《LANCET,2月6日,2019-nCoV epidemic: what about pregnancies?》

  • 来源专题:COVID-19科研动态监测
  • 编译者: xuwenwhlib
  • 发布时间:2020-02-07
  • 2019-nCoV epidemic: what about pregnancies?

    Guillaume Favre,Léo Pomar,Didier Musso,David Baud

    Published:February 06, 2020

    DOI:https://doi.org/10.1016/S0140-6736(20)30311-1

    On Feb 3, 2020, WHO confirmed 17?238 cases of novel coronavirus (2019-nCoV) infections in China. Among them, 2296 (13%) cases were reported as severe, and 361 deaths were declared (2%).1

    Members of the coronavirus family responsible for severe acute respiratory syndrome (SARS-CoV) and Middle East respiratory syndrome (MERS-CoV) are known to be responsible for severe complications during pregnancy.2, 3

    12 pregnant women were infected with SARS-CoV during the 2002–03 pandemic.2 Four (57%) of seven women in the first trimester had a miscarriage. In the second to third trimester, two (40%) of five women had fetal growth restriction, and four (80%) of five women had preterm birth (one spontaneous; three induced for maternal condition). Three (25%) women died during pregnancy.

    In a review of 11 pregnant women infected with MERS-CoV,3 ten (91%) presented with adverse outcomes, six (55%) neonates required admission to the intensive care unit, and three (27%) died. Two neonates were delivered prematurely for severe maternal respiratory failure.

    Considering that the 2019-nCoV seems to have a similar pathogenic potential as SARS-CoV and MERS-CoV,4 pregnant women are at increased risk of severe infections, there are no specific clinical signs of coronavirus infections preceding severe complications,5 coronaviruses have the potential to cause severe maternal or perinatal adverse outcomes, or both,2, 3 and the current lack of data on the consequences of a 2019-nCoV infection during pregnancy, we recommend systematic screening of any suspected 2019-nCoV infection during pregnancy. If 2019-nCoV infection during pregnancy is confirmed, extended follow-up should be recommended for mothers and their fetuses.

  • 原文来源:https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30311-1/fulltext
相关报告
  • 《LANCET,2月6日,2019-nCoV in context: lessons learned?》

    • 来源专题:COVID-19科研动态监测
    • 编译者:xuwenwhlib
    • 发布时间:2020-02-07
    • 2019-nCoV in context: lessons learned? Richard A Kock,William B Karesh,Francisco Veas,Thirumalaisamy P Velavan,David,Simons,Leonard E G Mboera,Osman Dar,Liã Bárbara Arruda,Alimuddin Zumla Published:February 06, 2020 DOI:https://doi.org/10.1016/S2542-5196(20)30035-8 The emergence of a new coronavirus (2019-nCoV) in Wuhan creates a sense of déjà vu with the severe acute respiratory syndrome coronavirus (SARS-CoV) epidemic in China in 2003. Coronaviruses are enveloped, positive-stranded RNA viruses of mammals and birds. These viruses have high mutation and gene recombination rates, making them ideal for pathogen evolution.1 In humans, coronavirus is usually associated with mild disease, the common cold. Previous emerging novel coronaviruses, such as SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV), which emerged in the Middle East in 2012, were associated with severe and sometimes fatal disease. MERS-CoV was less pathogenic than SARS-CoV, with the most severe infections mainly in individuals with underlying illnesses. Clinically and epidemiologically, the contemporary 2019-nCoV in China seems to resemble SARS-CoV. The genome of 2019-nCoV also appears most closely related to SARS-CoV and related bat coronaviruses.2 The infection has now spread widely, with phylogenetic analysis of the emerging viruses suggesting an initial single-locus zoonotic spillover event in November, 2019,3 and subsequent human-to-human transmission. The SARS epidemic in 2003 was followed soon after by avian influenza H5N1 in 2006, centred on the Asian continent and Middle East. Other surprising viral zoonoses that have caused serious disease include Nipah encephalitic virus in pigs and humans in southeast and south Asia in 1999–2014, and large-scale Ebola virus epidemics in 2014–16 and 2018–19 in west and central Africa. Taken together, these events ring alarm bells about disease emergence in the 21st century, and the importance of human diseases originating from indiscriminate contacts with infected animals.
  • 《LANCET,2月8日,What to do next to control the 2019-nCoV epidemic?》

    • 来源专题:COVID-19科研动态监测
    • 编译者:zhangmin
    • 发布时间:2020-02-07
    • What to do next to control the 2019-nCoV epidemic? Fu-Sheng Wang, Chao Zhang Published:February 08, 2020DOI:https://doi.org/10.1016/S0140-6736(20)30300-7 The 2019 novel coronavirus (2019-nCoV) infection can lead to acute resolved or fatal pneumonia. On the basis of knowledge of other coronaviruses, the main route of human-to-human transmission of 2019-nCoV is probably through respiratory droplets. As of Feb 4, 2020, statistical data show that the outbreak constitutes an epidemic threat in China, where the exponential increase in patients has reached 20?438 confirmed cases, with 2788 (13·64%) patients in critical condition and 425 (2·08%) deaths; 23?214 additional suspected cases have also been identified so far. The most affected city, Wuhan, and related regions in Hubei province of China have reported 13?522 confirmed patients (66·16% of total cases) and 414 deaths from 2019 nCoV infection (97·41% of total deaths in China). 632 patients with confirmed infection have recovered and have been discharged from hospital. However, the downward turning point for new cases of infection has not been observed yet (figure). Notably, 159 confirmed cases have been reported in 23 other countries beyond China, including Japan, Thailand, Singapore, South Korea, Australia, the USA, Malaysia, and Germany. Because of the seriousness of this outbreak, WHO declared it a public health emergency of international concern on Jan 30, 2020, followed by the USA announcing a public health emergency on Jan 31, 2020.