Clinical Presentation of Coronavirus Disease 2019 (COVID-19) in Pregnant and Recently Pregnant People.
Clinical Presentation of Coronavirus Disease 2019 (COVID-19) in Pregnant and Recently Pregnant People.
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DOI：
10.1097/aog.0000000000004178
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发表时间：
2020-12
影响因子：
7.2
通讯作者：
Pregnancy CoRonavIrus Outcomes RegIsTrY (PRIORITY) Study
中科院分区：
文献类型：
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作者：
Afshar Y;Gaw SL;Flaherman VJ;Chambers BD;Krakow D;Berghella V;Shamshirsaz AA;Boatin AA;Aldrovandi G;Greiner A;Riley L;Boscardin WJ;Jamieson DJ;Jacoby VL;Pregnancy CoRonavIrus Outcomes RegIsTrY (PRIORITY) Study
2019冠状病毒病（COVID-19）在非卧床妊娠患者中病程较长。描述妊娠期2019冠状病毒病（COVID-19）的临床表现、病理学和病程。PRIORITY（Pregnancy CoRonavIrus Outcomes RegIsTrY）研究是一项正在进行的全国性前瞻性队列研究，研究对象是美国怀孕或怀孕后6周内已知或疑似严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的人群。我们分析了SARS-CoV-2感染检测呈阳性并在检测时报告症状的参与者的COVID-19临床表现和病程。在2020年3月22日至2020年7月10日招募的991名参与者中，736人在检测时有COVID-19症状; 594人检测出SARS-CoV-2感染阳性，142人检测出阴性。平均年龄为31.3岁（SD 5.1），37%将未经产。95%是门诊病人。SARS-CoV-2感染检测呈阳性的参与者是一个地理上多样化的队列：34%来自东北部，25%来自西部，21%来自南部，18%来自中西部。31%的研究参与者是拉丁裔，9%是黑人。入组时的平均胎龄为24.1周，13%的参与者是在怀孕后入组的。在SARS-CoV-2感染检测呈阳性的患者队列中，最常见的首发症状是咳嗽（20%），喉咙痛（16%），身体疼痛（12%）和发烧（12%）。至症状缓解的中位时间为37天（95% CI 35-39）。四分之一（25%）的SARS-CoV-2感染检测呈阳性的参与者在症状发作后8周或更长时间内出现持续症状。COVID-19在怀孕期间和怀孕后6周内具有长期和非特异性的病程。ClinicalTrials.gov，NCT 04323839。
Coronavirus disease 2019 (COVID-19) has a prolonged course in ambulatory pregnant patients. To describe the clinical presentation, symptomology, and disease course of coronavirus disease 2019 (COVID-19) in pregnancy. The PRIORITY (Pregnancy CoRonavIrus Outcomes RegIsTrY) study is an ongoing nationwide prospective cohort study of people in the United States who are pregnant or up to 6 weeks postpregnancy with known or suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We analyzed the clinical presentation and disease course of COVID-19 in participants who tested positive for SARS-CoV-2 infection and reported symptoms at the time of testing. Of 991 participants enrolled from March 22, 2020, until July 10, 2020, 736 had symptoms of COVID-19 at the time of testing; 594 tested positive for SARS-CoV-2 infection and 142 tested negative in this symptomatic group. Mean age was 31.3 years (SD 5.1), and 37% will nulliparous. Ninety-five percent were outpatients. Participants who tested positive for SARS-CoV-2-infection were a geographically diverse cohort: 34% from the Northeast, 25% from the West, 21% from the South, and 18% from the Midwest. Thirty-one percent of study participants were Latina, and 9% were Black. The average gestational age at enrollment was 24.1 weeks, and 13% of participants were enrolled after pregnancy. The most prevalent first symptoms in the cohort of patients who tested positive for SARS-CoV-2 infection were cough (20%), sore throat (16%), body aches (12%), and fever (12%). Median time to symptom resolution was 37 days (95% CI 35–39). One quarter (25%) of participants who tested positive for SARS-CoV-2 infection had persistent symptoms 8 or more weeks after symptom onset. COVID-19 has a prolonged and nonspecific disease course during pregnancy and in the 6 weeks after pregnancy. ClinicalTrials.gov, NCT04323839.