Abstract
BackgroundAsymptomatic carriage of COVID-19 in pregnant women has been reported and could lead to outbreaks in maternity units. We sought to ascertain the impact of rapid isothernal nucleic acid based testing for COVID-19 in an unselected cohort of pregnant women attending our maternity unit. We also assessed the correlation between community prevalence and asymptomatic carriage.MethodsData for the retrospective cohort study were collected from a large UK tertiary maternity unit over a 4-week period using computerised hospital records. Literature searches were performed across multiple repositories. COVID-19 prevalence was extracted from online repositories.ResultsNasopharyngeal and oropharyngeal swabs were obtained from 457/465 (98%) women during the study period. The median turnaround time for results was 5.3 h (interquartile range (IQR) 2.6–8.9 h), with 92% of the results returned within 24 h. In our cohort, only one woman tested positive, giving a screen positive rate of 0.22% (1/457; 95% CI: 0.04–1.23%). One woman who tested negative developed a fever postnatally following discharge but was lost to follow-up. From our literature review, we did not find any correlation between asymptomatic carriage in pregnant women and the reported regional prevalence of COVID-19.ConclusionsTesting using the SAMBA-II machine was acceptable to the vast majority of pregnant women requiring admission and had a low turnaround time. Asymptomatic carriage is low, but not correlated to community prevalence rates. Screening pregnant women on admission will remain an important component in order to minimise nosocomial infection.
Highlights
Asymptomatic carriage of COVID-19 in pregnant women has been reported and could lead to outbreaks in maternity units
The World Health Organization (WHO) characterized Coronavirus disease 2019 (COVID-19) as a global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in March 2020 [1]
Asymptomatic carriage of COVID-19 was estimated to be 15% in general population [7] and Sutton et al [8] reported that positive rate of 13.7% (29/210) among asymptomatic group and 87.9% (29/33) of pregnant women infected with SARS-CoV-2 were asymptomatic at presentation
Summary
Asymptomatic carriage of COVID-19 in pregnant women has been reported and could lead to outbreaks in maternity units. COVID-19 often takes a prolonged disease course with viral load in throat and nose declining after the first week as antibody titres rise [5]. This can result in nucleic acid testing becoming negative after the first week, though neutralisation and SARSCoV-2 antibodies are readily detectable in most cases [6]. Asymptomatic carriage of COVID-19 was estimated to be 15% in general population [7] and Sutton et al [8] reported that positive rate of 13.7% (29/210) among asymptomatic group and 87.9% (29/33) of pregnant women infected with SARS-CoV-2 were asymptomatic at presentation. Identification of viral carriage could allow closer monitoring both during and after delivery, consideration of low molecular heparin for prophylaxis of venous thromboembolism, and longer term follow-up
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