PURPOSE:

• Sutton et al. (NEJM, 2020) sought to determine how many pregnant women admitted for delivery were positive for SARS-CoV-2, based on a universal screening program initiated in New York City, a high prevalence COVID-19 ‘hot spot’

METHODS:

• Retrospective review (March 22 and April 4, 2020)
• Setting
  • 2 Affiliated hospitals in New York City
• Participants
  • All pregnant women admitted for delivery
  • All women screened at time of admission for COVID-19 using nasopharyngeal swabs (quantitative polymerase-chain-reaction)

RESULTS:

• 215 pregnant women admitted to L&D
• Symptomatic: 1.9% (n=4)
  • 100% screened
  • Positive for SARS-CoV-2: 100% (4/4)
• Asymptomic: 98.1% (n=211)
  • 99.5% screening (210/211)
  • Positive for SARS-CoV-2: 13.7% (n=29)
  • 1 patient who was initially negative became symptomatic postpartum at which time repeat testing was positive
• COVID-19 positive patients who were asymptomatic on admission
  • Percent of screen positive patients who were asymptomatic on admission: 87.9% (29/33)
  • Of those asymptomatic but COVID-19 positive
    • Median length of stay: 2 days
    • Fever developed in 10% (n=3) prior to postpartum discharge
      • Two patients received antibiotics for endomyometritis
      • 1 patient received supportive care for COVID-19

CONCLUSION:

• Most patients admitted for delivery with COVID-19 were asymptomatic
• Potential benefits of universal screening can help
  • Determine which patients will benefit from isolation practices
  • Direct bed assignments
  • Guide neonatal care and PPE use
• The authors further state that

Although this prevalence has limited generalizability to geographic regions with lower rates of infection, it underscores the risk of Covid-19 among asymptomatic obstetrical patients

Moreover, the true prevalence of infection may be underreported because of false negative results of tests to detect SARS-CoV-2

Learn More – Primary Sources:

Universal Screening for SARS-CoV-2 in Women Admitted for Delivery

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