Abstract

Research Article

Universal testing for severe acute respiratory syndrome coronavirus 2 upon admission to three labor and delivery units in Santa Clara County, CA

Sophia Yang, Rishi Bhatnagar, James Byrne and Andrea Jelks*

Published: 31 August, 2020 | Volume 3 - Issue 2 | Pages: 109-113

Objective: To determine the prevalence of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in labor and delivery units in one of the epicentres of the West Coast.

Study Design: This was a retrospective chart review of patients admitted to labor and delivery from April 15, 2020-May 15, 2020 after implementation of a universal testing policy on Labor and Delivery.

Results: The prevalence of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the admitted labor and delivery population was 2.5%, of whom 87.5% were asymptomatic.

Conclusion: We present additional data on the prevalence of asymptomatic SARS-CoV-2 in pregnant patients on the West Coast, which is much lower compared to other locales, possibly as a result of aggressive ‘shelter in place’ policy. Universal screening is insufficient to detect asymptomatic SARS-CoV-2 and thus rapid, universal testing should be prioritized for labor and delivery units for the protection of patients and staff, and to better allocate appropriate resources. 

Key points:

1. 2.5% of 320 patients tested positive for SARS-CoV-2.

2. 87.5% of positive patients were asymptomatic.

3. Universal testing on labor and delivery is necessary.

4. ‘Shelter-in-place’ policies reduced SARS-CoV-2. 

Read Full Article HTML DOI: 10.29328/journal.cjog.1001060 Cite this Article Read Full Article PDF

Keywords:

Labor and delivery; Coronavirus disease 2019; Severe acute respiratory syndrome coronavirus 2; Pregnancy

References

  1. Center for Disease Control. Evaluating and Testing Persons for Coronavirus Disease 2019 (COVID-19). 2020. https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria/html
  2. The American College of Obstetrics and Gynecology. Novel Coronavirus 2019 Practice Advisory. 2020. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/03/novel-coronavirus/2019
  3. Vintzileos WS, Muscat J, Hoffmann E, John S, Vertichio R, et al. Screening all pregnant women admitted to Labor and Delivery for the virus responsible for COVID-19. Am J Obstet Gynecol. 2020; 223: 284-286. PubMed: https://pubmed.ncbi.nlm.nih.gov/32348743/
  4. Bianco A, Buckley AB, Overbey J, Smilen S, Wagner B, et al. Testing of Patients and Support Persons for Coronavirus Disease 2019 (COVID-19) Infection Before Scheduled Deliveries. Obstet Gynecol. 2020; 136: 283-287. PubMed: https://pubmed.ncbi.nlm.nih.gov/32433448/
  5. Khalil A, Hill R, Ladhani S, Pattisson K, O’Brien P. Severe acute respiratory syndrome coronavirus 2 in pregnancy: symptomatic pregnant women are only the tip of the iceberg. Am J Obstet Gynecol. 2020; 223: 296-297. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204681/
  6. California Department of Public Health. Covid-19 Updates. 2020. https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/ncov2019/aspx
  7. Santa Clara County Public Health County of Santa Clara Emergency Operations Center, Coronavirus (COVID-19) Data Dashboard. 2020. https://www.sccgov.org/sites/covid19/Pages/dashboard/aspx
  8. Johns Hopkins University & Medicine, Coronavirus Resource Center. 2020. https://coronavirus.jhu.edu/us/map
  9. Branson-Potts H, Reyes-Velarde A, Stiles M, Campa AJ. The price of being ‘essential’: Latino service workers bear brunt of coronavirus. Los Angeles Times. 2020. https://www.latimes.com/california/story/2020-05-17/latino-essential-workers-coronavirus
  10. Palomino J, Sanchez T. Latinos’ coronavirus burden. San Francisco Chronicle. 2020. https://www.sfchronicle.com/bayarea/article/Bay-Area-Latinos-hit-hardest-by-coronavirus-15252632.php
  11. Bender W, Srinivas S, Coutifaris P, Acker A, Hirshberg A. The psychological experience of obstetric patients and health care workers after implementation of universal SARS-CoV-2 testing. Am J Perinatol. 2020.
  12. Kotlyar A, Grechukhina O, Chen A, Popkhadze S, Grimshaw A, et al. Vertical transmission of COVID-19: a systematic review and meta-analysis. Am J Obstet Gynecol. 2020. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392880/
  13. Wilson NM, Norton A, Young FP, Collins DW. Airborne transmission of severe acute respiratory syndrome coronavirus-2 to healthcare workers: a narrative review. Anaesthesia. 2020; 75: 1086-1095. PubMed: https://pubmed.ncbi.nlm.nih.gov/32311771/

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