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The National Early Warning Score adapted to pregnancy in case of suspicion of COVID-19 infection: evaluation in a retrospective study.
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  • Louise Ghesquiere,
  • marc lambert,
  • cecile yelnik,
  • Mercé Jourdain,
  • Fanny Vuotto,
  • Damien Subtil,
  • Karine Faure,
  • Charles Garabedian
Louise Ghesquiere
CHRU Lille, hopital Jeanne-De-Flandre
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marc lambert
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cecile yelnik
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Mercé Jourdain
CHRU de Lille
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Fanny Vuotto
CHRU de Lille
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Damien Subtil
Jeanne De Flandre
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Karine Faure
CHRU de Lille
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Charles Garabedian
Jeanne De Flandre
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Abstract

Objective - Determine what is the best initial clinical score to evaluate and propose adequate management to pregnant women with suspicion of COVID-19 infection. Design – setting – population: Retrospective study in one center (Lille, France) from 15 March 2020 to 15 April 2020. Were included all pregnant consulting in our emergency center for a suspicion of COVID-19 infection. Methods – main outcome measures: Women had a clinical, radiologic and biologic first evaluation to adapt management at home or in hospitalization. The National Early Warning Score (NEWS) and the NEWS-PREG, which is an adaptation including trimester of pregnancy, were calculated in posteriori for each patient. Sensitivity, specificity, predictive positive and negative value of these scores to propose adequate management were calculated. Results: 63 women were included. Seventeen were hospitalized (27%) among 4 in intensive care (6,5%). Sensitivity, specificity, predictive positive value and predictive negative value to predict hospitalization of the NEWS were respectively 52.9%, 100%, 100% and 85.2%. There were respectively 82.4%, 93.5%, 82.4% and 93.4% for the NEWS-PREG. Areas under the curve to predict hospitalization of the two scores were 0.77 for the NEWS and 0.88 for the NEWS-PREG. No woman was readmitted or had to be transferred from conventionel hospitalization to intensive care within 48 hours of her initial assessment and orientation. Conclusion: The NEWS-PREG is an interesting initial clinical score which can be used in case of suspicion of COVID-19 infection to propose adequate management. It will be interesting to evaluate in a prospective study.