Most COVID-19-Positive Pregnant Women Are Asymptomatic

At the time of admission to a hospital

Part Two of Two

Asian Pregnant Woman

Asian Pregnant Woman

Although Stanford researchers recently reported that 2.5 to 4 percent of the population in Santa Clara County has most likely been exposed to coronavirus, based on their testing of 3,300 county residents, another team studying pregnant women across the nation in New York has found a much higher prevalence rate.

During the time that Covid-19 rapidly spread throughout New York City, researchers at New York–Presbyterian Allen Hospital and Columbia University Irving Medical Center first diagnosed a case of COVID-19 in an obstetrical patient on March 13, 2020. Between March 22 and April 4, 2020, a total of 215 pregnant women delivered infants at the hospitals. All the women were screened on admission for symptoms of COVID-19. Four women (1.9%) had fever or other symptoms on admission, and all tested positive. Of the 211 women without symptoms, all were without fever on admission.

Of these women, 29 (13.7%) were positive for SARS-CoV-2. Thus, 29 of the 33 patients who were positive for SARS-CoV-2 at admission (87.9%) had no symptoms at presentation, the doctors write in the April 20, 2020 issue of The New England Journal of Medicine.

Of the 29 women who had been asymptomatic but who were positive for SARS-CoV-2 on admission, fever developed in 3 (10 percent) before discharge upon giving birth (median length of stay, 2 days). Two of these patients received antibiotics for presumed endomyometritis, and one patient was presumed to have a COVID-19-related fever and treated appropriately.

“Our use of universal SARS-CoV-2 testing in all pregnant patients presenting for delivery revealed that at this point in the pandemic in New York City, most of the patients who were positive for SARS-CoV-2 at delivery were asymptomatic, and more than one of eight asymptomatic patients who were admitted to the labor and delivery unit were positive for SARS-CoV-2,” they write.

The potential benefits of a universal testing approach include the ability to use COVID-19 status to determine hospital isolation practices and bed assignments, inform neonatal care, and guide the use of personal protective equipment.

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