COVID-19 Evidence Alerts
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Current best evidence for clinical care (more info)

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Prognosis Oltean I, Tran J, Lawrence S, et al. Impact of SARS-CoV-2 on the clinical outcomes and placental pathology of pregnant women and their infants: A systematic review. Heliyon. 2021 Mar;7(3):e06393. doi: 10.1016/j.heliyon.2021.e06393. Epub 2021 Mar 2.

Pregnant women are susceptible to viral infections due to physiological changes such as cell-mediated immunity. No severe adverse pregnancy or neonatal outcomes have been consistently reported in 2019 novel coronavirus disease (COVID-19) positive pregnancy cases. There are controversies around the role of COVID-19 in pregnancy. A systematic review was conducted to examine clinical maternal and neonatal clinical outcomes. Studies were included if they reported SARS-CoV-2 infection among pregnant women and/or COVID-19 positive neonates as validated by positive antibody testing or viral testing using polymerase chain reaction. Case series, case reports, case-control studies, and comparative studies were included. Eight hundred and thirty-seven records were identified, resulting in 525 records for level I screening. Forty-one were included after full-text review. Results suggest elevated rates of intensive care unit (ICU) admission, gestational diabetes, preeclampsia, C-sections, pre-term birth, and C-reactive protein (CRP) in comparison to pregnant women without SARS-CoV-2. Careful monitoring of pregnancies with SARS-CoV-2 is recommended.

Discipline / Specialty Area Score
Infectious Disease
Pediatric Neonatology
Comments from MORE raters

Infectious Disease rater

This is a meta-analysis of pregnancy outcomes in the setting of SARS-CoV-2 infection. The majority of the reports are from Wuhan, China with a smattering from other countries. Most articles reviewed were case reports. Thus, it is very difficult to extract any meaning from this review other than narrative. Prospective studies are needed to assess the impact of SARS-CoV-2 on pregnancy outcomes.

Obstetrics rater

This is a useless systematic review. It's one of many so far and likely outdated already. I guess if you cannot enroll patients in a COVID registry, do a systematic review. None of these studies controlled for various issues that affect outcome independent of being infected.

Obstetrics rater

The result of this review are similar to previous reports apart from elevated C reactive protein and placental abnormalities. Monitoring of C reactive protein is a simple measure, but a non-specific marker.

Pediatric Neonatology rater

Another review of early not-very-good literature. It seems that pregnant women who are sick with this virus are sick. Small percentages have a myriad of complications. Even the "classic" ground glass CT finding is only in a small percentage of cases. I'm not sure how helpful this is.