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To augment the existing clinical information about COVID-19 during pregnancy, investigators in Wuhan detailed outcomes in 118 pregnant women infected with SARS-CoV-2 (64% during the third trimester). The most common presenting symptoms were fever (75%), cough (73%), chest tightness (18%), fatigue (17%), shortness of breath (7%), diarrhea (7%), and headache (6%). Lymphopenia was present in 44% of the cohort.
In all, 92% of the women had mild disease and 8% had severe disease (hypoxemia), 1 of whom developed critical disease (mechanical ventilation). No maternal deaths occurred. For comparison, 16% of all people with COVID-19 across mainland China had severe disease. Pregnancy outcomes included 68 deliveries with no intrauterine fetal deaths and no neonatal deaths. In addition, there were 3 spontaneous abortions, 2 ectopic pregnancies, and 4 abortions induced because of concern about COVID-19's effect on the pregnancy.
Chen L et al. Clinical characteristics of pregnant women with Covid-19 in Wuhan, China. N Engl J Med 2020 Apr 17; [e-pub]. (https://doi.org/10.1056/NEJMc2009226)
Comment
Unlike influenza, which confers increased risk for severe disease and death in pregnant women compared with the general population (Obstet Gynecol 2010; 115:717), SARS-CoV-2 infection was not associated with excess risk for severe disease in this cohort of pregnant women from Wuhan. In our experience, although most pregnant women with COVID-19 experience mild symptoms, those with comorbidities such as morbid obesity, type 2 diabetes, and active cancer appear to be at increased risk for severe disease.