scholarly journals Maternal and Perinatal Outcomes in Patients with Suspected COVID-19 and Their Relationship with a Negative RT-PCR Result

2020 ◽  
Vol 9 (11) ◽  
pp. 3552 ◽  
Author(s):  
Yolanda Cuñarro-López ◽  
Óscar Cano-Valderrama ◽  
Pilar Pintado-Recarte ◽  
Ignacio Cueto-Hernández ◽  
Blanca González-Garzón ◽  
...  

This study was designed to examine maternal-perinatal outcomes in pregnant women with suspected coronavirus disease 2019 (COVID-19) according to the result of a real-time reverse transcription polymerase chain reaction (RT-PCR) test and to investigate possible variables that could be useful for predicting a negative RT-PCR result. Participants of this retrospective cohort study were obstetrics patients with suspected COVID-19 who underwent an RT-PCR test in a tertiary hospital in Madrid, Spain. Maternal-perinatal features were analysed according to the results of this test. Clinical, radiological and analytical characteristics that could be associated with a negative result were also explored. In a final subgroup analysis, patients were included if they had pneumonia and a negative test result for the virus. Out of the 111 obstetric patients with suspected COVID-19 that were enrolled, 38.7% returned a negative result. In this RT-PCR-negative group, we recorded lower rates of pneumonia (21.4% vs. 45.6%, p = 0.009), severe or critical clinical features (4.7% vs. 11.8% and 0.0% vs. 5.9%, p = 0.02, respectively), lower lactate dehydrogenase (LDH) levels (168 UI/L vs. 224.5 UI/L, p = 0.003), a greater need for maternal treatment (60.3% vs 24.4%, p < 0.001), a reduced need for oxygen therapy (2.4% vs 28.8%, p < 0.001) and a lower rate of intensive care unit admission (0.0% vs. 3.7%, p = 0.046) than the RT-PCR-positive group. While no differences were found in other variables, the monocyte count was higher (946.2/μL vs. 518.8/μL, p = 0.022) in this group. The predictive model for a negative test result included the monocyte count, LDH level and no need for oxygen therapy. This model was able to identify 73.5% of patients with a negative RT-PCR result. Only 11% of the patients with pneumonia testing negative for the virus had IgG antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The proportion of pregnant women with suspected COVID-19 and a negative RT-PCR result was nearly 39%. In these patients, the symptoms were mild and the systemic severity of the disease was lower. The monocyte count, LDH level and no need for oxygen therapy were the factors that were more related to a negative test result in this group. These variables could be used to guide the management of patients with suspected COVID-19, mainly while waiting for RT-PCR results or in settings where this test is not available.

2021 ◽  
pp. 003022282110598
Author(s):  
Hümeyra Aslaner ◽  
Betül Özen ◽  
Zeliha K. Erten ◽  
Mebrure Beyza Gökçek

Urgent measures were taken for those at the age of 65 and over who were at the risk group all over the world due to the COVID-19 pandemic. It is known that many individuals at the age of 65 and over have experienced anxiety due to the uncertainties. This study aimed to determine the anxiety and death anxiety in individuals aged 65 and over who were isolation at home due to being diagnosed with COVID-19 or being in contact during the pandemic process. The study is descriptive and cross-sectional. It was performed with 656 home-quarantined individuals aged between 65–80 years with positive or negative real-time polymerase chain reaction (RT-PCR) test result. A form including questions about the death anxiety and the Coronavirus Anxiety Scale Short Form prepared by the researchers were administered to the individuals by phone call. Of the participants, 49.5% were male. Median COVID-19 anxiety score was 4 (0–18). Anxiety scores of the male and female participants were similar. Participants with negative polymerase chain reaction (PCR) results and those with death anxiety had higher COVID anxiety scores. Death anxiety has increased by 1.661 times in male gender, 1.983 times in RT-PCR positivity and 0.146 times in the presence of symptoms. Individuals with positive COVID-19 test results or those aged 65 and over who had death anxiety and negative COVID-19 test result but who were in home-isolation due to being a contact had higher anxiety score. For this reason, those with death anxiety can be supported in line with their religious beliefs to reduce anxiety. Those with negative PCR test results in quarantine can be adequately informed about the COVID-19.


2021 ◽  
Vol 10 (1) ◽  
pp. 36-40
Author(s):  
Erdinc Yavuz ◽  
Ese Basbulut

In these days when the effect of the COVID-19 pandemic is felt with all its severity, the findings of re-infection in people who have had COVID-19 disease have led to some questions about the natural immunity against this disease. Here, we report a possible COVID-19 reinfection. The second episode confirmed by RT-PCR with a more severe clinical picture one month after an incidentally detected first episode with mild symptoms of a doctor working as a microbiologist at a training research hospital. While a 47-year-old female doctor was working in a tertiary hospital serving as a reference hospital for the diagnosis and treatment of COVID-19 patients, symptoms of sore throat, cough and runny nose appeared on October 25. The patient, with a history of chronic tendinitis, COPD, asthma and allergic rhinitis, attributed these symptoms to her previous clinical diagnosis and did not consider consulting a doctor or testing for COVID-19 due to the mild course of symptoms. SARS-CoV-2 Ig G antibodies were found to be positive in a screening study conducted on November 11 in the patient whose complaints resolved within a few days. RT-PCR performed thereafter was reported as negative. The RT-PCR test performed on December 2 of the patient who complained of fever and severe weakness, immediately after her colleague had COVID-19, was interpreted as positive. No signs of viral pneumonia were found in the thoracic CT when the cough complaint of the patient who received COVID-19 treatment did not improve. The patient's complaints regressed with the addition of phenocodine to her treatment, and the RT-PCR test on December 12 was reported as negative. Further analysis of the frequency and possible causes of COVID-19 reinfections will be needed in the near future. Keywords: SARS-CoV-2, COVID-19, reinfection, coronavirus


2021 ◽  
pp. 31-32
Author(s):  
Sweety Sinha ◽  
Anjana Sinha ◽  
Ankita Ankita

Background: With the exponential increase in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) worldwide, an increasing proportion of pregnant women are now infected during their pregnancy. The knowledge gained from previous human coronavirus outbreaks suggests that pregnant women and their fetuses are particularly susceptible to poor outcomes. The aim of this study was to summarize the maternal and perinatal outcomes of pregnant women infected with COVID-19 during their pregnancy. Methods:Eligibility criteria included pregnant women positive for COVID-19 as detected by real-time polymerase chain reaction (PCR). Results: Atotal of 40 pregnant women positive for COVID-19 as conrmed by RT-PCR, were included in the study. 5% cases had preterm deliveries and LSCS was the preferred mode of delivery in 28 of 40 i.e., 70% cases. There was a tendency for low Apgar score at birth, higher rates of fetal distress, meconium, NICU admissions. There was one IUD only in this study. The treatment patterns of COVID-19 infection among pregnant women during their pregnancy or following delivery was mostly supportive in the form of oxygen and antibiotic therapy. Conclusions: Although the majority of mothers were discharged without any major complications, severe maternal morbidity as a result of COVID-19 were reported. Vertical transmission of the COVID-19 could not be ruled out. Pregnant infected women had different symptoms, and they were given mostly supportive treatments than the general infected population. Careful monitoring of pregnancies with COVID-19 and measures to prevent neonatal infection are warranted.


2021 ◽  
Author(s):  
Nupur Nandi ◽  
Ritika Agarwal ◽  
Garima Bajpai

Abstract Background: The ongoing pandemic situation by a highly infective Covid-19 virus is a global health threat. Pregnancy related physiological changes of cardio- respiratory system and relative immunosuppression might cause more infectivity and worsening complications of this novel respiratory virus infection. Limited data availability on feto -maternal outcome of Covid 19 positive pregnant women necessitates the current study.Methodology: A prospective cohort study was conducted in a government designated level III Covid care hospital at Teerthankar Mahaveer Medical College & Research Centre to assess the feto-maternal outcome in Covid 19 RT- PCR test positive pregnant women delivered between April 2020 to September 2020. Mothers were evaluated in terms of asymptomatic status or predominant symptoms (fever, cough, sore throat, and breathlessness), complication if any including need for ventilatory support for extensive pneumonia, or mortality. Neonates were tested for presence of infection by RT-PCR test on day 2 & 5 of delivery, and also looked for any symptoms of the disease or it’s complication.Results: Total 33 women with Covid19 positivity delivered at term pregnancy in the said period of 6 months. The most frequent (45.45%) age group was 26 to 30 years. Asymptomatic Covid 19 positive cases were more (57.58%) prevailing over symptomatic patients. Fever was most frequent (33.33%) physical symptom. Emotional quotient was significantly affected by presence of anxiety amongst 36.36%. Caesarean delivery conducted maintaining all protocol in 60.6% women, but all were indicated for other obstetric reason. None of the mother had developed significant pneumonia or other complication. One case of maternal mortality noted, but was not related to Covid 19 infection. Vertical transmission was nil in our study and no neonate was affected by any complication.Conclusion: Course of disease was not different in pregnant women infected by Covid 19 virus in late pregnancy in comparison to non-pregnant adults. No case of vertical transmission noted, neither any neonatal morbidity nor mortality in present study, shows the importance of following optimum protocol. All pregnant women should be screened for Covid 19 infection in current scenario.


Author(s):  
Saksha Dholakiya ◽  
Pooja S. Singh ◽  
Jaishree Bamniya ◽  
Haresh U. Doshi

Background: Pregnant women are likely to represent a high-risk population during current coronavirus 2019 pandemic caused by severe acute respiratory syndrome coronavirus-2. The aim and objective of this study was to evaluate how COVID-19 pandemic has affected the mode of delivery and whether complications of the disease and mortality rate are higher in pregnant women than in non‐pregnant women.Methods: This ambispective observational study was conducted in department of obstetrics and gynaecology of our institute. Pregnant women diagnosed with positive for COVID-19 via the SARS-CoV-2 RT-PCR test in the third trimester and all neonates with complete COVID-19 testing and delivery data. This data was analysed.Results: Out of total 66 cases studied, 48 patients (72.7%) were asymptomatic, while 13 (19.7%) had mild respiratory or gastro intestinal symptoms on initial assessment at admission, including cough, sore throat, fever, weakness or diarrhoea. Cesarean sections were performed in 57.6% of cases. There were no cases of maternal or neonatal mortality.Conclusions: The study revealed that COVID-19 positive pregnant women are usually asymptomatic or mild-moderately symptomatic, similar to COVID-19 positive non-pregnant women. There was a noted rise in the rate of caesarean sections as a mode of delivery. 


Author(s):  
Bushra A. A. Albazi ◽  
Dr Noof. Albaz ◽  
Dr Nayef. Alqahtani ◽  
Dr. Angham Salih ◽  
Dr Rafat Mohtasab

A large number of patients with coronavirus disease 2019 (COVID-19) present at hospitals. There are a limited number of isolation rooms open, and patients must often wait a long time to get a reverse transcription-polymerase chain reaction (RT-PCR) test done. This necessitates the introduction of effective triage plans. A patient with suspicions is referred to an emergency room (ED) depending on their medical record for a simple physical assessment, blood test findings, and chest imaging.A retrospective study design was conduct at Prince Sultan Medical Military City (PSMMC). Ethical approval was obtained from the institutional board to wave the consent forms since it is a retrospective study. Only the primary investigator has had the data access to the patients’ medical records. The collected patient records were under specific categories, including symptoms score starts from 5 and above, RT-PCR test result done after CXRP imaging, the patient admitted to the emergency department (ED). Excluding all CXRP done after RT-PCR TEST, positive Covid 19 admitted to the intensive care unit (ICU), pediatric patients, and patients with score symptoms were less than five. Two experienced radiologists reviewed the images blindly, and the inter-observer reliability of observations noted by the radiologists was calculated. As for the relationship between the x-ray reading and the RT-PCR test result, our results showed a high correlation between the variables (chi-square χ² = 12.44, with df =1, and p<0.001). The sensitivity of x-ray diagnosing covid19 was 65.52 %, while the specificity was 54.51 %, and the accuracy of radiologists reading was 58.17 %. Furthermore, the positive predictive value (PPV) was 41.76 %, and the negative predictive value (NPV) was 76.05%. Finally, the false positive rate (type-i error (alpha) was 45.49%, and the false-negative rate (type-ii error (beta) was 34.48% Our research findings show that CXRP imaging can detect COVID-19 infection in symptomatic patients and can be a valuable addition to RT-PCR testing. In an inpatient ED environment where availability of test kits, laboratory equipment, and laboratory personnel is compromised and risks delaying patient treatment and hospital workflow, serial CXRP could theoretically be used as an adjunct diagnostic function and monitoring in patients suspected of having COVID-19.


Author(s):  
Gabriela Zaharie ◽  
Monica Hasmasanu ◽  
Daniel Muresan ◽  
Tunde Kovacs ◽  
Melinda Matyas

Abstract Background: Severe acute respiratory distress syndrome with Coronavirus 2 (SARS-CoV-2) infection affected the pregnant women during the pandemics. Immunological particularity of this population and the increased need for medical assistance put this population in a high-risk category for SARS-Cov-2 infection.Because of high contamination risk and limited studies about vertical transmission, the labor and delivery of positive women require special conditions. Cesarean section is probably the best option for delivery of infants to reduce the risk of infection during birth.Aim: Our study aims to present the management and outcome of infants born to mothers confirmed with coronavirus disease 2019 (COVID19) before delivery.Material and methods: This is longitudinal, retrospective study, analyzing demographics, laboratory data and management of neonates born of mothers with diagnosis of SARS-Cov -2 infection.Results: 5 neonates were born of SARS-Cov-2 positive mothers , all by C- section and had negative real time –PCR ( RT-PCR) test. None of them was breastfed during hospital stay. The negative RT-PCR test allowed us to reduce the hospital stay of infants and care them in non –isolated area.Conclusion: In our study, vertical or perinatal transmission of the infection was not present. The testing of the pregnant women, their isolation and delivery in safe conditions for the medical staff were possible, using adequate protection equipment to limit their infection and the risk for the newborns.


Author(s):  
Claudia Fonseca

Abstract Inquiring into the impact of DNA technology on Brazilian family law,, through the consultation of legislation, jurisprudence and specific legal briefs concerning paternity disputes, we map out trends over the past thirty years. We show how, after a moment of original skepticism, genetic evidence appears to dominate the legal scene, rendering personal testimony irrelevant. However, with growing concern about men who use a negative test result to disclaim their paternal status, this testimony is once again needed to clarify whether or not the man originally believed the child was his blood-related offspring. Finally, we look at a recent period, showing how reactions against the “real biological truth” have spawned a new juridical category-socio-affective paternity-that, spreading well beyond paternity tests, is altering some basic tenets of family law.


2021 ◽  
pp. 003335492110492
Author(s):  
Miranda S. Moore ◽  
Angelica Bocour

Objective Curative treatments for hepatitis C virus (HCV) infection are available, but access and barriers to treatment can delay initiation. We investigated the time to first negative RNA test result among people with HCV infection and examined differences by homeless status and whether people were tested at a correctional facility or substance use treatment facility. Methods We used surveillance data to identify New York City residents first reported with HCV infection during January 1, 2015–December 31, 2018, with ≥1 positive RNA test result during January 1, 2015–November 1, 2019. We used Kaplan–Meier survival analysis to determine the time from the first positive RNA test result to the first negative RNA test result, with right-censoring at date of death or November 1, 2019. We determined substance use treatment, incarceration, or homelessness by ordering facility name and address or from patient residential address. Results Of 13 952 people with an HCV RNA–positive test result first reported during 2015-2018, 6947 (49.8%) subsequently received an RNA-negative test result. Overall, 25% received an RNA-negative test result within 208 (95% CI, 200-216) days and 50% within 902 (95% CI, 841-966) days. Homelessness, incarceration, or substance use treatment was indicated for 4304 (30.9%) people, among whom 25% received an RNA-negative test result within 469 (95% CI, 427-520) days and <50% received an RNA-negative test result during the study period. Conclusions Efforts to connect people to treatment should occur soon after diagnosis, especially for people who could benefit from hepatitis C care coordination.


1998 ◽  
Vol 9 (5) ◽  
pp. 291-293 ◽  
Author(s):  
Nigel George ◽  
John Green ◽  
Siobhan Murphy

Summary: The aim of the study was to evaluate the effect of having an HIV-positive or negative test result on sexual risk behaviour before and after the test. Longitudinal retrospective case-note survey identifying new episodes of sexually transmitted disease (STD) infections in 114 subjects testing HIV positive and 114 matched negatives were examined at the Genitourinary Medicine Department, St Mary's Hospital, Paddington, London. Across the whole sample in the year after HIV testing the number of cases of new STD infections was 40% of the number of cases in the year prior to HIV testing. There was no association between serostatus and incidence of STD infections before and after HIV testing. Of those testing negative, 5.3% were identified as having a new infection in the year after the HIV test, while amongst those testing positive there was a rate of new STDs of 2.6%. In conclusion, there was no evidence that having a negative test result increased the risk of acquisition of new STDs. Rates of new STD infections amongst seropositives in the year after HIV testing were low.


Sign in / Sign up

Export Citation Format

Share Document