Most SARS-CoV-2-positive pregnant women asymptomatic at screening

Universal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing of pregnant women presenting for delivery in New York City revealed that most positive patients were asymptomatic, according to a research letter published online April 13 in the New England Journal of Medicine.

Desmond Sutton, M.D., from Columbia University Irving Medical Center in New York City, and colleagues implemented universal testing to detect SARS-CoV-2 in women admitted for delivery at two New York medical centers.

A total of 215 pregnant women who delivered infants between March 22 and April 4, 2020, were included. The researchers note that all women were screened for symptoms of COVID-19 on admission. Four (1.9 percent) had fever or other symptoms and tested positive for SARS-CoV-2. Nasopharyngeal swabs were obtained from 210 of the 211 women without symptoms; 13.7 percent (29 women) were positive for SARS-CoV-2. Overall, 87.9 percent of the 33 patients who were positive for SARS-CoV-2 on admission had no symptoms at presentation. Three of the 29 women who had been asymptomatic when they tested positive developed fever before postpartum discharge. Two received antibiotics for presumed endomyometritis, and one was presumed to be febrile due to COVID-19. One patient who was negative for SARS-CoV-2 on admission became symptomatic postpartum and tested positive on repeat testing three days after the initial test.

"The potential benefits of a universal testing approach include the ability to use COVID-19 status to determine hospital isolation practices and bed assignments, inform neonatal care, and guide the use of personal protective equipment," the authors write.