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Perinatal outcomes and vertical transmission by SARS-CoV2 infection (COVID-19) during pregnancy: systematic review and meta-analysis.
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  • Alvaro Sepulveda-Martinez,
  • Sergio Lopez,
  • Nicolas Riquelme,
  • Maria Carolina Silva,
  • Hernan Muñoz,
  • Mauro Parra-Cordero
Alvaro Sepulveda-Martinez
Hospital Clinico de la Universidad de Chile Jose Joaquin Aguirre
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Sergio Lopez
Hospital Clinico de la Universidad de Chile Jose Joaquin Aguirre
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Nicolas Riquelme
Hospital Barros Luco Trudeau
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Maria Carolina Silva
Hospital Clinico de la Universidad de Chile Jose Joaquin Aguirre
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Hernan Muñoz
Hospital Clinico de la Universidad de Chile Jose Joaquin Aguirre
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Mauro Parra-Cordero
University of Chile Hospital
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Abstract

Background: COVID-19 is a new pandemic disease with severe respiratory outcome. However, there is little evidence of this condition during pregnancy based on small case series reports. Objective: to perform a systematic review and meta-analysis of proportions of case series focused on maternal and perinatal outcomes of COVID-19 during pregnancy. Search strategy: LILACS and Medline were searched from inception until April 24th, 2020. Selection criteria: all case series or case control studies involving SARS-CoV2 infection during pregnancy and neonatal period were identified. Excluded were duplicated data, case reports of individual patients or without clinical data. Data collection and analysis: a total of 14 studies were included. When possible, pooled proportions with 95% confidence interval through a random effect model were estimated. Heterogeneity was estimated with the use of I2 statistics and Tau2 test. Main results: Most common symptoms were fever (58%; I2= 69%) and cough (33%; I2= 65%). A pathognomonic CT-Scan was observed in 92% of patients (I2= 0%). Lymphopenia and increased D-dimer were observed in 50% (I2= 82%), and 80% (I2= 0%) of patients at admission, respectively. There were no maternal deaths, with 2 cases of neonatal death, both with negative SARS-CoV2 PCR. Vertical transmission was observed in 5 neonates. Conclusions: This systematic review and meta-analysis confirms that COVID-19 during pregnancy is associated with good maternal and perinatal outcome. Evidence of vertical transmission should be confirmed with larger cohorts. Funding: none. Key words: meta-analysis, COVID-19, vertical transmission, perinatal outcome, pregnancy.