Clinical and molecular epidemiological characteristics of SARS-CoV-2 infection in 352 pregnant and postpartum women at Changsha Maternal and Child Health Hospital
Clinical and molecular epidemiological characteristics of SARS-CoV-2 infection in 352 pregnant and postpartum women at Changsha Maternal and Child Health Hospital
Objective To understand the clinical characteristics and neonatal outcomes of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection among pregnant and postpartum women at Changsha Mater-nal and Child Health Hospital,Hunan province,and to analyze the molecular epidemiological characteristics of SARS-CoV-2.Methods The clinical data of pregnant women and newborns with a positive nucleic acid test of SARS-CoV-2 in Changsha Maternal and Child Health Hospital from December 8,2022 to January 7,2023 were collected.Whole-genome sequencing of SARS-CoV-2 was performed on positive samples using Nanopore third-generation sequencing.Sequence typing and comparative analysis were performed using the Nextclade web-site,and the phylogenetic tree was constructed using the neighbor-joining method by MEGA X software.Results A total of 993 pregnant women were treated in this study,of which 352 were positive for SARS-CoV-2,accounting for 35.45％.The peak incidence period was December 20,2022,with a positive rate of 93.75％(30/32).The average age of the infected women was(30.6±4.05)years old,and the average hospital stay was(3.88±2.41)days.A total of 341 cases of clinical symptoms were obtained,of which 81.52％(278/341)had a fever,67.74％(231/341)had a cough,and 49.85％(170/341)reported sore throat.Other symptoms included fatigue,myalgia,and headache,with 3.23％(11/341)exhibiting diarrhea.Two cases of severe pneumonia were treated successfully after transfer to specialized hospital.Among 326 SARS-CoV-2-positive pregnant women cases,there was no severe pneumonia,but the positive rate of the neonatal nucleic acid test was 3.37％(11/326),with a preterm birth rate of 10.43％(34/326).No maternal and neonatal deaths occurred,and the prognosis was good.The whole genome sequencing analysis showed that the eight strains were mainly in the BA.5.2 lineage,with phylogenetic analysis indicating distribution across multiple sub-branches and several transmission chains.Nucleotide site analysis showed 75-77 nucleotide mutation sites compared with the Wuhan reference strain,with a sequence homology of 99.6％.Amino acid sequence analy sis showed that the mutation sites occurred in ORF1a,ORF1b,ORF7a,and the S genes,including new mu-tation S371Y,T883I and D1146Y,and no recombinant strains were detected.Conclusion Clinical severe cases are not found among the pregnant and postpartum population at Changsha Maternal and Child Health Hos-pital,and the popular subtypes are common.
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