Testing of Patients and Support Persons for Coronavirus Disease 2019 (COVID-19) Infection Before Scheduled Deliveries
Testing of Patients and Support Persons for Coronavirus Disease 2019 (COVID-19) Infection Before Scheduled Deliveries
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DOI：
10.1097/aog.0000000000003985
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发表时间：
2020-08-01
影响因子：
7.2
通讯作者：
Stone, Joanne
中科院分区：
文献类型：
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作者：
Bianco, Angela;Buckley, Ayisha B.;Stone, Joanne
目的：通过使用通用检测来评估计划分娩的产科人群的 2019 冠状病毒病 (COVID-19) 感染率，以及在最初 2 周检测期间其支持人员之间的一致性或不一致率。此外，我们还评估了筛查工具在预测队列中严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 检测结果方面的效用。方法：这是一项观察性研究，我们联系了所有计划于 2020 年 4 月 4 日至 4 月 15 日在西奈山卫生系统内计划分娩的妇女，并为她们自己及其支持人员预约在计划分娩前 1 天接受 COVID-19 检测。通过电话采访，对患者和支持人员进行了针对 COVID-19 感染的标准化筛查。那些筛查呈阳性的支持人员不允许参加分娩。所有患者和筛查呈阴性的支持人员均接受了 SARS-CoV-2 检测。结果：在研究期间，155 名患者和 146 名支持人员接受了 SARS-CoV-2 检测。患者和支持人员中无症状 COVID-19 感染的患病率分别为 15.5% (CI 9.8-21.2%) 和 9.6% (CI 4.8-14.4%)。测试对之间的不一致率为 7.5%。在感染COVID-19的患者中，58%的支持人员也受到感染；在没有感染的患者中，其支持人员中只有不到 3.0% 感染。结论：我们发现，尽管使用电话筛查工具筛查结果呈阴性，但超过 15% 的无症状产妇的 SARS-CoV-2 感染检测结果呈阳性。此外，58% 的无症状筛查阴性支持人员的 SARS-CoV-2 感染检测也呈阳性。另外，对 COVID-19 感染检测呈阴性的女性的支持人员进行检测时，阳性结果的产生率较低。这对产科和新生儿护理实践以及医疗保健专业人员具有重要影响。
OBJECTIVE: To evaluate the rate of coronavirus disease 2019 (COVID-19) infection with the use of universal testing in our obstetric population presenting for scheduled deliveries, as well as the concordance or discordance rate among their support persons during the initial 2-week period of testing. Additionally, we assessed the utility of a screening tool in predicting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing results in our cohort. METHODS: This was an observational study in which all women who were scheduled for a planned delivery within the Mount Sinai Health system from April 4 to April 15, 2020, were contacted and provided with an appointment for themselves as well as their support persons to undergo COVID-19 testing 1 day before their scheduled delivery. Both the patients and the support persons were administered a standardized screen specific for COVID-19 infection by telephone interview. Those support persons who screened positive were not permitted to attend the birth. All patients and screen-negative support persons underwent SARS-CoV-2 testing. RESULTS: During the study period, 155 patients and 146 support persons underwent SARS-CoV-2 testing. The prevalence of asymptomatic COVID-19 infection was 15.5% (CI 9.8-21.2%) and 9.6% (CI 4.8-14.4%) among patients and support persons, respectively. The rate of discordance among tested pairs was 7.5%. Among patients with COVID-19 infection, 58% of their support persons also had infection; in patients without infection, fewer than 3.0% of their support persons had infection. CONCLUSION: We found that more than 15% of asymptomatic maternity patients tested positive for SARS-CoV-2 infection despite having screened negative with the use of a telephone screening tool. Additionally, 58% of their asymptomatic, screen-negative support persons also tested positive for SARS-CoV-2 infection. Alternatively, testing of the support persons of women who had tested negative for COVID-19 infection had a low yield for positive results. This has important implications for obstetric and newborn care practices as well as for health care professionals.