbstractThe new acute respiratory disease severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is highly contagious. It has caused many deaths, despite a relatively low general case fatality rate (CFR). The most common early manifestations of infection are fever, cough, fatigue and myalgia. The diagnosis is based on the exposure history, clinical manifestation, laboratory test results, chest computed tomography (CT) findings and a positive reverse transcription-polymerase chain reaction (RT-PCR) result for coronavirus disease 2019 (COVID-19). The effect of SARS-CoV-2 on pregnancy is not already clear. There is no evidence that pregnant women are more susceptible than the general population. In the third trimester, COVID-19 can cause premature rupture of membranes, premature labour and fetal distress. There are no data on complications of SARS-CoV-2 infection before the third trimester. COVID-19 infection is an indication for delivery if necessary to improve maternal oxygenation. Decision on delivery mode should be individualised. Vertical transmission of coronavirus from the pregnant woman to the fetus has not been proven. As the virus is absent in breast milk, the experts encourage breastfeeding for neonatal acquisition of protective antibodies."
AUTHORS
Andrzej Torbé
Sebastian Kwiatkowski
Małgorzata Sokołowska
Joanna Lebdowicz-Knul
Wioletta Mikołajek-Bedner
Aleksandra Rajewska
PUBLISHED
2020 in Journal of Perinatal Medicine

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Corona kills corona: convalescent sera option for global war against corona virus disease 2019
"On December 31st, 2019 China reported first case of atypical pneumonia in Wuhan, the capital of Hubei province. The causative virus was found to be a beta coronavirus, closely related to the severe acute respiratory syndrome coronavirus (SARS-CoV-1) from 2003 and similar to Sarbeco viruses isolated from bats. It was therefore termed SARS-CoV-2 and the disease was named corona virus disease 2019 (COVID-19). The outbreak in Wuhan expanded quickly and led to the lockdown of Wuhan and other parts of China. While the lockdown, at least temporarily, brought the situation under control in China, but SARS-CoV-2 spread globally causing a pandemic with more than 4 lakh infections and about 19000 fatalities (as of March 25, 2020). Nucleic acid tests that detect the SARS-CoV-2 RNA genome were quickly developed and are now widely employed to diagnose COVID-19."
AUTHORS
Babita .
Mahavir Jangra
S. K. Jha
Anita Punia
PUBLISHED
2020 in International Journal Of Community Medicine And Public Health

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