A considerable asymptomatic proportion and thromboembolism risk of pregnant women with COVID-19 infection in Wuhan, China
-
Yulan Wang
and
Lan Mi
Abstract
Objectives
The coronavirus disease 2019 (COVID-19) had become a worldwide pandemic, however, information is limited on the asymptomatic proportion and thromboembolism risk of pregnant women with infection.
Methods
All 32 pregnant women with COVID-19 who were admitted to the hospital in Wuhan during the outbreak from January 20 to March 18, 2020, were retrospectively reviewed for the clinical records, laboratory tests, chest CT scans, and neonatal outcomes.
Results
There were 17 of the 32 patients (53%) with no subjective symptoms before admission, and 13 (41%) remained asymptomatic throughout hospitalization. There were 28 patients (88%) showing typical radiographic evidence of pneumonia on chest CT. The patients with COVID-19 were found in an increased risk of thromboembolism with much higher D-dimer levels than uninfected pregnant women. One neonate with asphyxia and positive immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies was reported.
Conclusions
The considerable asymptomatic proportion of pregnant women with COVID-19 indicates symptom-based screening would miss a number of cases. Chest CT could provide a useful screening resource during the COVID-19epidemic outbreak. Anticoagulation therapy for the postpartum patients may be helpful for good prognosis. The findings provide important information for the hospital isolation, control strategies and clinical therapy.
Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ Institutional Review Board.
References
1. Tu, W, Tang, H, Chen, F, Wei, Y, Xu, T, Liao, K, et al.. Epidemic update and risk assessment of 2019 novel coronavirus — China, January 28, 2020. China CDC Wkly 2020;2:83–6. https://doi.org/10.46234/ccdcw2020.024.Search in Google Scholar
2. Zhou, X, Li, Y, Li, T, Zhang, W. Follow-up of asymptomatic patients with SARS-CoV-2 infection. Clin Microbiol Infect 2020;26:957–9. https://doi.org/10.1016/j.cmi.2020.03.024.Search in Google Scholar PubMed PubMed Central
3. Mizumoto, K, Kagaya, K, Zarebski, A, Chowell, G. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro Surveill 2020;25:2000180. https://doi.org/10.2807/1560-7917.es.2020.25.10.2000180.Search in Google Scholar
4. Nishiura, H, Kobayashi, T, Miyama, T, Suzuki, A, Jung, S, Hayashi, K, et al.. Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19). Int J Infect Dis 2020;94:154–5. https://doi.org/10.1016/j.ijid.2020.03.020.Search in Google Scholar PubMed PubMed Central
5. Van der Pol, LM, Mairuhu, AT, Tromeur, C, Couturaud, F, Huisman, MV, Klok, FA. Use of clinical prediction rules and D-dimer tests in the diagnostic management of pregnant patients with suspected acute pulmonary embolism. Blood Rev 2017;31:31–6. https://doi.org/10.1016/j.blre.2016.09.003.Search in Google Scholar PubMed
6. Obi, AT, Barnes, GD, Wakefield, TW, Brown, S, Eliason, JL, Arndt, E, et al.. Practical diagnosis and treatment of suspected venous thromboembolism during COVID-19 Pandemic. J Vasc Surg 2020;8:526–34. https://doi.org/10.1016/j.jvsv.2020.04.009.Search in Google Scholar PubMed PubMed Central
7. Chen, H, Guo, J, Wang, C, Luo, F, Yu, X, Zhang, W, et al.. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020;395:809–15. https://doi.org/10.1016/s0140-6736(20)30360-3.Search in Google Scholar PubMed PubMed Central
8. Baud, D, Greub, G, Favre, G, Gengler, C, Jaton, K, Dubruc, E, et al.. Second-trimester miscarriage in a pregnant woman with SARS-CoV-2 infection. J Am Med Assoc 2020;323:2198–200. https://doi.org/10.1001/jama.2020.7233.Search in Google Scholar PubMed PubMed Central
© 2020 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review
- Methods of detection and prevention of preterm labour and the PAMG-1 detection test: a review
- Corner of Academy
- Long term alterations of growth after antenatal steroids in preterm twin pregnancies
- Original Articles – Obstetrics
- SARS-CoV-2 in pregnancy: maternal and perinatal outcome data of 34 pregnant women hospitalised between May and October 2020
- Comparison of hematological parameters and perinatal outcomes between COVID-19 pregnancies and healthy pregnancy cohort
- The effect of mask use on maternal oxygen saturation in term pregnancies during the COVID-19 process
- Risk factors for pregnancy-associated venous thromboembolism in Singapore
- Does the length of second stage of labour or second stage caesarean section in nulliparous women increase the risk of preterm birth in subsequent pregnancies?
- Reference range for C1-esterase inhibitor (C1 INH) in the third trimester of pregnancy
- Termination of pregnancy following a Down Syndrome diagnosis: decision-making process and influential factors in a Muslim but secular country, Turkey
- High dose vs. low dose oxytocin for labor augmentation: a systematic review and meta-analysis of randomized controlled trials
- Extremely high levels of alkaline phosphatase and pregnancy outcome: case series and review of the literature
- Cervical elastography strain ratio and strain pattern for the prediction of a successful induction of labour
- Original Articles – Fetus
- CD34 immunostain increases sensitivity of the diagnosis of fetal vascular malperfusion in placentas from ex-utero intrapartum treatment
- The ability of various cerebroplacental ratio thresholds to predict adverse neonatal outcomes in term fetuses exhibiting late-onset fetal growth restriction
- Obstetric and pediatric growth charts for the detection of late-onset fetal growth restriction and neonatal adverse outcomes
- Original Articles – Neonates
- Bacterial stability with freezer storage of human milk
- Protein and genetic expression of CDKN1C and IGF2 and clinical features related to human umbilical cord length
- Short Communication
- A considerable asymptomatic proportion and thromboembolism risk of pregnant women with COVID-19 infection in Wuhan, China
Articles in the same Issue
- Frontmatter
- Review
- Methods of detection and prevention of preterm labour and the PAMG-1 detection test: a review
- Corner of Academy
- Long term alterations of growth after antenatal steroids in preterm twin pregnancies
- Original Articles – Obstetrics
- SARS-CoV-2 in pregnancy: maternal and perinatal outcome data of 34 pregnant women hospitalised between May and October 2020
- Comparison of hematological parameters and perinatal outcomes between COVID-19 pregnancies and healthy pregnancy cohort
- The effect of mask use on maternal oxygen saturation in term pregnancies during the COVID-19 process
- Risk factors for pregnancy-associated venous thromboembolism in Singapore
- Does the length of second stage of labour or second stage caesarean section in nulliparous women increase the risk of preterm birth in subsequent pregnancies?
- Reference range for C1-esterase inhibitor (C1 INH) in the third trimester of pregnancy
- Termination of pregnancy following a Down Syndrome diagnosis: decision-making process and influential factors in a Muslim but secular country, Turkey
- High dose vs. low dose oxytocin for labor augmentation: a systematic review and meta-analysis of randomized controlled trials
- Extremely high levels of alkaline phosphatase and pregnancy outcome: case series and review of the literature
- Cervical elastography strain ratio and strain pattern for the prediction of a successful induction of labour
- Original Articles – Fetus
- CD34 immunostain increases sensitivity of the diagnosis of fetal vascular malperfusion in placentas from ex-utero intrapartum treatment
- The ability of various cerebroplacental ratio thresholds to predict adverse neonatal outcomes in term fetuses exhibiting late-onset fetal growth restriction
- Obstetric and pediatric growth charts for the detection of late-onset fetal growth restriction and neonatal adverse outcomes
- Original Articles – Neonates
- Bacterial stability with freezer storage of human milk
- Protein and genetic expression of CDKN1C and IGF2 and clinical features related to human umbilical cord length
- Short Communication
- A considerable asymptomatic proportion and thromboembolism risk of pregnant women with COVID-19 infection in Wuhan, China
