Miscarriage Risk in COVID-19 Infection
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COVID-19
Miscarriage Risk in COVID-19 Infection Tze Cheng Wong 1
&
Zhi Yuan Lee 1 & Tonnii L. L. Sia 2 & Andrew K. W. Chang 2 & Hock Hin Chua 2
Accepted: 6 August 2020 / Published online: 15 August 2020 # Springer Nature Switzerland AG 2020
Dear Editor, The COVID-19 outbreak, which has its first reported case in Wuhan City, China, has evolved rapidly and was declared as a pandemic by the World Health Organization on 11 March 2020. The novel coronavirus is known officially as SARS-CoV-2. Genomic analysis revealed that SARS-CoV-2 is phylogenetically related to SARS-like bat viruses; therefore, bats could be the possible primary reservoir. Infected individuals have a broad spectrum of manifestations, ranging from asymptomatic and mild symptoms to severe disease with multiorgan involvement. Symptomatic patients commonly presented with fever, cough, shortness of breath and other non-specific symptoms such as muscle ache, headache, confusion and diarrhoea. The implications of COVID-19 infection during pregnancy remain unclear at this moment. Pregnancy is considered high risk as this population remains vulnerable to coronavirus infection. Till date, data regarding SARS-CoV-2 infection amongst pregnant women, their manifestations and outcomes remain limited. Most pregnancies had good outcomes, and transmission of SARS-CoV-2 to infant was uncommon [1]. This article is part of the Topical Collection on COVID-19 * Tze Cheng Wong [email protected] Zhi Yuan Lee [email protected] Tonnii L. L. Sia [email protected] Andrew K. W. Chang [email protected] Hock Hin Chua [email protected] 1
Department of Medicine, Sarawak General Hospital, Jalan Hospital, 93586 Kuching, Sarawak, Malaysia
2
Infectious Disease Unit, Department of Medicine, Sarawak General Hospital, Kuching, Sarawak, Malaysia
However, the relationship between SARS-CoV-2 infection and risk of miscarriage remains unclear. Sarawak General Hospital is the only tertiary hospital in southern Sarawak, Malaysia, serving a population of around 2.5 million people. We have in total 465 SARSCoV-2 RT-PCR confirmed COVID-19 cases which were from 12 March 2020 to 25 May 2020. We use nasopharyngeal and oropharyngeal combined swab (NPS/OPS) to collect the samples for SARS-CoV-2 RT-PCR. Seven of these cases were pregnant women, in which at the time of presentation, 2 were in the first trimester, 3 in the second trimester and another 2 in the third trimester of their pregnancies. Two of the cases who were in their first trimester of pregnancies had miscarriages. At the time of writing, the other 5 cases have no reported adverse pregnancy outcomes, in which one of the cases has undergone an uneventful delivery through caesarean section. We would like to highlight 2 cases of first trimester miscarriage in COVID-19 infected pregnant mothers. The first case involves a 34-year-old Malay lady, who was gravida 5, para 4 at a 10-week period of amenorrhea when she was diagnosed to have COVID-19 infection. She first experienced irregular cramping lower abdominal pain, w
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