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      Updated experience of a tertiary pandemic center on 533 pregnant women with COVID‐19 infection: A prospective cohort study from Turkey

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          Abstract

          Objective

          To investigate the clinical course and impact of coronavirus disease 2019 (COVID‐19) infection on pregnant women.

          Methods

          A prospective cohort study was conducted on pregnant women with confirmed COVID‐19 infection. Demographic features, clinical characteristics, and perinatal outcomes were prospectively evaluated.

          Results

          Of the 533 cases, 161 (30.2%) had co‐morbidities and 165 (30.9%) were asymptomatic. Cough ( n = 178, 33.4%) and myalgia ( n = 168, 31.5%) were the leading symptoms. In total, 261 patients (48.9%) received COVID‐19 therapy, 509 (95.5%) had mild disease, 7 (1.3%) were admitted to the intensive care unit (ICU), and invasive mechanical ventilation was necessary in 2 (0.4%) patients. Maternal mortality was observed in 2 (0.4%) cases. Of the patients, 297 (55.7%) were hospitalized, 39 (7.3%) had suspicious radiologic imaging findings, 66 (12.4) had pregnancy complications (preterm delivery [ n =22, 4.1%] and miscarriage [ n =12, 2.2%] were the most common pregnancy complications), 131 births occurred, and the cesarean section rate was 66.4%. All neonates were negative for COVID‐19. The rate of admission to the neonatal ICU was 9.9%. One specimen of breast milk was positive for the infection.

          Conclusion

          The course of COVID‐19 was mild in the majority of cases. However, increased rates of pregnancy complications and cesarean delivery were observed.

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          Most cited references23

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          Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

          Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
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            A Novel Coronavirus from Patients with Pneumonia in China, 2019

            Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)
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              Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention

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                Author and article information

                Contributors
                dilekuygur@gmail.com
                Journal
                Int J Gynaecol Obstet
                Int J Gynaecol Obstet
                10.1002/(ISSN)1879-3479
                IJGO
                International Journal of Gynaecology and Obstetrics
                John Wiley and Sons Inc. (Hoboken )
                0020-7292
                1879-3479
                12 December 2020
                March 2021
                12 December 2020
                : 152
                : 3 ( doiID: 10.1002/ijgo.v152.3 )
                : 328-334
                Affiliations
                [ 1 ] Department of Obstetrics and Gynecology Turkish Ministry of Health Ankara City Hospital University of Health Sciences Ankara Turkey
                [ 2 ] Department of Obstetrics and Gynecology Turkish Ministry of Health Ankara City Hospital Ankara Turkey
                [ 3 ] Department of Anesthesiology and Reanimation Turkish Ministry of Health Ankara City Hospital University of Health Sciences Ankara Turkey
                [ 4 ] Division of Neonatology Department of Pediatrics Turkish Ministry of Health Ankara City Hospital University of Health Sciences Ankara Turkey
                [ 5 ] Department of Infectious Diseases Turkish Ministry of Health Ankara City Hospital Ankara Turkey
                [ 6 ] Department of Medical Microbiology Turkish Ministry of Health Ankara City Hospital Ankara Turkey
                [ 7 ] Department of Medical Education and Informatics Gulhane Faculty of Medicine Ankara Turkey
                [ 8 ] Coordinator Head Physician of General Hospital, Turkish Ministry of Health Ankara City Hospital Ankara Turkey
                Author notes
                [*] [* ] Correspondence

                Dilek Sahin, 1604th Street, No. 9, Cankaya, Ankara 06800, Turkey.

                Email: dilekuygur@ 123456gmail.com

                Article
                IJGO13460
                10.1002/ijgo.13460
                9087535
                33131057
                eda0fc84-2709-4317-814f-dd6664257926
                © 2020 International Federation of Gynecology and Obstetrics

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 16 October 2020
                : 06 October 2020
                : 30 October 2020
                Page count
                Figures: 0, Tables: 3, Pages: 7, Words: 5411
                Categories
                Clinical Article
                Clinical Articles
                Obstetrics
                Custom metadata
                2.0
                March 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.5 mode:remove_FC converted:10.05.2022

                Obstetrics & Gynecology
                covid‐19,pandemic,perinatal outcomes,pregnancy,sars‐cov‐2
                Obstetrics & Gynecology
                covid‐19, pandemic, perinatal outcomes, pregnancy, sars‐cov‐2

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