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Follow-up study on the outcomes of recovered pregnant women who had previous COVID-19 during the first and second trimester: a retrospective cohort study
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  • Yin Zhao,
  • BangXing Huang,
  • Hui Ma,
  • You Shang,
  • Xiu Nie,
  • Li Zou
Yin Zhao
Union Hospital of TongJi Medical College of Huazhong University of Science and Techonology

Corresponding Author:zhaoyin@hust.edu.cn

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BangXing Huang
Union Hospital of TongJi Medical College of Huazhong University of Science and Techonolog
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Hui Ma
Union Hospital of TongJi Medical College of Huazhong University of Science and Techonolog
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You Shang
Union Hospital of TongJi Medical College of Huazhong University of Science and Techonolog
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Xiu Nie
Union Hospital of TongJi Medical College of Huazhong University of Science and Techonolog
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Li Zou
Huazhong University of Science and Technology Tongji Medical College
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Abstract

Objective: The research aimed to study the pregnancy outcomes and determine the safety of continued pregnancy until the third trimester after being infected with SARS-CoV-2 during early pregnancy. Design:Retrospective cohort study. Setting: Wuhan, Hubei, China.Population:Pregnant women in recovery who had a history of COVID-19 during early pregnancy at the Union Hospital from 15 Jan 2020 to 30 April 2020 were included. Methods:The clinical manifestation, laboratory examinations, treatment, pregnancy outcomes, maternal SARS-CoV-2 throat swab RT-PCR test results, and SARS-CoV-2 antibody tests in neonates were detected. The placental pathology, ACE2 expression and SARS-CoV-2 presence was also studied. Main outcome measures: Maternal and neonatal clinical and laboratory status. Results: We included cases in our study. Three cases were diagnosed with COVID-19 during early pregnancy (Case A to C), and two cases were serum IgG positive asymptomatic cases (Case D and E). Case A showed complete recovery after severe COVID-19. Case C was infected at 6 weeks during the first trimester and had induced medical abortion at 12 weeks. No pneumonia was found in all neonates, the nucleic acid test and serum IgM were negative, and IgG were positive. All placental samples were negative for SARS-CoV-2 nucleic acid test. Infants followed-up at 1-3 months were healthy and asymptomatic. Placental pathology showed chronic ischemia performance.Conclusions COVID-19 during pregnancy did not significantly affect pregnancy outcomes. No adverse outcomes were observed in all the neonates. The inflammatory state of COVID-19 may cause placental injury. The placenta does not appear be a target organ for SARS-CoV-2.