OBJECTIVE: The aim of this study was to describe baseline characteristics of a cohort of pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and determine if these correlate with disease severity and perinatal outcomes . STUDY

DESIGN: This was a retrospective cohort trial conducted at the University of Texas Medical Branch Galveston, Texas . All pregnant women presented to our medical center, who were screened and tested positive for SARS-CoV-2 virus, were included . We stratified our study population in three groups: asymptomatic, symptomatic not requiring oxygen therapy, and patients requiring oxygen support to maintain oxygen saturation> 94% . Relevant population characteristics, laboratory data, and maternal and neonatal outcomes were abstracted . A p-value <0.05 was considered statistically significant .

RESULTS: Between March and July 2020 , 91 women tested positive for SARS-CoV-2 upon admission to our labor and delivery unit . Among these , 61.5% were asymptomatic , 34.1% were symptomatic, and 4.4% required oxygen support . Our population was mainly Hispanic (80.2 %), multiparous (76.9 %), obese (70.3 %), and with a median age of 27 years . Median gestational age at symptom onset or diagnosis was 36 weeks . Significant differences were found between gestational age and disease severity . Maternal characteristics including age, body mass index (BMI), and presence of comorbid conditions did not appear to influence severity of SARS-CoV-2 infection . Significant laboratory findings associated with increasing disease severity included decreasing hemoglobin and white blood cell count, lymphopenia, and increasing levels of inflammatory markers including CRP, ferritin, and procalcitonin . Maternal and neonatal outcomes did not differ among groups . No SARS-CoV-2 was detected by polymerase chain reaction testing in neonates of mothers with COVID-19 .

CONCLUSION: Pregnant patients with COVID-19 infection are predominantly asymptomatic . Patients appear to be at increased risk for more severe infection requiring oxygen support later in pregnancy .

KEY POINTS: · The majority of pregnant patients with COVID-19 are asymptomatic and <1 in 20 require oxygen support .. · Women in the later stages of pregnancy may be at increased risk for severe infection .. · Anemia, leukopenia, CRP, ferritin, and procalcitonin are associated with increasing severity ..