Thank you to Professor Jim Thornton, professor of Obstetrics and Gynaecology in Nottingham, author and NHS consultant, for permission to post his primary source research and case report updates here.
THE RISK OF DYING FROM COVID-19 IN PREGNANCY: Professor Thornton has provided a ‘must-read’ analysis of the estimated pregnancy mortality rate that can be attributed to infection with SARS-CoV-2. You can find his post here.
DISAMBIGUATION: In addition to a running list of all the primary scientific reports, Professor Thornton also has a ‘must-read’ post where he sorts out “the various hospitals and universities where reported cases of Covid-19 in pregnancy were treated…[this] needs to be done because some authors have submitted the same manuscripts to multiple journals, included previously reported cases in new case series without making this clear, or reported different aspects of the same cases in multiple papers.” You can find his post on this disambiguation here.
REGISTRIES: Professor Thornton also provides a list of “Covid-19 & pregnancy” registries, as well as of some regional groups who have reported data here.
All material is copied with permission; use of the first person refers to Dr Thornton.
You can follow Dr Thornton on Twitter.
This is not a source for advice on COVID-19. Neither professional nor lay. For that, in the US, CDC advice is here and NIH research updates here. In the UK, visit the government website here, or the RCOG here.
Nor is this a place to report cases. The US registry is here . UK cases should be reported to the UK Obstetric Surveillance System (UKOSS) (click here) via each NHS Trust’s local UKOSS reporter. Early pregnancy cases, including miscarriages & ectopic pregnancies, should also be reported there. There also is an international registry here.
However, some of the primary sources are confusing, in that hospitals overlap and pre-prints appear before full publication. There must be a risk of double counting. Below are links to, & brief notes on, the primary scientific reports in English on Covid-19 in pregnancy and childhood. They are in, roughly, reverse order. Click here for running totals from Jim Thornton’s Ripe-tomato blog.
Studies 143 to 146 added.
Study 146 – 8 cases from Turkey
Two pregnant women with Covid-19 were delivered by Caesarean at term, one miscarried at 7 weeks and five pregnancies are ongoing (click here or jum.15367). One delivered baby tested negative. No details are reported of the other. All mothers recovered. The tertiary hopsital is not named but from author affiliations is probably Sehit Prof Dr Ilhan Varank Sancaktepe Training & Research Hospital, Istanbul. These case are therefore unlikely to overlap with those in Studies 31 and 145. Citation: Yassa M, Birol P, Mutlu AM, Tekin AB, Sandal K, Tug N. Lung Ultrasound Can Influence the Clinical Treatment of Pregnant Women With COVID-19 [published online ahead of print, 2020 Jun 1]. J Ultrasound Med. 2020;10.1002/jum.15367. doi:10.1002/jum.15367
Study 145 – Case report from Turkey
A 25 year old woman with Covid-19 was delivered by Caesarean at 38 weeks (click here or 1-s2.0-S0952818020308953-main). The mother recovered and the baby tested negative. The hospital is not named but from author affiliations is likely Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey. The patient is different from the one in study 31. Citation: Resul Yilmaz, FatmaKiliç, Şule Arican, Gülçin Hacibeyoğlu, Halime Süslü, Mustafa Koyuncu, Sema Tuncer Uzun. Anesthetic management for cesarean birth in pregnancy with the novel coronavirus (COVID-19). Journal of Clinical Anesthesia. Available online 27 May 2020.
Study 144 – 2 (or 3) cases from Tokyo
Of 52 asymptomatic pregnant women screened for SARS-CoV-2 between April 6 and April 27, two tested positive and one, whose partner had Covid-19, was treated as if she was infected despite a negative test (click here or ijgo.13252). All three were delivered by Caesarean section, and their babies isolated. No babies were infected. Patients were cared for in Keio University Hospital, Tokyo. These are the first cases of Sars-Cov2 from Japan. Citation: Ochiai, D., Kasuga, Y., Iida, M., Ikenoue, S. and Tanaka, M. (2020), Universal screening for SARS‐CoV‐2 in asymptomatic obstetric patients in Tokyo, Japan. Int J Gynecol Obstet. Accepted Author Manuscript. doi:10.1002/ijgo.13252
Study 143 – 12 cases from Korea
Twelve women with COVID-19 were admitted for delivery between February 26th & to April 3rd 2020 (click here or kja-20204). Four birthed vaginally and 8 by Caesarean. Two babies were stillborn. All patients were cared for at Daegu Fatimal Hospital, Korea, (see Study 22 cited in paper). Although there is no explicit statement about whether the patient in Study 22 was included, the clinical details (age and gestation) differ, so it is likely that all 12 have not previously been reported. Citation: Jeongmin Oh, Eunju Kim, Hyunkyum Kim, Sang-Ah Lee, Kyeong Hee Lee, Mi Hyae Yu, Jihyun An. Infection control of operating room and anesthesia for cesarean section during pandemic Coronavirus disease-19 (COVID-19) outbreak in Daegu, the republic of Korea – 8 cases report. Korean J Anesthesiol [Epub ahead of print]. Published online June 5, 2020.
Studies 141 and 142 added.
Study 142 – 61 cases from Boston Massachusetts
Of these 61 women with Covid-19 in pregnancy, cared for at a single academic medical centre, 21 were admitted to hospital, of whom 6 went to intensive care, of whom four were intubated (click here or Prevalence and Severity of Coronavirus Disease.97338). No mothers died. The hospital is not named, but from author affiliations is likely Massachusetts General Hospital, Boston, Mass. If so, these women probably differ from those reported in Study 129, and have not previously been reported. Citation: Goldfarb, Ilona Telefus MD, MPH; Clapp, Mark A. MD, MPH; Soffer, Marti D. MD, MPH; Shook, Lydia L. MD; Rushfirth, Katherine CNM, MSN; Edlow, Andrea G. MD, MSc; Boatin, Adeline A. MD, MPH; Kaimal, Anjali J. MD, MAS; Barth, William H. Jr MD; Bryant, Allison S. MD, MPH Prevalence and Severity of Coronavirus Disease 2019 (COVID-19) Illness in Symptomatic Pregnant and Postpartum Women Stratified by Hispanic Ethnicity, Obstetrics & Gynecology: June 02, 2020 – Volume Publish Ahead of Print – Issue – doi: 10.1097/AOG.0000000000004005
Study 141 – 201 women from the Netherlands Covid in pregnancy registry
The 22nd May update of NethOSS (click here), accessed 4 June 2020, contains the following. 7/176 women with brief additional details were admitted to intensive care. One mother died after prolonged admission and intubation as a result of pulmonary infection with multiple pulmonary emboli. 49 women have given birth, 16 by Caesarean. 124 pregnancies are ongoing. No baby has died. No babies were infected. Citation: See Studies 42, 46 & 120. Available here. Accessed 4 June 2020.
Study 140 added.
Study 140 – 42 cases from Barcelona
Forty two pregnant women with Covid-19 between March 13 & April 10 (click here or 1471-0528.16339). Eight required admission to ICU of whom 6 developed some features of pre-eclampsia, 4 requiring Caesarean, one of which was due to HELLP syndrome. No maternal or baby outcomes are reported but it is implied “after recovery from severe pneumonia, hypertensive therapy was no longer required in all cases” that all women recovered. The “tertiary care” hospital is not named but from author affiliations is likely to be Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona. If so, these cases have not been previously reported. Citation: Mendoza, M., Garcia‐Ruiz, I., Maiz, N., Rodo, C., Garcia‐Manau, P., Serrano, B., Lopez‐Martinez, R.M., Balcells, J., Fernandez‐Hidalgo, N., Carreras, E. and Suy, A. (2020). Preeclampsia‐like syndrome induced by severe COVID‐19: a prospective observational study. BJOG. doi:10.1111/1471-0528.16339
Studies 138 (HT Frederico Amedee Peret) & 139 added. Study 137 removed.
Study 139 – 13 cases in Washington state
Twelve women with Covid-19 were detected through targeted testing, and one by universal screening (click here or ciaa675). No separate clinical details given for the SARS-Cov2 positive women. Patients were treated at the University of Washington Montlake Labor and Delivery Unit and Northwest Birth Center. They therefore likely overlap with Study 102. Citation: Sylvia M LaCourse, Alisa Kachikis, Michela Blain, LaVone E Simmons, James A Mays, Amber D Pattison, Carol C Salerno, Stephen A McCartney, Nicole M Kretzer, Rebecca Resnick, Rosemary L Shay, Leah M Savitsky, Anna C Curtin, Emily M Huebner, Kimberly K Ma, Shani Delaney, Carlos Delgado, Adrienne Schippers, Jeff Munson, Paul S Pottinger, Seth Cohen, Santiago Neme, Lori Bourassa, Andrew Bryan, Alex Greninger, Keith R Jerome, Alison C Roxby, Erica Lokken, Edith Cheng, Kristina M Adams Waldorf, Jane Hitti. Low prevalence of SARS-CoV-2 among pregnant and postpartum patients with universal screening in Seattle, Washington. Clinical Infectious Diseases ciaa675
Study 138 – 36 deaths among 484 pregnant women with Covid-19 in Brazil
Bulletin no 17 from the Brazilian Ministry of Health contains a special section on pregnant women with Covid-19 (click here or 2020-05-25—BEE17—Boletim-do-COE). The report is in Portugese. I’ve prepared an English translation of the pregnancy section using google translate Brazil MoH Covid 19 Bulletin 17 translation of pregnancy section. Citation: Ministério da Saúde, Secretaria de Vigilância em Saúde. Boletim Epidemiológico Especial da COVID-19 no Brasil. Número do boletim 17. 25 May 2020
Study 137 added.
Study 137 – A patient with Covid-19 & an ectopic pregnancy
A 37-year-old woman tested positive for SARS-Cov2 and presented two days later with an ectopic pregnancy (click here or Ectopic Pregnancy During Coronavirus Disease 2019). The authors discuss treatment options but give no further clinical details. Although the report is ambiguous, it is conventional in educational medical reports to present real cases unless stated otherwise. From author affiliations the patient was likely cared for in South Dakota or Texas. Citation: Hansen, Keith A; Stovall, Dale W. Ectopic Pregnancy During Coronavirus Disease 2019 (COVID-19), Obstet Gynecol: May 27, 2020 doi: 10.1097/AOG.0000000000003995
Study 136 added.
Study 136 – 158 cases from New York
Of 158 pregnant women with Covid-19, 34 had moderate or severe disease, 9 received ICU or step down care and 1 required intubation. There were no deaths (click here or Andrikopoulou Green Symptoms and Critical Illness Among Obstetric Patients With Coronavirus Disease 2019 (COVID-19) Infection). No baby outcomes reported. Patients were cared for at New York Presbyterian/Columbia University Irving Medical Center, and at
New York-Presbyterian/Allen Hospital. Cases presumably overlap with those in studies 14, 27, 41 & 95. Citation: Andrikopoulou, Maria; Madden, Nigel; Wen, Timothy; Aubey, Janice J; Aziz, Aleha; Baptiste, Caitlin D; Breslin, Noelle; D’Alton, Mary E; Fuchs, Karin; Goffman Dena; Gyamfi-Bannerman, Cynthia; Matseoane-Peterssen, Dara N; Miller, Russell S; Sheen, Jean-Ju; Simpson, Lynn L; Sutton, Desmond; Zork, Noelia; Friedman, Alexander M. Symptoms and Critical Illness Among Obstetric Patients With Coronavirus Disease 2019 (COVID-19) Infection, Obstet Gynecol May 27, 2020 – doi: 10.1097/AOG.0000000000003996
Studies 133 to 135 added.
Study 135 – 50 cases from New York
Among 307 asymptomatic women tested on admission in labour, 50 were SARS CoV-2 positive (click here or Buckley Mount Sinai AJOGMFM). The women were tested between April 4 & 15, 2020, at two institutions within Mount Sinai Health System in New York. They therefore probably overlap with those in Study 119. Citation: Buckley A, Bianco A, Stone J, Universal testing of patients and their support persons for COVID-19 when presenting for admission to Labor and Delivery within the Mount Sinai Health System, Am J Obstet Gynecol MFM (2020).
Study 134 – 125 cases from New York
These authors report further details on 12 pregnant women with severe Covid 19, out of 125 in total (click here or McLaren AJOG PIIS0002937820305676). 7 were delivered by Caesarean, 2 vaginally, and 3 remain undelivered. No mothers died, although one remains in hospital. This is an update on study 113, and again the hospital is presumably Maimonides Medical Center, Brooklyn, NY. Citation: MCLAREN Jr. RA, LONDON V, ATALLAH F, MCCALLA S, HABERMAN S, FISHER N, STEIN JL, MINKOFF HL, Delivery For Respiratory Compromise Among Pregnant Women With COVID-19, Am J Obstet Gynecol (2020).
Study 133 – 3 cases identified by screening in North Tuscany
By screening 533 women admitted for delivery for SARS-CoV2 between March 26th & April 1st in North Tuscany and Liguria, these authors identified 3 positives, who all gave birth without clinical problems (click here or PIIS0002937820305421). The women birthed in all the 6 hospitals of Azienda USL “Toscana Nord Ovest” (Tuscany), and Gaslini Children’s Hospital (Genoa, Liguria). They have therefore probably not previously been reported. Citation: Gagliardi L, Danieli R, Suriano G, Vaccaro A, Tripodi G, Rusconi F, Ramenghi LA, Universal SARS-CoV-2 testing of pregnant women admitted for delivery in two Italian regions. Am J Obstet Gynecol (2020).
Study 132 added (HT @janevandis).
Study 132 – 42 cases from Connecticut
Of 782 women presenting for childbirth between April 2nd & 29th, 2020, 12 had already been diagnosed with Covid-19. Of the remainder 30/770 screened positive, 22 of whom were asymptomatic (click here or jama_campbell_2020_ld_200052). No clinical outcomes reported. No health care workers infected. Patients were cared for in 3 Yale New Haven Health hospitals in southern Connecticut. Citation: Katherine H. Campbell, Jean M. Tornatore, Kirsten E. Lawrence, Jessica L. Illuzzi, L. Scott Sussman, Heather S. Lipkind, Christian M. Pettker. Prevalence of SARS-CoV-2 Among Patients Admitted for Childbirth in Southern Connecticut. JAMA. Published online May 26, 2020. doi:10.1001/jama.2020.8904
Studies 129 to 131 added.
Study 131 – Anti-SARS-Cov2 IgA antibodies in breast milk of recovering women
The authors of this not yet peer-reviewed preprint report anti SARS-Cov2 IgA antibodies in breast milk samples from 15 women previously infected with SARS-Cov2 (click here or 2020.05.04.20089995v1.full). No clinical details. The authors, mainly from Icahn School of Medicine at Mount Sinai, New York, report that they have recruited over 350 lactating women who have recovered from COVID-19. Citation: Alisa Fox, Jessica Marino, Fatima Amanat, Florian Krammer, Jennifer Hahn-Holbrook, Susan Zolla-Pazner, Rebecca L Powell. Evidence of a significant secretory-IgA-dominant SARS-CoV-2 immune response in human milk following recovery from COVID-19
Study 130 – Case report from Amsterdam Medical Centre
A woman developed Covid-19 at 41 weeks gestation (Click here or ajh.25877). She also developed autoimmune throbocytopaenia. The baby was delivered by Caesarean. Citation: Man Wai Tang, Erfan Nur, Bart J. Biemond. Immune Thrombocytopenia during Pregnancy due to COVID-19. Am J Haematol. First published:23 May 2020
Study 129 – 15 patients from Boston, Massachusetts
Of 213 admitted pregnant women screened by differential white blood count, 15 had Sars-Cov2 (click here or Duffy Green Lymphopenia and Severe Acute Respiratory Syndrome). Three required critical care for hypoxia. No other clinical details. From author affiliations patients were probably cared for in Beth Israel Deaconess Med Center, Harvard Med School, Boston, Mass. Citation: Duffy, Cassandra R. MD, MPH; Hart, Jessica M. MD; Modest, Anna M. PhD; Hacker, Michele R. ScD; Golen, Toni MD; Li, Yunping MD, MSc; Zera, Chloe MD, MPH; Shainker, Scott A. DO, MS; Mehrotra, Preeti MD, MPH; Zash, Rebecca MD; Wylie, Blair J. MD, MPH Lymphopenia and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection Among Hospitalized Obstetric Patients, Obstetrics & Gynecology: May 19, 2020 – Volume Publish Ahead of Print – Issue – doi: 10.1097/AOG.0000000000003984
Studies 127-8 added.
Study 128 – 13 patients from North East Flanders
Of 470 pregnant women screened, 13 tested positive for SARS-Cov2, 8 were asymptomatic 4 had mild upper airway symptoms, and one respiratory symptoms. None developed severe disease (click here or Ceulemans Flanders uog.22099 (1)) The hospitals caring for the four patients are unnamed but shown on a map. Citation: D. Ceulemans, I. Thijs, A. Schreurs, J. Vercammen, L. Lannoo, J. Deprest, J. Richter, L. De Catte, R. Devlieger. Screening for COVID-19 at childbirth: does it deliver? Ultrasound Obstet Gynecol. In press.
Study 127 – SARS-CoV-2 in human breastmilk
Breast milk from two nursing mothers infected with SARS-CoV-2 was tested. Samples from one woman were positive (click here or PIIS0140673620311818). Where the patients were cared for, was not reported. The authors came from Ulm in Germany. Citation: Rüdiger Groß, Carina Conzelmann, Janis A Müller, Steffen Stenger, Karin Steinhart, Frank Kirchhoff, Jan Münch. Detection of SARS-CoV-2 in human breastmilk. Lancet. Published online May 21, 2020
Study 126 – The ISARIC report in the BMJ
Among 20,133 patients admitted to hospital with covid-19 in the UK, 100/1033 (10%) women of childbearing age, were reported as being pregnant (click here or bmj.m1985.full). This is similar to the estimated proportion of pregnant women in the community. Pregnancy was not associated with mortality. This is an update of study 68. Citation: Docherty Annemarie B, Harrison Ewen M, Green Christopher A, Hardwick Hayley E, Pius Riinu, Norman Lisa et al. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ 2020; 369 :m1985
Studies 121-125 added.
Study 125 – 60 cases from Madrid
Of 60 pregnant women with COVID-19 (click here or aogs.13921), 18 had pneumonia, 2 severely. One woman was admitted to ICU. No mothers died. Of 23 women delivered, 5 were by cesarean and 18 vaginally. Two delivered preterm. All 23 babies tested negative, and 21 were breast fed. Two babies were admitted to NICU for other reasons. No babies died. The patients were all were treated at Puerta de Hierro University Hospital Madrid, Spain from March 14th to April 14th, 2020. Citation: Pereira, A., Cruz‐Melguizo, S., Adrien, M., Fuentes, L., Marin, E. and Perez‐Medina, T. (2020), Clinical course of Coronavirus Disease‐2019 (COVID‐19) in pregnancy. Acta Obstet Gynecol Scand. Accepted Author Manuscript. doi:10.1111/aogs.13921
Study 124 – 16 cases from Chicago
Fourteen patients delivered at term, 1 at 34 weeks, & 1 at 16-weeks (click here or aqaa089). No mothers admitted to ITU. No mother or baby deaths. No baby infections. The cases were identified via a search of placental pathology records. Where the women were cared for is not recorded, but from author affiliation and a footnote probably includes Prentice Women’s Hospital, Northwestern Memorial Hospital and Feinberg School of Medicine, Northwestern University, Chicago. Citation: Elisheva D Shanes, Leena B Mithal, Sebastian Otero, Hooman A Azad, Emily S Miller, Jeffery A Goldstein. Placental Pathology in COVID-19, Am J Clin Pathol. aqaa089, Published: 22 May 2020
Study 123 – 16 cases from Michigan
Two patients received oxygen via nasal cannula, none were admitted to ITU. There were 8 vaginal births (one preterm) and 2 Caesareans. No babies were infected. Six women remain undelivered (click here or Qadri Michigan Pregnancy affected by SARS CoV 2 infection a flash report…). Citation: Farnoosh Qadri & Federico Mariona (2020) Pregnancy affected by SARS-CoV-2 infection: a flash report from Michigan. J Mat-Fetal & Neonatal Med. DOI: 10.1080/14767058.2020.1765334
Study 122 – Response of Northwell Health to Covid-19 in pregnancy
A detailed description of how a large multi-hospital network in the centre of the New York pandemic organised itself to care for women with Covid-19 in pregnancy (click here or Rochelson [16193997 – Journal of Perinatal Medicine] New York). No patient numbers or details. Citation: Burton Rochelson, Michael Nimaroff, Adriann Combs, Benjamin Schwartz, Natalie Meirowitz, Nidhi Vohra, Victor R. Klein, Orlando Santandreu, Mitchell Kramer, Navid Mootabar, Eli Serur, Lisa Spiryda, Scott Berlin. Frank Chervenak. The Care of Pregnant Women During the COVID-19 Pandemic – Response of a Large Health System in Metropolitan New York. J Perinat Med. 2020 May 20;/j/jpme.ahead-of-print/jpm-2020-0175/jpm-2020-0175.xml. doi: 10.1515/jpm-2020-0175. Online ahead of print.
Study 121 – One week’s screening in Los Angeles
The Cedars-Sinai Medical Center, Los Angeles, California screened 82 pregnant women over a one week period (Bianco Green – Testing of Patients and Support Persons for Coronavirus Disease 2019 (COVID-19) – Infection Before Scheduled Deliveries). None of the 80 asymptomatic women tested positive but one of two symptomatic ones did. No further details reported. Citation: Mariam Naqvi, Richard M Burwick, John A Ozimek, Naomi H Greene, Sarah J Kilpatrick, Melissa S Wong. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Universal Testing Experience on a Los Angeles Labor and Delivery Unit. Obstet Gynecol. In press.
Studies 116-120 added.
Study 120 – 191 women from the Netherlands Covid-19 registry
This 14 May update of NethOSS (click here), accessed 21 May 2020, contains the following. 6/156 women with brief additional details were admitted to intensive care; one remains there. One mother had a molar pregnancy and one a miscarriage. 47 women have given birth, 16 by Caesarean. 109 pregnancies are ongoing. No mother or baby has died. No babies were infected. Citation: See Studies 42 and 46. Available here. Accessed 21 May. Note: we probably missed some intermediate updates from this registry.
Study 119 – 24 cases identified by screening in New York
24/155 asymptomatic women screened for SARS-COV-2 prior to a planned delivery, tested positive (click here or Bianco Green – Testing of Patients and Support Persons for Coronavirus Disease 2019 (COVID-19) – Infection Before Scheduled Deliveries). All their newborns were tested and none were positive. No maternal outcomes were reported. The patients were all cared for in the Mount Sinai Health system between April 4th and 15th. From author affiliations this was Icahn School of Medicine at Mount Sinai Hospital. These cases may therefore overlap with some in study 64. Citation: Bianco, Angela; Buckley, Ayisha B; Overbey, Jessica; Smilen, Scott; Wagner, Brian; Dinglas, Cheryl; Loudon, Holly; Garely, Alan; Brodman, Michael; Stone, Joanne. Testing of Patients and Support Persons for Coronavirus Disease 2019 (COVID-19) Infection Before Scheduled Deliveries, Obstetrics & Gynecology: May 19, 2020 – Volume Publish Ahead of Print – Issue – doi: 10.1097/AOG.0000000000003985
Study 118 – a maternal death from New York
A 36-year-old woman developed Covid-19 at 37 weeks gestation (click here or Vallejo Green A Postpartum Death Due to Coronavirus Disease 2019 (COVID-19) in the United States). Within three hours of admission she required intubation and Caesarean, and she died within 36 hours. The baby tested negative and survived. The hospital is not named, and she was not transferred. From the author affiliations it was either Dept OBGYN, Urban Health Plan, Inc., Bronx, or Division of Maternal-Fetal Med, Dept OBGYN, Weill Cornell Medicine, New York. Citation: Victoria Vallejo, John G. Ilagan. A Postpartum Death Due to Coronavirus Disease 2019 (COVID-19) in the United States. Obstet Gynecol 2020;00:1–4 DOI: 10.1097/AOG.0000000000003950
Study 117 – 77 cases from 12 Italian hospitals
From Feb 23 to March 28th, 14/77 women with Covid-19 were severely affected, and one required ECMO (click here or Savasi Green Clinical Findings and Disease Severity in Hospitalized Pregnant Women With Coronavirus Disease 2019 (COVID-19)). 57 gave birth, 22 by Caesarean. Four newborns tested positive for SARS-COV-2, but none had symptoms. 20 pregnancies are ongoing. No mothers or babies died. The 12 hospitals L. Sacco (Milan), Mangiagalli (Milan), S. Gerardo MBBM Foundation (Monza), Papa Giovanni XXIII (Bergamo), and San Matteo (Pavia) and the hospitals of Padua, Florence, Lecco, Trento, Modena, Seriate and Piacenza. These are the same hospitals as studies 33 & 64. The patients probably overlap. Citation: Valeria M. Savasi, Francesca Parisi, Luisa Patanè, Enrico Ferrazzi, Luigi Frigerio, Antonio Pellegrino, Arsenio Spinillo, Saverio Tateo, Mariacristina Ottoboni, Paola Veronese, Felice Petraglia, Patrizia Vergani, Fabio Facchinetti, Donata Spazzini, Irene Cetin. Clinical Findings and Disease Severity in Hospitalized Pregnant Women With Coronavirus Disease 2019 (COVID-19). Obstet Gynecol in press.
Study 116 – A “universal testing in pregnancy” series from Chicago
Northwestern Memorial Hospital, tested a consecutive series of 635 pregnant women admitted between April 8th & 28th, 2020. Of these 23 (3.6%) tested positive for SARS-CoV-2, of whom 10 (44%) were asymptomatic on presentation (click here or Miller NorthWestern Clinical Implications of Universal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Testing in Pregnancy). No maternal or baby outcomes were reported. Citation: Emily S. Miller, William A. Grobman, Allie Sakowicz, Jessica Rosati, Alan M. Peaceman. Clinical Implications of Universal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Testing in Pregnancy. Obstet Gynecol. In press.
Studies 113 (HT Fred Peret. We’d missed it!) to 115 added.
Study 115 – Case report of Covid-19 & severe pre-eclampsia
A 26-year-old with Covid-19 at 37 weeks gestation also had severe pre-eclampsia (click here or AJOGMFM-20-1073 ). She was treated with magnesium sulphate and delivered vaginally. The baby tested negative. Both recovered. From author affiliations likely cared for at Stanford University Hospital. Citation: Noor Joudi, Andrea Henkel, W. Scott Lock, Dierdre Lyell, Preeclampsia Treatment in SARS-CoV-2. Am J Obstet Gynecol. In press.
Study 114 – 22 women from Bergamo, Italy
Of 22 women with Covid-19 in pregnancy two neonates tested positive, one born vaginally and one by caesarean. Both did well. Their placental histology is described (click here or AJOGMF-20-1112). No other mother or baby details are given. The women were cared for between March 5, & April 21, 2020 at Papa Giovanni XXIII Hospital, Bergamo, in the Lombardy region of Italy, so the women were probably also reported in study 32 & study 64.
Study 113 – 68 SARS-Cov-2 positive pregnant women from New York
46 had Covid-19 and a further 22 asymptomatic women tested positive for SARS-Cov-2 (click here or s-0040-1712164). 12 women had severe disease, one requiring ventilation. There was one intrauterine death at 17 weeks but otherwise no mothers or babies died. All babies tested negative. 12 pregnancies are ongoing. Women were cared for at a tertiary care hospital in Brooklyn, from March 15 to April 15, 2020. From author affiliations probably Maimonides Medical Center, Brooklyn, NY. If so, they have not been previously reported. Citation: Viktoriya London, Rodney McLaren Jr., Fouad Atallah, Catherine Cepeda, Sandra McCalla, Nelli Fisher, Janet L. Stein, Shoshana Haberman, Howard Minkoff. The Relationship between Status at Presentation and Outcomes among Pregnant Women with COVID-19. Am J Perinatol. ISSN 0735-1631. Online April 27, 2020
Studies 108 to 112 added.
Study 112 – Case report from Nashville, Tennessee
A 35-year-old developed Covid-19 at 22 weeks gestation requiring intubation & ventilation (click here or 1-s2.0-S2214911220300515-main). She recovered and the pregnancy is ongoing. U Tennessee Health Science Center has not previously reported cases. Citation: J. Anderson, J. Schauer, S. Bryant, et al., The use of convalescent plasma therapy and remdesivir in the successful management of a critically ill obstetric patient with novel coronavirus 2019 infection: A case report. Case Rep Women’s Health (2020)
Study 111 – Case report from Livingstone, New Jersey
A 39-year-old woman, with IVF twins developed Covid-19 at 27 weeks of gestation (click here or 1-s2.0-S2214911220300503-main). She required ventilation and then an emergency classical Cesarean section a the bedside due to rapid deterioration. She recovered. One twin was infected, but both survived. She was cared for in Saint Barnabas Medical Center, Livingston, New Jersey, which has not previously reported a case. Citation: H. Mehta, S. Ivanovic, A. Cronin, et al., Novel coronavirus related acute respiratory distress syndrome in a patient with twin pregnancy: A case report. Case Rep Women’s Health (2020)
Study 110 – Case report from Thailand
A 43-year-old with mild Covid-19 at 18 weeks gestation (click here or Panichaya Thailand PIIS0301211520303134). Amniocentesis done a week earlier showed trisomy 21, & the pregnancy was terminated. Placental & fetal swabs were negative. Citation: Panichaya P, Thaweerat W, Uthaisan J. Prolonged viral persistence in COVID-19 second trimester pregnant patient, Eur J Obstet & Gynecology & Reprod Biol (2020)
Study 109 – 4 women from Parma, Italy
Four women with Covid-19 recovered and later delivered healthy term neonates (click here or Acta BioMed Parma 9743-Article Text-49126-2-10-20200514). They were cared for in Parma Hospital, in the Emilia-Romagna (not Lombardy) region of Italy. Citation: Serafina Perrone, Michela Deolmi, Maurizio Giordano, Tiziana D’Alvano, Lucia Gambini, Mara Corradi, Tiziana Frusca, Tullio Ghi, Susanna Esposito. Report of a series of healthy term newborns from convalescent mothers with COVID-19. Acta Biomed 2020; Vol. 91, N. 2: 251-255 DOI: 10.23750/abm.v91i2.9743
Study 108 – 27 cases from Central Hospital of Wuhan
These 27 women with Covid-19 in pregnancy included 4 early pregnancies. They delivered 24 babies (1 set of twins) (click here or Yang Wuhan arpa.2020-0232-sa). They were cared for at “Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology in Wuhan” between Jan 20 & Mar 19, 2020. Assuming this is Central Hospital of Wuhan, grid.440160.7 these cases likely overlap with studies 39 and 73. They are probably also included in studies 55 & 57. Citation: Hui Yang, Bin Hu, Sudong Zhan, Li-ye Yang, Guoping Xiong. Effects of SARS-CoV-2 infection on pregnant women and their infants: A retrospective study in Wuhan, China. Arch Pathol Lab Med. In press. doi: 10.5858/arpa.2020-0232-SA
Studies 105 to 107 added.
Study 107 – Maternal death in Birmingham, UK
A 29-year-old woman with severe Covid-19 was delievered by Caesareran section at Birmingham Heartlands Hospital at 31 weeks gestation (click here or Mat Death Bham BrJH bjh.16849). The baby tested negative and is doing well. The mother intially improved and was extubated on day 2 post natal. However on day 6 she developed basilar artery thrombosis, and she died on day 7. Case presumably included in study 92 UKOSS. Citation: Irshad Ahmed, Ahamed Azhar, Nashwa Eltaweel, Bee K Tan. First Covid-19 maternal mortality in the UK associated with thrombotic complications. In press. doi: 10.1111/bjh.16849
Study 106 – 2 cases from Reading, UK
Two women with severe Covid-19 were treated at the Royal Berkshire Hospital (click here or Cooke Reading PIIS0301211520302761 (002). Both were preterm (28+4, 28+6 days) and required Caesarean for deteriorating maternal condition. Both mothers recovered. One baby had a perforated bowel but both eventually recovered. Presumably both cases were included in study 92 UKOSS. Citation: Cooke WR, Billett A, Gleeson S, Jacques A, Place K, Siddall J, Walden A, Soulsby K. SARS-CoV-2 infection in very preterm pregnancy: experiences from two cases, Eur J Obstet Gynecol & Reprod Biol (2020)
Study 105 – 12 cases from from Hospital Pedro Hispano, Portugal
All 123 pregnant women admitted to Hospital Pedro Hispano in Porto between March 25 & April 15 were tested for SARS-CoV-2. 12 were positive, of whom 11 were asymptomatic, 10 have delivered, 6 by
cesarean section and 4 vaginally. There was one set of twins. There were no maternal complications and all the newborns tested negative (click here or Doria N Portugal PIIS0301211520303122 (002) This series may include the cases in study 74 & study 94. Citation: D´oria M, Peixinho C, Laranjo M, Varejao AM, Silva PT. Covid-19 during pregnancy: a case series from an universally tested population from the north of Portugal. Eur J Obstet Gynecol & Reprod Biol (2020)
Study 104 added.
Study 104 – ICNARC 15th May update
The 15th May ICNARC update (click here or ICNARC COVID-19 report 2020-05-15.pdf) contains 23 currently, and 32 recently, pregnant women critically ill with Covid-19. Of these 9 and 16 respectively had received advanced respiratory support.
Study 103 – Case report from Toronto, Ontario
A 40-year-old woman developed Covid-19 at 35 weeks gestation and was delivered by Caesarean (click here or cmaj.200821.full). The baby tested positive on the day of birth, breast fed and had some minor feeding difficulties, but eventually thrived. Citation: Maksim Kirtsman, Yenge Diambomba, Susan M. Poutanen, Ann K. Malinowski, Evangelia Vlachodimitropoulou, W. Tony Parks, Laura Erdman, Shaun K. Morris, Prakesh S. Shah. Probable congenital SARS-CoV-2 infection in a neonate born to a woman with active SARS-CoV-2 infection CMAJ 2020. doi: 10.1503/cmaj.200821; early-released May 14, 2020 (HT Jon Dorling & Don Sharkey).
Study 102 – 46 patients from Washington State, USA
Of 46 pregnant women with SARS-CoV-2, 43 were symptomatic, 7 hospitalized, 6 categorised as severe, and 1 admitted to ICU (click here or Lokken-AJOG). Eight women delivered, 5 vaginal, 3 Caesarean. All mothers survived. There were 7 livebirths & one stillbirth at 38 weeks. That fetus tested negative. One baby was preterm. No further baby details were given. 38 pregnancies are ongoing. The women were cared for in 16 hospitals: University of Washington Hospital system (Montlake, Northwest, & Harborview campuses), Swedish Medical Center (First Hill, Ballard, Issaquah and Edmonds campuses), University of Washington Valley Medical Center, MultiCare Health System (Auburn Medical Center, Covington Medical Center, Tacoma General Hospital, Good Samaritan Hospital, Valley Hospital and Deaconess Hospital), Evergreen Health Medical Center, and PeaceHealth-St. Joseph’s Medical Center. Citation: Erica M. LOKKEN et al. Clinical Characteristics of 46 Pregnant Women with a SARS-CoV-2 Infection in Washington State. Am J Obstet Gynecol. in press.
Study 101 – Case report from Tabriz, Iran
A 33-year-old woman with severe Covid-19 at 34 weeks gestation was treated at Imam Reza hospital of Tabriz (click here or Taghizadieh Iran 1-s2.0-S2213007120302306-main). She required intubation, ventilation, renal dialysis & delivery by Caesarean. The baby tested negative & was in good health. The mother remains intubated but is recovering. The clinical details differ sufficiently from the two women who survived in study 67 to make it likely that this is a previously unreported case. Citation: Taghizadieh A, Mikaeili H, Ahmadi M, Valizadeh H, Acute kidney injury in pregnant women following SARS-CoV-2 infection: A case report from Iran, Respiratory Medicine Case Reports (2020).
Study 100 added.
Study 100 – Case report at 26 weeks (& 5 other cases) from Belgium
A woman was diagnosed with Covid-19 six days after giving birth at 26 weeks by Caesarean because of pre-eclampsia & HELLP syndrome at Cliniques Universitaires Saint Luc, in Brussels, Belgium, (click here or Lancet Piersigilli PIIS2352464220301401). The baby tested positive for SARS-CoV-2 but but otherwise behaved as expected for her gestational age. Subsequently five further women with Covid-19 delivered in the same hopsital. All babies were negative. Only one required NICU for unrelated reasons. Citation: Fiammetta Piersigilli, Katherine Carkeek, Catheline Hocq, Bénédicte van Grambezen, Corinne Hubinont, Olga Chatzis, Dimitri Van der Linden, Olivier Danhaive COVID-19 in a 26-week preterm neonate. Lancet Child Adolesc Health 2020 Published Online May 7, 2020
Studies 97-99 added.
Study 99 – Placental pathology of 20 cases from Weill Cornell Medical Center
Of 20 women with Covid-19, five delivered by Caesarean and 15 vaginally (click here or Baergen Ped Pathol 1093526620925569). Three gave birth preterm and there was one set of twins. No baby outcomes are reported. These may overlap with other New York cases. Citation: Baergen, R. N., & Heller, D. S. (2020), Placental Pathology in Covid-19 Positive Mothers: Preliminary Findings. Pediatric and Developmental Pathology, 23(3), 177–180.
Study 98 – Ulcerative Colitis & COVID-19 in pregancy
A 26-year-old woman with known ulcerative colitis developed Covid-19 very early in pregnancy (fetal heartbeat & yolk sac on scan). She did not require admission to ITU or ventilation, and recovered, but the pregnancy miscarried (click here or UC and COVID pregnancy IBD izaa109 (1). She was treated at NY Langone so may also be included in studies 85 & 86. Citation: Melissa H Rosen, MD, Jordan Axelrad, MD, MPH, David Hudesman, MD, David T Rubin, MD, Shannon Chang, MD, Management of Acute Severe Ulcerative Colitis in a Pregnant Woman With COVID-19 Infection: A Case Report and Review of the Literature, Inflammatory Bowel Diseases
Study 97 – Case report from Stasbourg
A 21 year old with severe Covid-19 at 23 weeks gestation (click here or Case rep Strasbourg PIIS0301211520302736) was admitted to ICU, treated with noninvasive ventilation and positional therapy and recovered. The pregnancy is ongoing. Citation: Vibert F, Kretz M, Thuet V, Barthel F, De Marcillac F, Deruelle P, Lecointre L, Prone positioning and high-flow oxygen improved respiratory function in a 25-week pregnant woman with COVID-19. European Journal of Obstetrics & Gynecology and Reproductive Biology (2020).
Studies 95 & 96 added (HT Shakila Thangaratinam).
Study 96 – another report of 5 cases from NY Presbyterian, Cornell
The same 5 cases as study 95 (click here). Citation: J. Justin Mulveya, Cynthia M.Magro, Lucy X Ma, Gerard J Nuovo, Rebecca N Baergen. Analysis of complement deposition and viral RNA in placentas of COVID-19 patients. Annals of Diagnostic Pathology Volume 46, June 2020
Study 95 – placental pathology of the first 5 cases from NY Presbyterian, Cornell
Five patients with Covid-19, one delivered by Caesarean, & four vaginally (click here). All resulted in healthy, term deliveries, but no further baby details reported. All mothers recovered. Discussion, “at the time of writing these patients represent 100% of the confirmed COVID-19 deliveries at New York Presbyterian Hospital, Cornell Campus“. A different hospital from NY Presbyterian Allen (studies 27 & 41). Citation: Justin Mulveya, Cynthia M.Magro, Lucy X Ma, Gerard J Nuovo, Rebecca N Baergen. A mechanistic analysis placental intravascular thrombus formation in COVID-19 patients. Annals of Diagnostic Pathology Volume 46, June 2020
Studies 93 & 94 added.
Study 94 – Case report from Portugal
A 31-year-old woman with Covid-19 at 38 weeks had a vaginal birth in a level 3 hospital in Porto (click here or PIIS030121152030258X). The baby was isolated and not infected. Not the same case as study 74 because delivered vaginally. Citation: Polonia-Valente R, Moucho M, Tavares M, Vilan A, Montenegro N, Rodrigues T. Vaginal delivery in a woman infected with SARS-CoV-2 – the first case reported in Portugal. European Journal of Obstetrics & Gynecology & Reproductive Biology (2020)
Study 93 – 9 cases from North Middlesex Hospital, London
Out of 9 hospital cases, 1 was preterm, 1 had a vaginal birth, and 1 baby was infected (click here or Govind EJOG London PIIS0301211520302578). Presumably all 9 included in study 92. Citation: A. Govind, et al., Re: Novel Coronavirus COVID-19 in late pregnancy: Outcomes of first nine cases in an inner city London hospital, Eur J Obstet Gynecol (2020)
Keelin’s found study 91’s figures. And study 92, the first report from UKOSS, added.
Study 92 – UKOSS
The first report from the UK Obstetric Surveillance System (UKOSS) Covid-19 registry of 427 pregnant women admitted to hospital with confirmed Sars-CoV-2 from all 194 UK obstetric units (click here). Twice the size of all previous studies combined. No overlaps. Too important to summarise. Read it. Citation: Marian Knight, Kathryn Bunch, Nicola Vousden, Eddie Morris, Nigel Simpson, Chris Gale, Patrick O’Brien, Maria Quigley, Peter Brocklehurst, Jennifer J Kurinczuk. Characteristics and outcomes of pregnant women hospitalised with confirmed SARS-CoV-2 infection in the UK: a national cohort study using the UK Obstetric Surveillance System (UKOSS) in press.
Studies 88 to 91 added.
Study 91 – Alleged visualisation of the SARS-Cov-2 virus invading the placenta
Case report of a woman, aged 40, with severe Covid-19 requiring ventilation, and later delivery at 28 weeks gestion by Caesarean section (click here or ALGARROBA). The mother recovered and was discharged on day 10. The baby tested negative. The paper is missing its figures, but there’s a video clip (click here). Author affiliations suggest she was cared for at NYU Langone Health, Winthrop Hospital. Citation: Gabriela N. ALGARROBA,, Patricia REKAWEK, Sevan A. VAHANIAN, Poonam KHULLAR, Thomas PALAIA, Morgan R. PELTIER, Martin R. CHAVEZ, Anthony M. VINTZILEOS. Visualization of SARS-CoV-2 virus invading the human placenta using electron microscopy. Am J Obstet Gynecol. in press.
Study 90 – ICNARC 8th May update
The 8th May update (click here or ICNARC COVID-19 report 2020-05-08.pdf) contains 21 currently, and 30 recently, pregnant women critically ill with Covid-19. Of these 9 and 16 respectively had received advanced respiratory support. Excluded from running totals.
Study 89 – Case report from San Francisco
A 34-year-old woman developed Covid-19 at at 28 weeks of gestation (click here or Acute_Respiratory_Distress_Syndrome_in_a_Preterm.97348). Her deteriorating condition necessitated delivery by Caesarean section. She required 10 days mechanical ventilation. Neonatal swabs for SARS-CoV-2 and COVID-19 immunoglobulin (Ig) G and IgM were negative. Citation: Blauvelt CA, Chiu C, Donovan AL, Prahl M, Shimotake TK, George RB, Schwartz BS, Farooqi NA, Ali SS, Cassidy A, Gonzalez JM, Gaw SL. Acute Respiratory Distress Syndrome in a Preterm Pregnant Patient With Coronavirus Disease 2019 (COVID-19). Obstet Gynecol. 2020 May 8. doi: 10.1097/AOG.0000000000003949. [Epub ahead of print]
Study 88 – 13 pregnant women with Covid-19 in intensive care in Sweden
Of 53 women aged 20-45 years with SARS-CoV-2 reported to the Swedish Intensive Care Registry, 13 were either pregnant or <1 week postpartum (click here or ). Citation: Collin J, Byström E, Carnahan A, Ahrne M. Pregnant and postpartum women with SARS-CoV-2 infection in intensive care in Sweden. Acta Obstet Gynecol Scand. 2020 May 9. doi: 10.1111/aogs.13901. [Epub ahead of print]
Study 87 added.
Study 87 – Case report from Detroit
A 36-year-old developed severe Covid-19 at 23 weeks gestion, and required 7 days ventilation (click here or 1-s2.0-S2214911220300473-main DETROIT). She survived, and the pregnancy is ongoing. She was treated at the Henry Ford Hospital, Detroit. Citation: L. Hong, N. Smith, M. Keerthy, et al., Severe COVID-19 infection in pregnancy requiring intubation without preterm delivery: A case report. Case Reports in Women’s Health (2020)
Studies 84-86 added.
Study 86 – 64 pregnant women with severe Covid-19 in 12 US hospitals
Of 64 pregnant women with severe (n=44) or critical (n=20) Covid-19, one had a cardiac arrest, 19 were intubated, none had ECMO, and 13 remain hospitalized, but none have died (click here or COVID_CC_post_review_04302020). Of the 32 who have given birth 24 were delivered by Caesarean. One baby was infected, but no babies died. The women had been admitted to 12 unnamed hospitals between March 5 & April 20. From the author affiliations the hospitals probably include Pennsylvania, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia; Perelman School of Medicine, University of Pennsylvania; St. Luke’s University Health Network, Bethlehem; Crozer Chester Medical Center, Chester; Einstein Healthcare Network, Philadelphia. New York Montefiore Medical Center/Albert Einstein College of Medicine, Bronx; New York University Langone Medical Center; Icahn School of Medicine at Mount Sinai; New Jersey Rutgers Robert Wood Johnson Medical School, New Brunswick; Saint Barnabas Medical Center, Livingston; Ohio TriHealth-Good Samaritan Hospital, Cincinnati. Citation: Rebecca A.M. Pierce-Williams, Julia Burd, Laura Felder, Rasha Khoury, Peter S. Bernstein, Karina Avila, Christina A. Penfield, Ashley S. Roman, Chelsea A. DeBolt, Joanne L. Stone, Angela Bianco, Adina R. Kern-Goldberger, Adi Hirshberg, Sindhu K. Srinivas,, Jenani S. Jayakumaran, Justin S. Brandt, Hannah Anastasio, Meredith Birsner, Devon S. O’Brien, Harish M. Sedev, Cara D. Dolin, William T. Schnettler, Anju Suhag, Shabani Ahluwalia, Reshama S. Navathe, Adeeb Khalifeh, Kathryn Anderson, Vincenzo Berghella. Clinical course of severe and critical COVID-19 in hospitalized pregnancies: a US cohort study. Am J Obstet Gynecol. In press.
Study 85 – 32 women from New York University, Langone Health
Between March 1 & April 20, 32 women with Covid-19 gave birth at NYU Langone Health. Eleven had placental or membrane swabs tested of which 3 were positive. Of the 11 women 3 women with critical, and one with severe disease, were delivered by caesarean. All the rest, one severe disease, the remainder mild, gave birth vaginally. None of the infants tested positive or demonstrated symptoms of COVID-19 infection. Citation: Christina A. Penfield, Sara G. Brubaker, Meghana A. Limaye, Jennifer Lighter, Adam J. Ratner Kristen M. Thomas, Jessica Meyer, Ashley S. Roman. Detection of SARS-COV-2 in Placental and Fetal Membrane Samples. Am J Obstet Gynecol. In press.
Study 84 – Twins from St Thomas’s, London
A woman with twins developed Covid-19 at 32 weeks (click here or Twins abruption STH london AJOGMFM-20-1053). She was delivered by Caesarean section due to suspected abruption. Both babies tested negative for COVID-19. Citation: Katy Kuhrt, Jess McMicking, Surabhi Nanda, Catherine Nelson Piercy, Andrew Shennan. Placental abruption in a twin pregnancy at 32 weeks’ gestation complicated by COVID-19, without vertical transmission to the babies. Am J Obstet Gynecol in press.
Studies 82 & 83 added. Study 81 comment revised; this is probably the same ECMO case as previously reported in studies 3 and 57.
Study 83 – 82 women in New York
Of 82 pregnant women with Covid-19, admitted to seven hospitals within an unnamed large hospital group in New York State, eight (9.8%) were admitted to intensive care (click here or L20-081), a similar proportion to non-pregnant women of reproductive age. No clinical outcomes are reported. Study 49 by the same group, reporting Covid-19 admissions in an unnamed 14 hospital group, is cited. Although not explicitly stated, it seems likely that the cases overlap. Citation: Matthew J. Blitz, Amos Grünebaum, Asma Tekbali, Eran Bornstein, Burton Rochelson, Michael Nimaroff, Frank A. Chervenak. Intensive Care Unit Admissions for Pregnant and Non-Pregnant Women with COVID-19. Am J Obstet Gynecol in press.
Study 82 – 9 screen-positive women at The Portland, London
Between March 27 & April 20th, The Portland, a private hospital in London, performed planned Caesareans for 129 NHS patients. All were screened for SARS-CoV2, and 9 (7%) were positive, of whom only one was symptomatic (click here or SARS-CoV-2_and_pregnancy_letter_line_nbrs). None of the positive asymptomatic women developed COVID-19 symptoms. The outcome of the symptomatic woman was not reported. All babies were well at birth and at discharge. Citation: Asma KHALIL, Robert HILL, Shamez LADHANI, Katherine PATTISSON, Pat O’BRIEN. SARS-CoV-2 in pregnancy: symptomatic pregnant women are only the tip of the iceberg. Am J Obstet Gynecol. in press.
Studies 79 (HT Shakila Thangaratinam) & studies 80, 81 added.
Study 81 – Case report from Xiaolan People’s Hospital of Zhongshan
A 31 year old woman developed Covid-19 at 31 weeks gestation (click here, full text not yet available). The baby died. Zhongshan People’s Hospital disambiguates as grid.476868.3 Citation: Li J, Wang Y, Zeng Y, Song T, Pan X, Jia M, He F, Hou L, Li B, He S, Chen D. Critically ill pregnant patient with COVID-19 and neonatal death within two hours of birth. Int J Gynaecol Obstet. 2020 May 5. doi: 10.1002/ijgo.13189.
Study 80 – 13 women from Renmin Hospital, Wuhan
These 13 women were cared for in Renmin Hospital of Wuhan University, Wuhan (click here for abstract. Full text not yet available). Citation: Wu Y, Liu C, Dong L, Zhang C, Chen Y, Liu J, Zhang C, Duan C, Zhang H, Mol BW, Dennis CL, Yin T, Yang J, Huang H. Coronavirus disease 2019 among pregnant Chinese women: Case series data on the safety of vaginal birth and breastfeeding. BJOG. 2020 May 5. doi: 10.1111/1471-0528.16276. [Epub ahead of print]
Study 79 – Case report from Turin
A 28-year-old woman with Covid-19 gave birth vaginally at 37 weeks (click here or PIIS0301211520302025). The baby tested positive but was otherwise well. The baby was born at Sant’Anna Hospital, Turin, Italy. Turin is outside Lombardy; this case was not included in studies 32 and 64. Citation: A. Carosso, et al., Pre-labor anorectal swab for SARS-CoV-2 in COVID-19 pregnant patients: is it time to think about it? Eur J Obstet Gynecol (2020)
Study 78 added.
Study 78 – Case report from Fondazione Policlinico Universitario Agostino Gemelli
A 23 weeks pregnant woman with Covid-19 admitted on 10th March to Fondazione Policlinico Universitario Agostino Gemelli (click here or PIIS0002937820304683). Obstetric ultrasound revealed a normally grown fetus with normal amniotic fluid and Doppler parameters. No further pregnancy details. Likely to be one of the women with ongoing pregnancy in study 76. Citation: Inchingolo R, Smargiassi A, Moro F, Buonsenso D, Salvi S, Del Giacomo P, Scoppettuolo G, Demi L, Soldati G, Testa AC, The Diagnosis of Pneumonia in a Pregnant Woman with COVID-19 Using Maternal Lung Ultrasound. American Journal of Obstetrics and Gynecology (2020).
Studies 76 & 77 added.
Study 77 – ICNARC 1st May update
The 1st May update (click here or ICNARC COVID-19 report 2020-05-01) contains 20 currently, and 27 recently, pregnant women critically ill with Covid-19. Of these 7 and 14 respectively had received advanced respiratory support. Excluded from running totals.
Study 76 – 7 cases from Fondazione Policlinico Universitario Agostino Gemelli Rome, Italy
Of seven pregnant women with Covid-19, one miscarried at 7 weeks, 4 pregnancies are ongoing, and 2 were delivered, both by Caessarean (click here or buonsenso Rome AJP s-0040-1710541). Both babies had many swabs tested but were well. Citation: Danilo Buonsenso, Simonetta Costa, Maurizio Sanguinetti, Paola Cattani, Brunella Posteraro, Simona Marchetti, Brigida Carducci, Antonio Lanzone, Enrica Tamburrini, Giovanni Vento, Piero Valentini. Neonatal Late Onset Infection with Severe Acute Respiratory Syndrome Coronavirus 2. Am J Perinatol.
Studies 73 to 75 added.
Study 75 – 10 vaginal births in Zhongnan Hospital
Among 88 pregnant women with confirmed or suspected COVID-19 admitted to the obstetric isolation ward of Zhongnan Hospital of Wuhan University between January 20 and March 2, ten delivered vaginally (click here or LIAO ijgo.13188). All 7 tested neonates were negative. Three babies were not tested. These ten cases don’t overlap with those in studies 1, 13 & 56, who had all delivered by Caesarean, but probably overlap with studies 55 and 57. Not added to running totals. Citation: Jing Liao, Xiaoyan He, Qing Gong, Lingyun Yang, Chunhua Zhou, Jiafu Li. Analysis of vaginal delivery outcomes among pregnant women in Wuhan, China during the COVID‐19 pandemic. First published: 29 April 2020
Study 74 – Case report from Portugal
A healthy woman with “occasional dry cough” tested positive at term and was delivered by Caesarean (click here or Lyra Portugal case13883-54440-1-PB. The baby was uninfected and both did well. Citation: Joana LYRA, Rita VALENTE, Marta ROSÁRIO, Mariana GUIMARÃES. Cesarean Section in a Pregnant Woman with COVID-19: First Case in Portugal. Acta Med Port 2020
Study 73 – 28 women from The Central Hospital of Wuhan
Among pregnant women cared for in the Central Hospital of Wuhan between 15 January to 15 March 2020. (click here or Quancheng IJID 1-s2.0-S1201971220302800-main) there were 17 Caesareans, 5 vaginal births, 4 medical abortions and 2 ongoing pregnancies. Total 30 [sic]. They include one set of twins. No babies were infected, and no mothers or babies died. The authors admit that these data are included in Study 55. They are probably also included in study 57, & overlap with Study 39. Not added to running totals. Citation: Qiancheng X, Jian S, Lingling P, Lei H, Xiaogan J, Weihua L, Gang Y, Shirong L, Zhen W, GuoPing X, Lei Z, The sixth batch of Anhui medical team aiding Wuhan for COVID-19, Coronavirus disease 2019 in pregnancy, International Journal of Infectious Diseases (2020)
Study 72 added.
Study 72- Miscarriage in Switzerland
A 28-year-old with Covid-19 miscarried at 19 weeks gestation at Lausanne University Hospital (click here or second trimester miss jama_baud_2020_ld_200040 ). Placental swabs were positive for SARS-CoV-2. The mother’s outcome was not reported. Citation: David Baud, Gilbert Greub, Guillaume Favre, Carole Gengler, Katia Jaton, Estelle Dubruc, Léo Pomar. Second-Trimester Miscarriage in a Pregnant Woman With SARS-CoV-2 Infection. JAMA. Published online April 30, 2020. doi:10.1001/jama.2020.7233
Studies 68 to 71 added.
Study 71 – Follow-up of 4 women from Study 6
Patients 12-15 in Study 6 from Tongji were still in hospital at the time of the report. This (click here or YANG L_Tongji_AJR) describes follow-up till March 30th. All four had been discharged and were still pregnant. Citation: Lin Li, Dehan Liu, Lian Yang. Follow-Up Information About the Four Pregnant Patients With Coronavirus Disease (COVID-19) Pneumonia Who Were Still in the Hospital at the End of Our Study American Journal of Roentgenology: W1-W2. 10.2214/AJR.20.23247
Study 70 – Maternal death from Iran
A 22-year-old developed Covid-19 at 32 (or possibly 30) weeks gestation, and was treated at Imam Khomeini Hospital of Mazandaran University, Sari, Iran (click here or ZAMANIYAN M_Iran_Prenatal diagnosis). She was delivered by Caesarean section, but on day 10 required ventilation, and died on day 15. The first baby swabs were negative, but amniotic fluid and later baby swabs were positive. Apart from developing a fever the baby did well. The clinical details suggest that she was not included in Study 67. Citation: Marzieh Zamaniyan, Aghdas Ebadi, Samaneh Aghajanpoor Mir, Zahra Rahmani, Mohammadreza Haghshenas, Setareh Azizi. Preterm delivery in pregnant woman with critical COVID‐19 pneumonia and vertical transmission. Prenatal diagnosis. First published:17 April 2020
Study 69 – Case report from Missouri
A patient with Covid-19 at 33 weeks gestation required intubation and ventilation for 11 days (click here or Kelly false negative SARSCOV2 AJOGMFM). The baby was delivered by Caesarean. The mother has been extubated, and is recovering. The baby tested negative and is well. Citation: Jeannie C Kelly, Michael Dombrowksi, Micaela O’neil-Callahan, Annessa S Kernberg, Antonina I Frolova, Molly J Stout. False-Negative COVID-19 Testing: Considerations in Obstetrical Care. American Journal of Obstetrics & Gynecology MFM Available online 28 April 2020
Study 68 – 55 pregnant women in the UK ISARIC report
This preprint from the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) (click here or ISARIC UK 2020.04.23.20076042v1.full) includes 16,749 hospitalised UK patients with COVID-19. This represents 14.7% of people who have tested positive for COVID-19 in the UK, most of whom have not required hospital admission, and 28% of admissions with COVID-19. 55/963 (6%) of the women of reproductive age were pregnant. This is similar to the estimated proportion of pregnant women in the community. Pregnancy was not associated with mortality. Citation: Annemarie B Docherty, Ewen M Harrison, Christopher A Green, Hayley E Hardwick, Riinu Pius, Lisa Norman, Karl A Holden, Jonathan M Read, Frank Dondelinger, Gail Carson, Laura Merson, James Lee, Daniel Plotkin, Louise Sigfrid, Sophie Halpin, Clare Jackson, Carrol Gamble, Peter W Horby, Jonathan S Nguyen-Van-Tam, Jake Dunning, Peter JM Openshaw, J Kenneth Baillie, Malcolm Gracie Semple. Features of 16,749 hospitalised UK patients with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol. medRxiv 2020.04.23.20076042
Study 67 – 7/9 maternal deaths with severe disease in Iran
This preprint from Am J Obstet Gynecol (click here or Aagaard_W20-2021) reports 9 pregnant women with severe Covid-19 treated between mid-February & mid-March 2020 in Iran. The hospitals, exact ages and exact dates of admission and death were concealed to protect anonymity. Seven mothers died, one recovered and one remains seriously ill. Of the babies 6 died (incl one set of twins) and 5 survived (incl one set of twins). These cases may overlap with those in studies 23 & 43. Citation: Sedigheh Hantoushzadeh, Alireza A. Shamshirsaz, Ashraf Aleyasin, Maxim D Seferovic, Soudabeh Kazemi Aski, Sara E. Arian, Parichehr Pooransari, Fahimeh Ghotbizadeh, Soroush Aalipour, ,Zahra Soleimani, Mahsa Naemi, Behnaz Molaei, Roghaye Ahangari, Mohammadreza Salehi, Atousa Dabiri Oskoei, Parisa Pirozan, Roya Faraji Darkhaneh, Mahboobeh Gharib Laki, Ali Karimi Farani, Shahla Atrak, Mir Mohammad Miri, Mehran Kouchek, Seyedpouzhia Shojaei, Fahimeh Hadavand, Fatemeh Keikha, Maryam Sadat Hosseini, Sedigheh Borna, Shideh Ariana, Mamak Shariat, Alireza Fatemi, Behnaz Nouri, Seyed Mojtaba Nekooghadam, Kjersti Aagaard. Maternal Death Due to COVID-19 Disease. Am J Obstet Gynecol. In press.
Studies 64-66 added.
Study 66 – A review from Brazil of 9 maternal deaths due to Covid-19
This preprint from AJOG refers to nine maternal deaths (click here or Maternal deaths AJOG L20-082. Two from Iran had been reported in Study 23 below. Of the five from Brazil, two post-partum deaths in women delivered by Caesarean section, are referenced to the Brazilian Ministry of Health. No further details are given. The other three are sourced to Brazilian newspapers. The first link provided (click here) goes to the newspaper Folha de Londrina, but not to the report of the maternal death. The 2nd link (click here) describes the death of Viviane Albuquerque, age 33 from Pernambuco, at 32 weeks gestation (added here). The third link (click here) is broken. The final two deaths occurred in Mexico. The first is attributed to the Mexican Ministry of Health. The second to a newspaper report. The link provided (click here) goes to a report of two maternal deaths from Covid-19. Added it to the news reports here. Citation: Amorim MMR, Takemoto MLS, Fonseca EB. Maternal Deaths with Covid19: a different outcome from mid to low resource countries? Am J Obstet Gynnecol. In press.
Study 65 – 5 patients with severe disease from Philadelphia
This preprint from AJOG (click here or Hirshberg AJOG L20-083) describes five women in Phaladelphia, who required ventilation. Three were delivered by Caesarean, and two remain undelivered. No mothers or babies died, but one woman remains severely ill. Citation: Adi HIRSHBERG,, Adina R. KERN-GOLDBERGER, Lisa D. LEVINE,, Rebecca PIERCE-WILLIAMS, William R. SHORT, Samuel PARRY, Vincenzo BERGHELLA, Jourdan E. TRIEBWASSER, Sindhu K. SRINIVAS. Care of critically ill pregnant patients with COVID-19: a case series. Am J Obstet Gynecol. In press.
Study 64 – 42 cases from Lombardy
This pre-print in BJOG (click here or 1471-0528.16278) describes the 42 cases in study 32 in much more detail. Citation: Enrico Ferrazzi, Luigi Frigerio, Valeria Savasi, Patrizia Vergani, Federico Prefumo, Santa Barresi, Stefano Bianchi, Elena Ciriello, Fabio Facchinetti, Maria Teresa Gervasi, Enrico Iurlaro, Alessandra Kustermann, Giovanna Mangili, Fabio Mosca, Luisa Patanè, Donata Spazzini, Arsenio Spinillo, Giuseppe Trojano, Michele Vignali, Antonella Villa, GianVincenzo Zuccott,i Fabio Parazzini, Irene Cetin. Vaginal delivery in SARS‐CoV‐2 infected pregnant women in Northern Italy: a retrospective analysis. BJOG 27 April 2020
Studies 58-63 added.
Study 63. ICNARC 24 April update
The 24 April update (click here or ICNARC COVID-19 report 2020-04-24) contains 20 currently, and 25 recently, pregnant women critically ill with Covid-19. Of these 5 and 7 respectively had received advanced respiratory support. Excluded from running totals.
Study 62. Case report from Hefei city
A 22 year old woman with asymptomatic COVID-19 was delivered by Caesarean on Feb 11, 2020 at the No 2 People’s Hospital of Hefei City (click here). The baby tested negative and both did well. Although this hospital does not appear on www.grid.ac this is the first report from Hefei City, which is 373 km from Wuhan. Citation: Lu D, Sang L, Du S, Li T, Chang Y, Yang XA. Asymptomatic COVID-19 infection in late pregnancy indicated no vertical transmission. J Med Virol. 2020 Apr 24. doi: 10.1002/jmv.25927. [Epub ahead of print]
Study 61. 32 Covid-19 screen positive women from New York Winthrop Hospital
Out of 161 pregnant women admitted in labour to New York University Winthrop Hospital between March 30 & April 12, and screened for Covid-19, 32 were positive, of whom 11 were symptomatic (click here or AJOG_Screening_all_pregnant_women vintzileos). Of 29 neonates tested all were negative with three results pending. No clinical outcomes reported. Citation: William S VINTZILEOS, Jolene MUSCAT, Eva HOFFMANN, Duc VO, Nicole S JOHN, Rosanne VERTICHIO, Anthony M VINTZILEOS, Screening all pregnant women admitted to Labor and Delivery for the virus responsible for 2 COVID-19 American Journal of Obstetrics & Gynecology. in press.
Study 60. Preterm labour in a patient with Covid-19
A woman from South Carolina developed Covid-19 at 23 weeks, was treated for suspected preterm labour at 24 weeks, and recovered. The pregnancy is ongoing at 27 weeks (click here or Browne Aj Peri preterm labour). Citation: Paul C. Browne, Jennifer B. Linfert, Emilio Perez-Jorge. Successful Treatment of Preterm Labor in Association with Acute COVID-19 Infection. Am J Perinatol. Published Online 24 April 2020. DOI: 10.1055/s-0040-1709993
Study 59. Two patients with Covid-19 & negative amniocentesis
Two women from Tongji Hospital, Wuhan developed Covid-19 in the first trimester and underwent amniocentesis in the second (click here or Yu SARS COV2 in AF Lancet Infect Dis 20). Both specimens were negative. Both cases may overlap with those in Studies 55 and 57. Not added to running totals. Citation: Nan Yu, Wei Li, Qingling Kang, Wanjiang Zeng, Ling Feng, Jianli Wu. No SARS-CoV-2 detected in amniotic fluid in mid-pregnancy. Lancet Infect Dis 2020 Published Online April 22, 2020
Study 58. First case report from India
An asymptomatic woman at 38+6 weeks gestation tested positive for COVID-19 (click here or Sharma India ijgo.13179). She delivered by Caesarean section, and her breast-fed baby tested negative on day 7. Both recovered. Citation: K. Aparna Sharma, Rajesh Kumari, Garima Kachhawa, Anjolie Chhabra, Ramesh Agarwal, Akash Sharma, Neerja Bhatla. Management of the first patient with confirmed COVID‐19 in pregnancy in India: From guidelines to frontlines. Int J Gynecol Obstet. In press. doi:10.1002/ijgo.13179
Studies 56 & 57 added.
Study 57. 116 cases from 25 hospitals in China
This preprint from Am J Obstet Gynecol (click here) includes 116 mothers with Covid-19 (65 lab confirmed, 51 clinically diagnosed), of whom 8 had severe disease. None died. 99 mothers had delivered 100 babies (one set of twins) of whom one died. This paper claims to be an “an expanded series that have included 33 published cases.16,18-20”. Their reference 16 is our Study 1, ref 18 is our Study 38 and ref 19 is our Study 6a. Their reference 20 is as follows: “Lei D, Wang C, Li C, et al. Clinical characteristics of COVID-19 in pregnancy: analysis of nine cases. Chin J Perinat Med 2020,23:doi: 10.3760/cma.j.cn113903-20200216-00117.” Although cited in a number of reviews we have so far been unable to find the original source.
The patients were collected from 25 hospitals within and outside Hubei province, between January 20 and March 24, 2020. Three recruiting hospitals, all from Wuhan, listed in the supplementary material, overlap with those in study 55 (appendix table s1). These are Zhongnan Hospital of Wuhan univerisity, the Central Hospital of Wuhan, and Tongi Hospital, all multiple reporters of Covid-19 in pregnancy. Thus it is likely that, in addition to the studies cited, this series overlaps considerably with Study 55. Not added to running totals. Citation: Yan J, Guo J, Fan C, Juan J, Yu X, Li J, Feng L, Li C, Chen H, Qiao Y, Lei D, Wang C, Xiong G, Xiao F, He W, Pang Q, Hu X, Wang S, Chen D, Zhang Y, Poon LC, Yang H, Coronavirus disease 2019 (COVID-19) in pregnant women: A report based on 116 cases, American Journal of Obstetrics and Gynecology (2020)
Study 56. Seven mothers and babies from Zhongnan Hospital
All mothers had Covid-19 and were delivered by Caesarean. No mothers or babies died (click here). 6/7 babies had a range of swabs taken, all of which were negative. Due to probability of duplication with Studies 1 and 55, not included in running totals. Citation. Pu Yang, Xia Wang, Pin Liu, Cong Wei, Bingyan He, Junwen Zheng, Dongchi Zhao. Clinical characteristics and risk assessment of newborns born to mothers with COVID-19 Journal of Clinical Virology Volume 127, June 2020, 104356.
Studies 53-55 added.
Study 55. 118 cases with Covid-19 from Wuhan collected by the National Health Commission of China
This regional series of women treated between December 8, 2019, & March 20, 2020, was extracted by the National Health Commission of China, which stores the medical records of all 50 designated hospitals in Wuhan city (click here). Nineteen of the 50 hospitals had reported cases (Appendix table S1, click here). No mothers died, and apart from 3 spontaneous abortions, 2 ectopic pregnancies, & 4 induced abortions, no babies died. At the next running total update we will replace all other cases from hospitals in Wuhan with these data. Citation: Lian Chen, Qin Li, Danni Zheng, Hai Jiang, Yuan Wei, Li Zou, Ling Feng, Guoping Xiong, Guoqiang Sun, Haibo Wang, Yangyu Zhao, Jie Qiao, Clinical Characteristics of Pregnant Women with Covid-19 in Wuhan, China. New Engl J Med. April 17, 2020 DOI: 10.1056/NEJMc2009226
Study 54. Six confirmed, & two suspected cases from the Maternal & Child Health Hospital, Wuhan
The eight patients from the Maternal and Child Health Hospital of Hubei Province, Wuhan, between January 23 and February 10, 2020 (click here) probably overlap with other reports from the same hospital. They are not included in the running totals. Citation: Wu, C., Yang, W., Wu, X. et al. Clinical Manifestation and Laboratory Characteristics of SARS-CoV-2 Infection in Pregnant Women. Virol. Sin. (2020).
Study 53. Case report from Las Palmas de Gran Canaria, Spain
A 44-year-old woman developed Covid-19 at 29+2 weeks gestation (click here or 1-s2.0-S0014256520301120-main (002)). She was treated at Hospitalario Universitario Insular Materno Infantil, and required mechanical ventilation and delivery by caesarean. Both mother and baby recovered. [Spanish. Google translate] Citation: González Romero D, Ocampo Pérez J, González Bautista L, Santana-Cabrera L. Pronóstico perinatal y de la paciente embarazada con infección por COVID-19. Revista Clínica Española Available online 17 April 2020.
Studies 48 – 52 added.
Study 52. ICNARC update 17 April
This update of the UK Intensive Care National Audit & Research Centre (ICNARC) database (click here or ICNARC COVID-19 report 2020-04-17.pdf (1) mentions 16 currently, and 21 recently, pregnant women with Covid-19 who are or had been critically ill. Three & six respectively had received advanced respiratory support. Excluded from running totals.
Study 51. Case report from the British American Hospital, Lima, Peru
A 41 year old women with severe Covid-19 requiring ventilation was delivered by caesarean section at 33 weeks gestation (click here or Alzamora Am J Perintal Apr 18 . The baby was isolated but a nasopharyngeal swab taken at 16 hours was positive for SARS-COV-2. The baby was ventilated for 12 hours, and later, at age 6 days, developed mild respiratory symptoms. The mother’s serology is reported on day 4, but otherwise the maternal outcome is not reported. It is presumed that she recovered. Citation: Maria Claudia Alzamora, Tania Paredes, David Caceres, Camille M. Webb, Luis M. Valdez, Mauricio La Rosa. Severe COVID-19 during Pregnancy and Possible Vertical Transmission. Am J Perinatal. Online April 18.
Study 50. A severe case of Covid-19 from the Good Samaritan Hospital. Cincinnati, Ohio
A 39 year old woman presented at 31 weeks gestation with severe Covid-19. She required ventilation. After 8 days on ITU she was delivered by Caesarean section for fetal bradycardia. The baby was intubated on NICU for three days, and isolated for 14. Amniotic fluid and nasopharyngeal swabs were negative. The mother remains on synchronized intermittent mandatory ventilation. The clinical details and patient age indicate that this is not patient no. 42 (click here) reported in the Ohio newspapers. Citation: Schnettler WT, Al Ahwel Y, Suhag A, Severe ARDS in COVID-19-infected pregnancy: obstetric and intensive care considerations American Journal of Obstetrics & Gynecology MFM (2020).
Study 49. 62 pregnant women from a 14 hospital group in New York State
Over four weeks to March 29th, 62 out of 3064 pregnant women attending an unnamed 14 hospital group in New York State tested positive for SARS-COV2 (click here). No further details given, & since they may overlap with other New York Cases, not included in running totals. Citiation: Tekbali A, Grünebaum A, Saraya A, McCullough L, Bornstein E, Chervenak FA. Pregnant versus non-pregnant SARS-CoV-2 and COVID-19 Hospital Admissions: The first 4 weeks in New York, American Journal of Obstetrics and Gynecology (2020).
Study 48. One case from Toronto & one from Clamart, France.
Two cases (click here or COVID coagulopathy Canada jth.14856) One delivered in Mount Sinai Hospital, Toronto, Canada, and one in Antoine Béclère hospital in Clamart, France. Citation: Evangelia Vlachodimitropoulou Koumoutsea, Alexandre J. Vivanti, Nadine Shehata, Alexandra Benachi, Agnes Le Gouez, Celine Desconclois, Wendy Whittle, John Snelgrove, Kinga Ann Malinowski. COVID19 and acute coagulopathy in pregnancy. J Thrombosis Haemostasis. 17 April 2020.
Study 47 added.
Study 47. Report of 13 pregnant women in ITU from Santé Publique France
Thirteen pregnant women have been admitted to intensive care in France (click here or COVID19_PE_20200418 Report in French). None have died. Citation: COVID-19: epidemiological update of April 16, 2020 Santé Publique France.
Study 46 (16 April update of NethOSS) added, & study 42 (prev NethOSS data) removed from running totals
Study 46. 107 women from the Netherlands Covid-19 registry
This 16 April update of NethOSS (click here), accessed 18 April 2020, contains the following. 5/91 women with brief additional details were admitted to intensive care. 25 have given birth, eight by Caesarean. No mother or baby has died. Citation: See Study 42. Available here. Accessed 18 April.
Studies 44 & 45 added. HT @Belinda_J_Lowe for study 45. We’ve also done some housekeeping today. Study 13 probably overlaps with study 1, so 13 has been removed from running totals. Study 3 includes 13 patients from multiple centres, both in and outside Hubei province, who may overlap with other studies. 12 mothers (3 undelivered) and 9 babies therefore removed from the running total. Only case 6, where the woman was reported to be on ECMO and the baby stillborn and preterm, does not appear to have been reported elsewhere, so remains in the running totals.
Study 45. Case report from Bond University, Australia
This case report from Bond University Hospital, Southport, Queensland, is the first from Australia (click here). Full text to follow. Citation: Lowe B, Bopp B. COVID‐19 vaginal delivery – a case report. ANZOG 15 April 2020.
Study 44. 42 suspected & 13 confirmed cases from Tongji Hospital
Thirteen pregnant women all seen at Tongji Hospital grid.412793.a between Jan 20 & Mar 5, 2020 (click here). Four delivered vaginally and nine by Caesarean. All mothers had mild disease and none died. The baby details for the Covid and non-Covid mothers are reported together. These cases probably overlap with previous reports from Tongji hospital so not included in running totals. Citation: Hui yang, Guoqiang Sun, Fei Tang, Min Peng, Ying Gao, Jing Peng, Hui Xie, Yun Zhao, Zhichun Jin, Clinical Features and Outcomes of Pregnant Women Suspected of Coronavirus Disease 2019, Journal of Infection (2020).
Studies 41 – 43 added.
Study 43. A maternal death from Covid-19 in Iran
A 27 year old woman was transferred to Vali-e-asr Hospital at 30 weeks gestation (click here or Karami Travel med Apr 11 2020) with severe respiratory failure. She required intubation and ventilation. A few hours later she delivered a stillborn baby vaginally, and a few hours after that she died. Post-mortem on the mother confirmed SARS-Cov-2 in the lungs. No further details are given about the baby. Vali-e-asr Hospital does not appear on Grid.ac but is part of Zanjan University of Medical Sciences. grid.469309.1. This is the first academic report (as opposed to unconfirmed news reports) of a maternal death due to Covid-19. Citation: Parisa Karami, Maliheh Naghavib, Abdolamir Feyzib, Mehdi Aghamohammadic, Mohammad Sadegh Novinc, Ahmadreza Mobaiend, Mohamad Qorbanisania, Aida Karamia, Amir Hossein Norooznezhad. Travel Medicine and Infectious Disease, in press. https://doi.org/10.1016/j.tmaid.2020.101665
Study 42. 89 women from the Netherlands Covid-19 registry
This is the first Covid-19 in pregnancy registry report of which we are aware. It has not been formally published, but is available here and regularly updated. Using Google translate, the 9 April version, accessed 14 April 2020 contains the following. 5/89 pregnant women with Covid-19 have been admitted to intensive care. 19 women have given birth, four by Caesarean. No mother or baby has died. Citation: The Nederlandse Vereniging voor Obstetrie en Gynaecologie (Dutch Association for Obstetrics and Gynecology) (NVOG). Registratie COVID-19 positieve zwangeren in NethOSS (Update registration COVID-19 positive pregnant women in NethOSS). Accessed 14 April.
Study 41. 33 women from NY Presbyterian & Columbia
These 33 women with Covid-19 delivered infants at the New York–Presbyterian Allen Hospital and Columbia University Irving Medical Center between March 22 & April 4, 2020 (click here). They presumably include the 18 women with Covid-19 previously reported as having delivered in the same two hospitals (Studies 14 & 27), as well as some of the women who were at the time undelivered in those two series. Since no birth details are given, these cases have not been included in running totals. Citation: Sutton, D, Fuchs, K, D’Alton M, Goffman D. Universal Screening for SARS-CoV-2 in Women Admitted for Delivery. New Engl J Med April 13, 2020. DOI: 10.1056/NEJMc2009316
Studies 39 and 40 added.
Study 40. 17 pregnant women from Renmin
These 17 women with Covid-19, all delivered by Caesarean section in Remnin hospital (click here or Khan Clin Micro Infect 27 Mar), almost certainly are the same women as in studies 6a & 12. They have not been added to the running totals. Citation: Khan S, Jun L, Nawsherwan Siddique R, Li Y, Han G, Xue M, Nabi G, Liu J, Association of COVID-19 infection with pregnancy outcomes in healthcare workers and general women, Clinical Microbiology and Infection,
Study 39. 23 pregnant women from the Central Hospital Wuhan
23 pregnant women with COVID-19 from the Central Hospital of Wuhan. Wu ijgo.13165 Three patients terminated the pregnancy in the first trimester. Of the other 20, 18 delivered by Caesarean and two vaginally. There was one set of twins. No neonates were infected. This is the first report from this hospital which has a unique GRID reference. We have therefore added these to the running totals. Citation: Xiaoqing Wu, Ruihong Sun, Jianpu Chen, Yuanliang Xie, Shutong Zhang, Xiang Wang. Radiological findings and clinical characteristics of pregnant women with
COVID-19 pneumonia In J Gynecol Obstet. In press doi: 10.1002/ijgo.13165
Studies 34 – 38 added
Study 38. 41 women from the Maternal & Child Health Hospital of Hubei Province
Out of 41 pregnant women from the Maternal and Child Health Hospital of Hubei Province, with typical Covid-19 infection on lung CT, 16 were SARS-CoV-2 positive, 17 negative and 8 not tested. Nineteen were inpatients for delivery, and the rest outpatients from 22 weeks onwards. No birth details were given and in view of the probability of overlap with other cases in the same hospital none have been added to the running totals. Citation: H. Liu, F. Liu and J. Li et al., Clinical and CT imaging features of the COVID-19 pneumonia: Focus on pregnant women and children, Journal of Infection
Study 37. Three vaginal births in Renmin
Three babies were born vaginally to women with Covid-19, one preterm, two term. None were infected. Khan 3 vaginal births renmin. All previous reports from Renmin (Studies 6a, 10, 12 & 36) were of Caesarean births, so these have been included as non-duplicates in the summary totals. Citation: Suliman Khan, Liangyu Peng, Rabeea Siddique, Ghulam Nabi, Nawsherwan, Mengzhou Xue, Jianbo Liu, Guang Han. Infection Control & Hospital Epidemiology as part of the Cambridge Coronavirus Collection. March 2020. DOI: 10.1017/ice.2020.84
Study 36. Caesarean birth in 17 women in Remnin
This case series includes details of the Caesarean births of 17 women with Covid-18 in Renmin Hospital of Wuhan University Chen 17 renmin cs. All mothers and babies survived. However the series probably includes the 16 cases also reported from Remnin in Chinese (study 6a), which included the same number, three, preterm patients, all also delivered by Caesarean. They may also overlap with study 10; both studies mention two doctors delivered by Caesarean in Renmin. The obstetrican on study 36, Bi-heng Cheng, is shared with study 6a. We have therefore not included these cases in the running total. Citation: Rong Chen, Yuan Zhang, Lei Huang, Bi-heng Cheng, Zhong-yuan Xia, Qing-tao Meng, Safety and efficacy of different anesthetic regimens for parturients with COVID-19 undergoing Cesarean delivery: a case series of 17 patients. Can J Anesth
Study 35. Four neonates with Covid-19 from China
Four infected neonates (age less than 1 month) all born by Caesarean section (click here). They were identified by searching China’s national database of 81,026 laboratory-confirmed cases up to March 13 using the same methods as in a study of infants age 1 month to one year reported in JAMA (click herebut not listed in this blog post). It seems likely that they overlap with the three infected neonates reported earlier in JAMA (study 12), the case report in Clinical Infectious Diseases (study 11) or the infected neonate reported in Lancet Inf Dis (study 15). We have therefore not included them in the running totals. Citation: Zhi-Jiang Zhang, Xue-Jie Yu, Tao Fu, Yu Liu, Yan Jiang, Bing Xiang Yang, Yongyi Bi. Novel Coronavirus Infection in Newborn Babies Under 28 Days in China. European Respiratory Journal 2020; DOI: 10.1183/13993003.00697-2020
Study 34. Case report of uninfected baby from Beijing
Abstract (click here). Full text (here). A 25 year old woman with Covid-19 at 35 weeks recovered and had a normal vaginal birth of a 3070g boy at 38w + 4d. The baby had no signs of past or present infection with SARS-COV-2. The birth occurred at YouAn Hospital, Capital Medical University, Beijing, which has not previously reported cases in pregnancy, but the mother had been transferred from an unnamed hospital in Wuhan. Nevertheless we have included this as a non-duplicated case in summary totals. Citation: Xiali Xiong, Hong Wei, Zhihong Zhang, Jing Chang, Xiaopeng Ma, Xiang Gao, Qiang Chen, Qiumei Pang. Vaginal Delivery Report of a Healthy Neonate Born to a Convalescent Mother with COVID-19 J Med Virol. 2020 Apr 10. doi: 10.1002/jmv.25857.
Study 33 added
Study 33. US Centres for Disease Control reports 143 pregnant women
Preliminary data on lab-confirmed COVID-19 reported to CDC Feb 12–March 28, 2020. Of 7,162 cases, 143 were pregnant. Of these 72 stayed home, 31 hospitalised (non ICU), 4 entered ICU, and 36 had unknown hospitalisation status. “[…] for […] pregnancy, few severe outcomes were reported […].” Many probably reported elsewhere, so not added to running totals. Citation: Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 — United States, February 12–March 28, 2020. MMWR Morb Mortal Wkly Rep 2020;69:382–386. DOI: http://dx.doi.org/10.15585/mmwr.mm6913e2external icon.
Study 31 & 32 added. Keelin O’Donoghue & Kate Walker have joined the team. Thank you also to Nicola Vousden for alerting us to 31.
Study 32. 42 women from Lombardy
This pre-print Ferrazzi Lombardy ijgo.13162 cites a paper in press describing 42 pregnant women from Lombardy, Italy who had Covid-19 and delivered, 18 by Caesarean, and 24 vaginally. Two were spontaneously preterm. Seven women required CPAP or were admitted to ICU, but all “eventually did well”. No baby details are given. This is the first scientific report from Italy. Citation: Ferrazzi EM, Frigerio L, Cetin I, Vergani P, Spinillo A, Prefumo F, Pellegrini E, Gargantini G.COVID-19 Obstetrics Task Force, Lombardy, Italy: executive management summary and short report of outcome. Int J Gynecol Obstet in press.
Study 31. Case report from Ankara, Turkey
Report from Dept OBGYN, Ankara University, Faculty of Medicine. Woman age 32, with Covid-19 at 35 weeks gestation, delivered by Caesarean section prior to admission to intensive care (click here). Birthweight 2790g. Three days after birth mother required intubation and ventilation, and she remains in intensive care. Baby not infected. Citation: E. Kalafat E. Yaprak G. Cinar B. Varli S. Ozisik C. Uzun A. Azap A. Koc Lung ultrasound and computed tomographic findings in pregnant woman with COVID‐19 Ultrasound Obstet Gynecol. First published: 06 April 2020 https://doi.org/10.1002/uog.22034
Study 30. 16 women with Covid-19 pneumonia from Hubei province
Sixteen pregnant women with confirmed COVID-19 pneumonia, and 18 with pneumonia on chest imaging who tested negative, were compared with two groups of control pregnancies (click here or ciaa352). The comparative design is similar to study 6a which, apart from an English abstract, has only been published in Chinese. However the hospital and authors differ, so I’m confident there is no overlap. Citation: Li N, Han L, Peng M, Lv Y, Ouyang Y, Liu K, Yue L, Li Q, Sun G, Chen L, Yang L. Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: a case-control study. Clin Infect Dis. 2020 Mar 30. pii: ciaa352. doi: 10.1093/cid/ciaa352. [Epub ahead of print]
Study 29. ICNARC report 4 April 2020
This report from the UK Intensive Care National Audit & Research Centre (ICNARC) mentions two currently, and six recently (<6 weeks) pregnant women with Covid-19 who were also critically ill. One of the currently pregnant, and two of the recently pregnant women, were receiving advanced respiratory support. Excluded from running totals.
Study 28. Seven cases from Newark Beth Israel Medical Center. Newark, NJ
Pre-print from Am J Obstet Gynecol MFM (click here ) of two pregnant women with Covid-19 who developed cardiomyopathy. Report also mentions five other pregnant women with Covid-19 in Newark Beth Israel Medical Center. Details are only given for the two women with cardiomyopathy, and no baby details are given. For consistency of numbers I’ve assumed the other five pregnancies are ongoing in running totals.
Study 27. Expanded series from New York Presbyterian
This pre-print reports 43 pregnant women with COVID-19. It includes 36 new cases, identified during a period of universal testing, and 7 previously reported (Study 14) 43_COVID_040320. Click here.
No new scientific reports today. But obstetricians & midwives will enjoy reading the first newspaper report of a Covid-19 pregnancy and birth in France. Case 10 here. Better written and more detailed than many scientific reports.
Study 26 added. The first report of puerperal Covid-19. Not added to running totals.
Study 26. The first case report of puerperal COVID-19
This baby developed COVID-19 symptoms at age 10 days and was admitted to Wuhan Children’s Hospital age 17 days on February 5, 2020. Click here for the article in Chinese. What follows is based on Google translate. Both parents are reported to have had Covid-19 symptoms from three days before admission, i. e. day 14 after birth. This is therefore not a case of COVID infection in pregnancy or at birth, and therefore excluded from the running totals. However, the mother had puerperal Covid-19 and is, I believe, the first such case reported. The baby recovered and by implication, albeit not stated explicitly, so did the parents. The first author Zeng Lingkong shares a name with the first author of the series of 33 neonatal cases reported in JAMA Paediatrics, Study 8., but this is clearly not one of the three infected babies reported in that paper. Citation: Zeng Lingkong, Tao Xuwei, Yuan Wenhao, et al. The first neonatal coronavirus pneumonia in China [J]. Chinese Journal of Pediatrics, 2020,58 (04): 279-280. DOI: 10.3760 / cma.j.cn112140 -20200212-00081
Study 25 added belatedly.
Study 25. Report of the WHO-China Joint Mission on Coronavirus Disease 2019, 16-24 February 2020
Click here or who-china-joint-mission-on-covid-19-final-report for full text including annexes. (For Chinese version click here or who-china-joint-mission-on-covid-19-final-report chinese version. Annexe 6, page 32 of English version: “As opposed to Influenza A(H1N1)pdm09, pregnant women do not appear to be at higher risk of severe disease. In an investigation of 147 pregnant women (64 confirmed, 82 suspected and 1 asymptomatic), 8% had severe disease and 1% were critical.” Neither raw numbers, a citation, nor any further details are given. Assuming the percentages are of all 147, this would imply 12 women with severe disease, and one or two who were critical. In view of the high possibility of double counting – cases notified to the WHO team are likely to have also got reported elsewhere – I’ve left these out of the running total. Citation: Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) 16-24 February 2020. Report submitted 28 February 2020
Study 23 added. Not yet added to running totals.
Study 23 Three cases from Iran
This review article (click here, full text here) from researchers from both Tehran and Shiraz in Iran, reports the births of three infants from infected mothers. The authors’ source was this Iranian ministry website (click here). All three babies were uninfected and survived, but two of the three mothers developed acute respiratory distress syndrome (ARDS) after delivery and died. Presumably this was related to their Covid-19 infection. Citation: Mojgan Karimi-Zarchia, Hossein Neamatzadeh, Seyed Alireza Dastgheib, Hajar Abbasi, Seyed Reza Mirjalili, thena Behforouz, Farzad Ferdosian, Reza Bahrami. Vertical Transmission of Coronavirus Disease 19 (COVID-19) from Infected Pregnant Mothers to Neonates: A Review. Fetal & Paed Pathol.
Thank you to Keelin O’Donoghue, Cork, for pointing me to Studies 18 & 19, which I had missed, and to Ganesh Acharya, Editor-in-Chief AOGS, for permission to upload a pre-publication version of Study 20.
Study 22. Case report from Korea
Delivered by Caesarean section at 37 weeks at Daegu Fatimal Hospital, Korea (click here). The baby was not infected. Mother and baby did well. Citation: Dong Hwan Lee, Jihyang Lee, Eunju Kim, Kyeongyoon Woo, Hak Youle Park, Jihyun An. Emergency cesarean section on severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) confirmed patient. Korean J Anesthesiol. [Epub ahead of print]
Study 21. Case report from Washington DC
The patient had a normal vaginal delivery at 39 weeks at MedStar Washington Hospital Center (click here). Baby not infected. Both fine. Citation: Iqbal SN Rachael Overcash R, Neggin Mokhtari N,.
Haleema Saeed H, Gold S, Auguste T, Mirza M-U, Ruiz M-E, Chahine JJ, Waga M, Wortmann G. An Uncomplicated Delivery in a Patient with Covid-19 in the United States New Engl J Med April 1, 2020 DOI: 10.1056/NEJMc2007605
Study 20. Case report of twins from Stockholm
Twins born by Caesarean at 36 weeks in Southern General Hospital, Stockholm. Twins, breast milk & maternal vaginal secretions all Covid-19 negative. Pre-publication version here AOGS-20-0296_Proof_hi with permission of the editor, Ganesh Acharya. Link will follow. Citation: Gidlof S, Savchenko J, Brune, T, Josefsson H. COVID-19 in pregnancy with comorbidities: More liberal testing strategy is needed. Acta Obstetricia et Gynecologica Scandinavica
Study 19. Case report from Souzhou, China
Woman delivered by Caesarean at 30 weeks in the Affiliated Infectious Hospital of Soochow University, Souzhou, China. Although “no improvement was made on maximal ventilator support for four hours”, later “informed consent was obtained, an emergency cesarean section under combined spinal-epidural anesthesia was performed” and “uneventful perinatal course”. Baby isolated and not infected. Both survived. Citation: Xiaotong Wang, Zhiqiang Zhou, Jianping Zhang, Fengfeng Zhu, Yongyan Tang, Xinghua Shen. A case of 2019 Novel Coronavirus in a pregnant woman with preterm delivery. Clinical Infectious Diseases, ciaa200
Study 18. Case report from Honduras, Central America
The woman went into preterm labour and delivered vaginally at 32 weeks. Baby not infected. Both doing well at time of report. Citation. Zambrano LI, Fuentes-Barahona IC, Bejarano-Torres DA, Bustillo C, Gonzales G, Vallecillo-Chinchilla G, Sanchez-Martínez FE, Valle-Reconco JA, Sierra M, Bonilla-Aldana DK, Cardona-Ospina JA, Rodríguez-Morales AJ. A pregnant woman with COVID-19 in Central America. Travel Medicine and Infectious Disease. Online 25 March 2020.
Study 6a added (details below).
Study 17. Five from Maternal & Child Hospital of Hubei Province, Tongji Medical College
Two Caesarean and three vaginal births delivered in the Maternal and Child Hospital of Hubei Province, Tongji Medical College (click here). Or siyu chen. All mothers recovered. All babies well. According to Wikipaedia the MCH of HP is the 10th clinical college/hospital associated with Tongji Medical College. It is distinct from both Union hospital and Tongji hospital. These five births are therefore additional to those in the various Union Hospital reports, and to those in study 15. Citation: Chen S, Liao E, Shao Y. Clinical analysis of pregnant women with 2019 novel coronavirus pneumonia. J Med Virol. 2020 Mar 28. doi: 10.1002/jmv.25789. [Epub ahead of print]
Study 16. Three non-cases from Shenzhen 2nd People’s Hospital
Shenzen, a city of 13 million had had 420 confirmed cases of Covid-19, the second highest number outside Hubei, up to March 11th. Despite an annual birth rate in the city of 188,000, the 2nd People’s Hospital saw no COVID-19 infected pregnant women. Instead they report three suspected cases who, after barrier nursing, and in one case surgery for an ectopic pregnancy, were later confirmed negative. Citation: Yu Chen, Zhe Li, Yuan-Yuan Zhang, Wei-Hua Zhao, Zhi-Ying Yu. Maternal health care management during the outbreak of coronavirus disease 2019 (COVID-19) J Med Virol. 2020 Mar 26. doi: 10.1002/jmv.25787. [Epub ahead of print]
Study 15. Seven cases from Tongji in Lancet Respiratory Med
These seven cases (click here) delivered at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (Wuhan, China) between Jan 1 and Feb 8, 2020. All mothers had mild Covid-19 disease and all were delivered around term by Caesarean section. One baby (Patient 1) tested positive for Covid-19 by throat PCR at 36 hours and was transferred to Wuhan Children’s hospital. His mother’s age, gravidity, parity, lack of direct contact with Hunan seafood market and history of hypothyroidism all suggest this is the same mother/infant dyad as in report 11. Note however the reported birthweights differ 3250g v 3205g. No babies had any clinical symptoms and all (including the transferred one) were discharged home well. Wikipedia lists ten different hospitals/clinical colleges affiliated with Tongji Medical College in Wuhan. The 1st clinical college is called Wuhan Union Hospital. The 2nd clinical college is called Wuhan Tongji Hospital. This series is therefore unlikely to overlap with the various case series from Union Hospital Tongji. Citation: Nan Yu, Wei Li, Qingling Kang, Zhi Xiong, Shaoshuai Wang, Xingguang Lin, Yanyan Liu, Juan Xiao, Haiyi Liu, Dongrui Deng, Suhua Chen, Wanjiang Zeng, Ling Feng, Jianli Wu. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. Lancet Infect Dis 2020 Published Online March 24, 2020
Study 14. Seven pregnant women from New York Presbyterian
AJOG MFM Preprint (click here) or COVID_Early_Lessons_032620 NY presbyterian. via @neel_shah. The first reported cases outside China. Citation; Breslin N, Baptiste C, Miller R, Fuchs K, Goffman D, Gyamfi-Bannerman C, D’Alton M. COVID-19 in pregnancy: early lessons. Am J Obstet Gynecol. Available online 27 March 2020.
Four more primary reports including ten more cases. All previously unreported.
Study 13. Cord blood serology from six babies in Zhongnan Hospital, Wuhan
Six cases reported in JAMA (click here). All births by Caesarean. All mothers mild disease. All babies asymptomatic. Since they were born in a different hospital these are probably additional to the other 33 Wuhan neonates reported in JAMA. Citation: Hui Zeng, Chen Xu, Junli Fan, Yueting Tang, Qiaoling Deng, Wei Zhang, Xinghua Long. Antibodies in Infants Born to Mothers With COVID-19 Pneumonia. JAMA. Published online March 26, 2020.
Study 12. Case report from Renmin Hospital Wuhan
Case report in JAMA of baby, born at Renmin Hospital, Wuhan, by Caesarean, 23 days after mother developed Covid-19, had IgM antibodies detected in cord blood (click here). This is additional to the two Remnin cases below, because the clinical details differ substantially. Citation: Lan Dong, Jinhua Tian, Songming He, Chuchao Zhu, Jian Wang, Chen Liu, Jing Yang. Possible Vertical Transmission of SARS-CoV-2 From an Infected Mother to Her Newborn. JAMA. Published online March 26, 2020.
Study 11. Caesarean birth & neonatal infection, Wuhan
Case report (click here) of a baby born by Caesarean to an infected mother at Wuhan Tongji Hospital. The baby was separated from the mother at birth but became infected (pharyngeal PCR at 36 hours). Both mother and baby recovered. I believe this case report is additional to the 33 Wuhan neonatal cases reported in JAMA, because the details (e.g. birth weight) do not align. This is therefore the fourth infected baby born by Caesarean. Citation: Shaoshuai Wang, Lili Guo, Ling Chen, Weiyong Liu, Yong Cao, Jingyi Zhang, Ling Feng A Case Report of Neonatal 2019 Coronavirus Disease in China. Clinical Infectious Diseases, ciaa225.
Study 10. Two cases from Renmin Hospital, Wuhan
Two pregnant doctors with Covid-19 both delivered by Caesarean at term (click here). Also remnin two cases. Babies separated and not infected. Probably additional to the 33 JAMA Wuhan neonates because neither neonate was transferred to Wuhan Children’s Hospital. Citation: Cuifang Fan, Di Lei, Congcong Fang, Chunyan Li, Ming Wang, Yuling Liu, Yan Bao, Yanmei Sun, Jinfa Huang, Yuping Guo, Ying Yu, Suqing Wang Perinatal Transmission of COVID-19 Associated SARS-CoV-2: Should We Worry? Clinical Infectious Diseases, ciaa226
Three more more primary scientific reports.
Study 9. A Caesarean birth from Zhejiang
This case report is in Chinese but has an English abstract. Click here. It’s from the First Affiliated Hospital, College of Medicine, Zhejiang University School of Medicine, Hangzhou. There appears to be no overlap of the authors with the Zhejiang Caesarean below, so this may be a new case. The Caesarean is reported as being “successful” which presumably means both mother and baby survived. Citation: Kang X, Zhang R, He H, Yao Y, Zheng Y, Wen X, Zhu S. Anesthesia management in cesarean section for a patient with coronavirus disease 2019. Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020 May 25;49(1):0. Chinese. PMID: 32207592
Study 8. The 33 neonatal cases from Wuhan
A series of 33 neonates born to mothers who had Covid-19. All from Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Reported in JAMA here. It seems possible that some or all of these infants are also included in the other Union Hospital Tongji series below. Of the 26 neonates delivered by Caesarean three became infected. One born at 30 weeks and 2 days developed RDS, pneumonia and suspected sepsis, and required non-invasive ventilation. The authors speculate that some of his problems were related to prematurity rather than COVID-19. The other two neonates were healthy. All three survived. By inference, although this is not specifically stated in the paper, none of the seven infant born vaginally became infected. Citation: Lingkong Zeng, Shiwen Xia, Wenhao Yuan, Kai Yan, Feifan Xiao, Jianbo Shao, Wenhao Zhou. Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates Born to Mothers With COVID-19 in Wuhan, China. JAMA Pediatr. Published online March 26, 2020.
Study 7. The Quingdao case
This appears to be the first pregnancy case from that city. Click here. The mother developed Covid-19 at 30 weeks but recovered and was discharged. At the time the report was written the pregnancy was ongoing. Citation: Rong Wen, Yue Sun, Quan-Sheng Xing A patient with SARS-CoV-2 infection during pregnancy in Qingdao, China Journal of Microbiology, Immunology and Infection. Available online 10 March 2020
Assuming all the Union Hospital Tongji cases overlap, i.e. that Tongji has reported only 15 in total, there have been 38 published cases (39 babies) of Covid-19 infection in pregnancy. There have been no reports in the scientific literature of any maternal deaths, and all neonates have survived and not been infected. Four neonates remain undelivered.
David A Schwarz (click here) in a review in Arch Pathol (preprint available March 21st) also makes the total 38 published cases. However he includes a series published only in Chinese (his reference 17) Zhang I, Jiang Y, Wei M, Cheng BH, Zhou XC, Li J, et al. 湖北地区新型冠状病毒肺炎流行期间孕妇的 384 妊娠结局分析 [Analysis of the Pregnancy Outcomes in Pregnant Women With COVID-19 in Hubei Province]. Zhonghua Fu Chan Ke Za Zhi . 2020;55(0), E009. Accessed and translated 12 March 2020. He reports this as including 16 cases. For the moment I’ve not included this Hubei series, (but see Study 6a added 1 April).
Study 6a. 16 cases from Remnin
The cases included by David Schwarz on March 21 (see note above). English abstract (click here). Full text in Chinese here. Google translate used. The authors come from Remnin Hospital, but the paper reports that all 16 women were delivered by Caesarean at the Eastern Hospital of Wuhan University People’s Hospital. Therefore assume no duplicates. Citation: Zhang Lu, Jiang Yan, Wei Min, et al. Analysis of pregnancy outcomes of pregnant women during the epidemic of new coronavirus pneumonia in Hubei [J / OL]. Chinese Journal of Obstetrics and Gynecology, 2020,55 (2020-03-08). DOI: 10.3760 / cma.j.cn112141-20200218-00111.
Study 6. The 15 Union hospital Tongji cases
A series of 15 pregnant women, of whom 11 had delivered and four remained undelivered from Union Hospital, Tongji Medical College, click here. These may include the four from the same hospital below and also possibly the 9 cases from the same hospital in Translational Paediatrics. Citation: Dehan Liu, Lin Li, Xin Wu, Dandan Zheng, Jiazheng Wang, Lian Yang and Chuansheng Zheng. Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis American Journal of Roentgenology: 1-6. 10.2214/AJR.20.23072
Study 5. The 9 Union Hospital Tongji cases
Published in Translational Paediatrics (click here). Nine mothers, ten neonates. Citation: Huaping Zhu, Lin Wang, Chengzhi Fang, Sicong Peng, Lianhong Zhang, Guiping Chang, Shiwen Xia, Wenhao Zhou. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Translational Pediatrics Vol 9, No 1 (February 2020)
Study 4. The Zeijang case
From the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China (click here) Caesarean for unclear indication. Baby not infected. Citation: Yang Li, Ruihong Zhao, Shufa Zheng, Xu Chen, Jinxi Wang, Xiaoli Sheng, Jianying Zhou, Hongliu Cai, Qiang Fang, Fei Yu, Jian Fan, Kaijin Xu, Yu Chen and Jifang Sheng Lack of Vertical Transmission of Severe Acute Respiratory Syndrome Coronavirus 2, China. Emerging Infectious Diseases. 2020 Apr [date cited].
Study 3. The Sun Yat Sen series
These 13 cases were reported from the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Province. Guangdong, P.R. China. (click here). Also pre-publication text). They included 3 patients from Zhejiang, 3 from other cities of Hubei and 1 each from Fujian, Shanxi, Beijing, Guangdong, Jiangxi, Heilongjiang and Anhui. No infected neonates but one mother seriously ill on ECMO. Citation: Yangli Liu, Haihong Chen, Kejing Tang, Yubiao Guo. Clinical manifestations and outcome of SARS-CoV-2 infection during pregnancy J Infect.
Study 2. The first Union Hospital Tongji series
From Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan. The original abstract here, described three cases and linked to an original paper in Chinese. These may overlap with four cases later published in Frontiers click here. There is also a pre-print of three cases from Tongji, (Click here) which includes some authors from the Liverpool School of Tropical Medicine & Hygiene. Again these may overlap, or even be the same cases.
Study 2a. Citations: Chen S, Huang B, Luo DJ, Li X, Yang F, Zhao Y, Nie X, Huang BX. Pregnant women with new coronavirus infection: a clinical characteristics and placental pathological analysis of three cases. Zhonghua Bing Li Xue Za Zhi. 2020 Mar 1;49(0):E005. doi: 10.3760/cma.j.cn112151-20200225-00138.
Study 2b. Liu, W.; Wang, Q.; Zhang, Q.; Chen, L.; Chen, J.; Zhang, B.; Lu, Y.; Wang, S.; Xia, L.; Huang, L.; Wang, K.; Liang, L.; Zhang, Y.; Turtle, L.; Lissauer, D.; Lan, K.; Feng, L.; Yu, H.; Liu, Y.; Sun, Z. Coronavirus Disease 2019 (COVID-19) During Pregnancy: A Case Series. Preprints 2020, 2020020373
Study 2c. Yan Chen, Hua Peng, Lin Wang, Yin Zhao, Lingkong Zeng, Hui Gao and Yalan Liu. Infants Born to Mothers With a New Coronavirus (COVID-19) Front. Pediatr., 16 March 2020
Study 1. The original Lancet nine
All from Zhongnan Hospital of Wuhan University, Wuhan, click here. Citation: Huijun Chen, Juanjuan Guo, Chen Wang, Fan Luo, Xuechen Yu, Wei Zhang, Jiafu Li, Dongchi Zhao, Dan Xu, Qing Gong, Jing Liao, Huixia Yang, Wei Hou, Yuanzhen Zhang. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. Volume 395, Issue 10226, 7–13 March 2020, Pages 809-815.
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