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Testing of Patients and Support Persons for Coronavirus Disease 2019 (COVID-19) Infection Before Scheduled Deliveries
Angela Bianco1, Ayisha B Buckley, Jessica Overbey
1Department of Obstetrics, Gynecology, and Reproductive Medicine, Icahn School of Medicine at Mount Sinai Hospital, New York, New York.
Insights
Universal COVID-19 testing revealed over 15% of asymptomatic pregnant patients and nearly 10% of their support persons tested positive for SARS-CoV-2. A significant portion of infected patients had infected support persons, highlighting testing
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic necessitated rapid adaptation of healthcare protocols, particularly in obstetric settings.
- Universal screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was implemented to mitigate transmission risks.
- The effectiveness of screening tools and the prevalence of infection in asymptomatic obstetric patients and their support persons required evaluation.
Purpose of the Study:
- To determine the rate of coronavirus disease 2019 (COVID-19) infection in an obstetric population undergoing universal testing.
- To assess the concordance and discordance rates of SARS-CoV-2 infection between obstetric patients and their support persons.
- To evaluate the predictive utility of a telephone screening tool for SARS-CoV-2 infection in this cohort.
Main Methods:
- An observational study was conducted involving scheduled deliveries within the Mount Sinai Health system.
- Pregnant patients and their designated support persons underwent telephone screening and SARS-CoV-2 testing prior to delivery.
- Data on infection rates, screening tool accuracy, and concordance among pairs were analyzed.
Main Results:
- 15.5% of asymptomatic pregnant patients tested positive for SARS-CoV-2.
- 9.6% of asymptomatic support persons tested positive for SARS-CoV-2.
- Discordance in testing results between patients and support persons occurred in 7.5% of pairs; 58% of infected patients had infected support persons.
Conclusions:
- Universal SARS-CoV-2 testing identified a significant prevalence of infection in asymptomatic obstetric patients and their support persons.
- Telephone screening tools demonstrated limited utility in predicting actual infection.
- Findings underscore the importance of testing both patients and support persons to inform obstetric and newborn care practices.
Objective:
To evaluate the rate of coronavirus disease 2019 (COVID-19) infection with the use of universal testing in our obstetric population presenting for scheduled deliveries, as well as the concordance or discordance rate among their support persons during the initial 2-week period of testing. Additionally, we assessed the utility of a screening tool in predicting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing results in our cohort.
Methods:
This was an observational study in which all women who were scheduled for a planned delivery within the Mount Sinai Health system from April 4 to April 15, 2020, were contacted and provided with an appointment for themselves as well as their support persons to undergo COVID-19 testing 1 day before their scheduled delivery. Both the patients and the support persons were administered a standardized screen specific for COVID-19 infection by telephone interview. Those support persons who screened positive were not permitted to attend the birth. All patients and screen-negative support persons underwent SARS-CoV-2 testing.
Results:
During the study period, 155 patients and 146 support persons underwent SARS-CoV-2 testing. The prevalence of asymptomatic COVID-19 infection was 15.5% (CI 9.8-21.2%) and 9.6% (CI 4.8-14.4%) among patients and support persons, respectively. The rate of discordance among tested pairs was 7.5%. Among patients with COVID-19 infection, 58% of their support persons also had infection; in patients without infection, fewer than 3.0% of their support persons had infection.
Conclusion:
We found that more than 15% of asymptomatic maternity patients tested positive for SARS-CoV-2 infection despite having screened negative with the use of a telephone screening tool. Additionally, 58% of their asymptomatic, screen-negative support persons also tested positive for SARS-CoV-2 infection. Alternatively, testing of the support persons of women who had tested negative for COVID-19 infection had a low yield for positive results. This has important implications for obstetric and newborn care practices as well as for health care professionals.
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