Screening and Testing Pregnant Patients for SARS-CoV-2: First Wave Experience of a Designated COVID-19 Hospitalization Centre in Montreal

Abstract Objective Coronavirus Disease 2019 (COVID-19) may present asymptomatically in a large proportion of cases in endemic areas. Accordingly, universal testing has been suggested as a potential strategy for reducing transmission in the obstetrical setting. We describe the clinical characteristics of patients who tested positive for Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) during pregnancy at a designated COVID-19 hospitalization centre in Montreal, Quebec. Methods A single-centre retrospective cohort was constructed to include all pregnant patients who tested positive for SARS-CoV-2 between March 22 and July 31, 2020, and received care at the Jewish General Hospital. Initially, testing was restricted to at-risk patients, identified through the use of a screening questionnaire. Beginning on May 15, 2020, universal testing was implemented, and all pregnant patients admitted to hospital were tested. Data were collected through chart review. Results Of 803 patients tested for SARS-CoV-2 during the study period, 41 (5%) tested positive. Among those patients who were symptomatic, the most commonly reported symptoms were cough (53%), fever (37%), dyspnea (30%), and anosmia and/or ageusia (20%). Prior to the implementation of universal testing, 13% (3/24) of patients with SARS-CoV-2 were asymptomatic. Following the implementation of universal testing, 80% (8/10) of patients with SARS-CoV-2 were asymptomatic. Conclusion Our findings suggest that most pregnant patients with SARS-CoV-2 are asymptomatic or have mild symptoms of COVID-19. Particularly in endemic areas, universal testing of pregnant patients presenting to hospital should be strongly considered as an important measure to prevent in-hospital and community transmission of COVID-19.