Incidence and Clinical Characteristics of and Risk Factors for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection Among Pregnant Individuals in the United States
Incidence and Clinical Characteristics of and Risk Factors for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection Among Pregnant Individuals in the United States
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DOI：
10.1093/cid/ciab713
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发表时间：
2021-10-25
影响因子：
11.8
通讯作者：
Stockwell, Melissa S.
中科院分区：
文献类型：
--
作者：
Dawood, Fatimah S.;Varner, Michael;Stockwell, Melissa S.
背景需要有关孕妇感染严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）风险的数据，以便为该人群提供感染预防指导和咨询。方法：在2020年8月至2021年3月期间，我们在美国3个地点前瞻性地随访了一组孕妇。三个主要结局是在SARS-CoV-2流行期间妊娠期间任何SARS-CoV-2感染、有症状感染和无症状感染的发生率。参与者每周自行收集中鼻甲拭子进行SARS-CoV-2逆转录聚合酶链反应测试，每周完成疾病症状问卷调查，并提交额外的2019冠状病毒病（COVID-19）样症状拭子。计算各州育龄妇女人口数量加权后的总体SARS-CoV-2感染发病率。结果在平均随访10周的1098名孕妇中，9%（99/1098）在研究期间感染了SARS-CoV-2。任何感染的SARS-CoV-2感染的人口加权发病率为10.0 / 1000（95%可信区间为5.7-14.3）人周，有症状感染为5.7 / 1000(1.7-9.7)，无症状感染为3.5 / 1000（0-7.1）。在96名有SARS-CoV-2感染和症状资料的参与者中，最常见的症状是鼻塞（72%）、咳嗽（64%）、头痛（59%）和味觉或嗅觉改变（54%）；28%有发热或主观发热。中位症状持续时间为10天（四分位数范围6-16）。结论本研究中的孕妇每周感染SARS-CoV-2的风险为1%，这强调了在SARS-CoV-2在社区传播的情况下，怀孕期间接种COVID-19疫苗和其他预防措施的重要性。在2020年8月至2021年3月期间，美国3个地点孕妇中SARS-CoV-2感染的发病率为10.0 / 1000，相当于每周感染风险为1%。无症状感染者占35%。
Background Data about the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among pregnant individuals are needed to inform infection-prevention guidance and counseling for this population. Methods We prospectively followed a cohort of pregnant individuals during August 2020-March 2021 at 3 US sites. The 3 primary outcomes were incidence rates of any SARS-CoV-2 infection, symptomatic infection, and asymptomatic infection, during pregnancy during periods of SARS-CoV-2 circulation. Participants self-collected weekly midturbinate nasal swabs for SARS-CoV-2 reverse transcription-polymerase chain reaction testing, completed weekly illness symptom questionnaires, and submitted additional swabs with coronavirus disease 2019 (COVID-19)-like symptoms. An overall SARS-CoV-2 infection incidence rate weighted by population counts of women of reproductive age in each state was calculated. Results Among 1098 pregnant individuals followed for a mean of 10 weeks, 9% (99/1098) had SARS-CoV-2 infections during the study. Population-weighted incidence rates of SARS-CoV-2 infection were 10.0 per 1000 (95% confidence interval, 5.7-14.3) person-weeks for any infection, 5.7 per 1000 (1.7-9.7) for symptomatic infections, and 3.5 per 1000 (0-7.1) for asymptomatic infections. Among 96 participants with SARS-CoV-2 infections and symptom data, the most common symptoms were nasal congestion (72%), cough (64%), headache (59%), and change in taste or smell (54%); 28% had measured or subjective fever. Median symptom duration was 10 (interquartile range, 6-16) days. Conclusions Pregnant individuals in this study had a 1% risk of SARS-CoV-2 infection per week, underscoring the importance of COVID-19 vaccination and other prevention measures during pregnancy while SARS-CoV-2 is circulating in the community.During August 2020-March 2021, the incidence rate of SARS-CoV-2 infection among pregnant individuals at 3 US sites was 10.0 per 1000, equating to a 1% risk of infection per week. The asymptomatic fraction of infection was 35%.