COVID severity doesn't depend on trimester of pregnancy, research shows
The severity of COVID-19 does not change based on pregnancy trimester, finds research presented today at the Society for Maternal-Fetal Medicine's (SMFM's) virtual annual meeting.
According to an abstract published Jan 1 in the American Journal of Obstetrics & Gynecology (AJOG), the research team studied the outcomes of 1,092 pregnant COVID-19 patients who delivered at a Dallas hospital from Mar 18, 2020, to May 31, 2021.
Among them, 66 (6%) women were diagnosed in their first trimester, while 309 (28%) tested positive in their second trimester, and 716 (66%) were diagnosed in their third trimester. The groups had similar demographic characteristics; 87% were Hispanic.
Of patients hospitalized within 14 days of their COVID-19 diagnosis, 2 (15%) in their first trimester, 16 (47%) in their second trimester, and 24 (5%) in their third trimester were admitted for treatment of COVID-19.
Across trimesters, 90.9% of women had no or mild COVID-19 symptoms, and 10.1% who were initially asymptomatic developed moderate, severe, or critical symptoms. Of patients who were initially asymptomatic or had mild symptoms, 2 of 62 (3.2%) first-, 15/295 (5.1%) second-, and 36/689 (5.2%) third-trimester patients later developed moderate, severe, or critical illness.
"Regardless of what trimester they are in, pregnant people are at risk of developing severe COVID illness," lead author Rachel Schell, MD, of the University of Texas Southwestern Medical Center in Dallas, said in an SMFM news release.
The authors noted that previous studies have shown that pregnant women infected with COVID-19 are at elevated risk for hospitalization, ventilation, and death relative to their uninfected peers.
Senior author Emily Adhikari, MD, also of the University of Texas, said that the findings are helpful for clinicians counseling pregnant women who test positive for COVID-19. "There is no reason to be hesitant to get vaccinated because you are early in your pregnancy," she said. "You’re still at risk of getting really sick from COVID in your first trimester."
Noting that COVID-19 vaccines are safe and effective, SMFM, the Centers for Disease Control and Prevention (CDC), and the American College of Obstetricians and Gynecologists recommend that all pregnant women be vaccinated against COVID-19.
Jan 1 AJOG abstract
Feb 3 SMFM news release
Strokes most likely to occur within 3 days of COVID-19 diagnosis in seniors
Among older adults, the risk of stroke is highest within 3 days of COVID-19 diagnosis, and a new scoring system could help predict the risk of stroke, according to preliminary research presented at the International Stroke Conference 2022 this week.
The research was based on examining the health records of 37,379 Medicare beneficiaries ages 65 and older who were diagnosed with COVID-19 between Apr 1, 2020 and Feb 28, 2021 and were hospitalized for stroke from Jan 1, 2019 through Feb 28, 2021. Strokes occurring 7 days before diagnosis or 28 days after served as the control period.
The average age of patients was 80 years old, 57% were women, and more than 75% were white.
Stroke risk was greatest within 3 days of COVID-19 diagnosis and was 10 times higher than the control group. The lowest stroke risk occurred after 15 to 28 days, when the risk of stroke was still 9% higher than during the control period.
"These findings can inform diagnosis, treatment and care of stroke among patients with COVID-19," Quanhe Yang, PhD, lead study author and senior scientist in the Division for Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention, said in a press release on the findings. "Further studies are needed to clarify the age-dependent risk of stroke associated with COVID-19."
Feb 3 American Heart Association press release
Minnesota adds congenital CMV to newborn screening program
Paving the way for Minnesota to become the first state to add congenital cytomegalovirus (cCMV) to its newborn screening program, state health commissioner Jan Malcolm recently accepted a recommendation from an advisory panel and signed an order to begin steps to implement the process.
Passed from pregnant women to their unborn babies, cCMV is the most common viral infection in newborns, affecting an estimated 290 of 65,000 babies born in Minnesota each year, the Minnesota Department of Health (MDH) said yesterday in a press release. About 10% have symptoms, which can include small head, jaundice, and enlarged liver and spleen. Affected children are at risk for intellectual and physical disabilities, including hearing loss.
Of babies with asymptomatic infections, 10% are at risk for permanent hearing loss. However, early identification and intervention can lessen the impact.
Unlike other newborn screening tests that rely on dried bloodspots from infants, there isn't yet a validated test for cCMV screening, and health officials said it will be a number of months before screening begins in Minnesota.
Malcolm thanked the advisory committee and work groups for laying the foundation for adding cCMV screening. "Future generations of Minnesota’s children and families will be healthier thanks to their work."
Feb 2 MDH press release
CDC winds down imported onion Salmonella investigation after 1,040 cases
The US Centers for Disease Control and Prevention (CDC) yesterday said a Salmonella Oranienburg outbreak linked to onions imported from Mexico is over, with 148 more cases added to the total since its last update on Nov 16.
Overall, the CDC reported 1,040 cases from 39 states, plus Puerto Rico and the District of Colombia. Of people with available information, 260 were hospitalized, and no deaths were reported. The latest illness onset was Jan 1.
In interviews with 407 people who were sick, 72% reported eating or maybe eating raw onions or dishes with raw onions before their symptoms began.
Traceback investigations have found that the illnesses were linked to whole red, white, and purple onions distributed by ProSource Produce. The Food and Drug Administration (FDA) also determined that Keeler Family Farms was an onion supplier for restaurants where sick people ate. The whole fresh onions were sourced from Chihuahua state in Mexico.
Feb 2 CDC final outbreak update