Short‐term outcomes of pregnant women with convalescent COVID‐19 and factors associated with false‐negative polymerase chain reaction test: A prospective cohort study

Sahin, Orhan; Yildirmak, Taner; Karacalar, Serap; Aydın, Emine; Ciftci, Mehmet Ali; Bagci, Helin; Yildirim, Sukran; Emeklioglu, Cagdas; Balci, Burcu Gulsah; Genc, Simten; Cingillioglu, Basak; Mihmanli, Veli; Khalil, Asma; Kalafat, Erkan

AIM: To evaluate the clinical factors associated with false‐negative RT‐PCR results and to report the outcome of a cohort of pregnant women with COVID‐19. METHODS: This cohort study was conducted in a tertiary referral pandemic hospital and included 56 pregnant women. A study including pregnant women with either a laboratory or clinical diagnosis for COVID‐19 were included in the study. The primary outcome was clinical factors associated with false‐negative RT‐PCR results defined as a positive immunoglobulin M assessed by rapid testing in clinically diagnosed patients. Clinical outcomes of laboratory diagnosed patients were also reported. RESULTS: In total, 56 women with either RT‐PCR or clinical COVID‐19 diagnosis were included in the study. Forty‐three women either had RT‐PCR positivity or IgM positivity. The clinical outcome of these pregnancies was as follows: mean maternal age 27.7, immunoglobulin M positive patients 76.7%, RT‐PCR positive patients 55.8%, maternal comorbidities 11.5%, complications in patients below 20 weeks 34.8%, complications in patients above 20 weeks 65.1%, elevated CRP 83.7%, lymphopenia 30.2%, time from hospital admission to final follow‐up days 37 and stillbirth 8.3%. The proportion of women who tested positive for SARS‐CoV‐2 immunoglobulin M was 100% in the RT‐PCR positive group and 56.5% in the clinical diagnosis group (P = .002). The symptom onset to RT‐PCR testing interval longer than a week (risk ratio: 2.72, 95% CI: 1.14‐5.40, P = .003) and presence of dyspnoea (risk ratio: 0.38, 95% CI: 0.14‐0.89, P = .035) were associated with false‐negative RT‐PCR tests. The area under the curve of these parameters predicting false‐negative RT‐PCR was 0.73 (95% CI: 0.57‐0.89). CONCLUSIONS: Symptomatic women with a negative RT‐PCR should not be dismissed as potential COVID‐19 patients, especially in the presence of prolonged symptom onset‐test interval and in women without dyspnoea.