Coronavirus Disease 2019 in Pregnancy: The Experience at an Urban Safety Net Hospital
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ORIGINAL PAPER
Coronavirus Disease 2019 in Pregnancy: The Experience at an Urban Safety Net Hospital Amanda Dhuyvetter1 · Helen E. Cejtin1 · Megan Adam2 · Ashlesha Patel1 Accepted: 21 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Shortly after the identification of a novel coronavirus, the coronavirus disease 2019, or COVID-19, a global pandemic was declared. There have been conflicting data about the severity of COVID-19 disease course in pregnant women, with most US data suggesting an increase in severity and increased need for hospitalization and intubation in obstetric patients. In the general population, the disease is more common among racial and ethnic minority populations, and severity is increased with comorbid conditions and obesity. The purpose of this study is to characterize COVID-19 infection in pregnancy in a population of women getting prenatal care at an urban safety-net hospital. Beginning in April, 2020, all women were tested at admission for delivery, and additionally as an outpatient if presenting with COVID-19 symptoms. In three months, there were 208 discrete women tested and 23 (11.1%) who were positive for COVID-19. The incidence of COVID-19 was 5.1% in asymptomatic women being screened upon admission to the hospital. There was a high prevalence of obesity (68.2%) and other comorbid conditions (43.5%) in this population, and all patients were racial/ethnic minorities. Despite these risk factors, the patients uniformly had either mild or asymptomatic disease. No symptomatic patients required hospitalization for their infection. In this population of pregnant women at high risk for severe COVID-19 infection, only mild disease was observed. Keywords COVID-19 · Pregnancy · Urban · Comorbid conditions
Introduction In December 2019 a novel coronavirus outbreak was first reported in Wuhan China, and subsequently the World Health Organization (WHO) declared a global pandemic [1]. The severity of coronovirus disease 2019 (COVID-19) can range from asymptomatic to critical disease. National data demonstrate a higher prevalence and severity of COVID-19 infection among African American and Latino populations, and this has been confirmed in Chicago [2]. Other risk factors for disease severity include older age, chronic kidney disease, chronic obstructive pulmonary disease, immunocompromise, obesity, cardiovascular disease, diabetes mellitus, and possibly asthma, smoking, * Helen E. Cejtin [email protected] 1
Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, John H. Stroger Jr. Hospital of Cook County, Chicago, IL 60612, USA
Division of Family Planning Services, John H. Stroger Jr. Hospital/Cook County Health, Chicago, USA
2
and hypertension [3]. There are conflicting data on disease course in pregnancy [4, 5], with obesity and gestational diabetes risks for severe infection in pregnant women [6, 7]. The purpose of this study was to determine the prevalence and disease course of COVID-19 among pregnan
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