New Testing Options and SARS-CoV-2 in Pregnancy

One of the most challenging aspects of the SARS-CoV-2 epidemic to date has been the difficulty in testing to determine the presence of infection. The currently available tests require a nasopharyngeal swab (obtained not from the front of the nose like a flu test, but much deeper). This test is uncomfortable for the patient and can only be performed by healthcare personnel with appropriate personal protective equipment (PPE) including mask and face shield. Yesterday, Rutgers University was granted emergency approval by the FDA for a newly developed test for the SARS-CoV-2 virus which uses saliva. If proven effective in trials that are underway now, this may provide a much-needed option for testing outpatients for SARS-CoV-2. Stay tuned for more on this!

A paper published yesterday in the New England Journal of Medicine reviewed admissions testing data for 215 pregnant women admitted to Labor and Delivery units in New York, all were screened for SARS-CoV-2. At the time of admission, 1.9% had fever or other symptoms of COVID-19, and all had positive tests for the SARS-CoV-2 virus. Of those without symptoms, 13.5% tested positive for the SARS-CoV-2 virus. So, 29 of 33 (88%) patients who tested positive for the SARS-CoV-2 virus had neither fever nor symptoms. On one hand, this is reassuring (only one patient was reported to develop symptoms felt due to COVID-19) because it would suggest that young pregnant women remain at low risk. On the other hand, one in eight women who delivered a baby in New York would have returned home with a newborn. We all know that babies are a lot of work and often grandparents want to help. This could lead to a disastrous spread of the SARS-CoV-2 virus in families.