key: cord-0897208-b169vw1i authors: Cosma, Stefano; Borella, Fulvio; Carosso, Andrea; Sciarrone, Andrea; Cusato, Jessica; Corcione, Silvia; Mengozzi, Giulio; Preti, Mario; Katsaros, Dionyssios; Di Perri, Giovanni; Benedetto, Chiara title: The “scar” of a pandemic: cumulative incidence of COVID‐19 during the first trimester of pregnancy date: 2020-07-07 journal: J Med Virol DOI: 10.1002/jmv.26267 sha: c5b592c65e3be700d9d00047abd90e266e681def doc_id: 897208 cord_uid: b169vw1i Congenitally‐ or perinatally‐acquired viral infections can be harmful to the fetus but data are limited about prevalence and outcomes of COVID‐19 disease during the first trimester of pregnancy. We report epidemiologic data from a study investigating a cohort of women who became pregnant just before or during the COVID‐19 pandemic. We recruited 138 consecutive pregnant women attending for first trimester screening (11‐13 weeks of gestation) at Sant'Anna Hospital, Turin, Piedmont, Italy, during the plateau and the falling phase of the COVID‐19 epidemic curve. Patients were tested for SARS‐CoV‐2 IgM/IgG antibody levels and SARS‐CoV‐2 detection in sera and nasopharyngeal swab samples. COVID‐19 cumulative incidence during the first trimester was of 10.1% with high prevalence of asymptomatic patients (42.8%). Similar to the course of the disease in non pregnant adults, 80‐90% of infections were not severe. The prevalence of reported symptoms was four‐fold higher in SARS‐CoV‐2 positive patients (57%) than in those negative (13%) (p<0.001), suggesting that direct self‐testing should open doors to confirmatory testing for COVID‐19. Our findings support the need for COVID‐19 screening in early pregnancy in epidemic areas to plan materno‐fetal health surveillance programs. This article is protected by copyright. All rights reserved. On 31st December 2019, the World Health Organization (WHO) was informed of a cluster of pneumonia cases of unknown origin in Wuhan City, Hubei Province, China. Since then, and as of June 14, 2020, 7,789,024 cases of coronavirus disease 19 (COVID-19) have been reported with 430,173 deaths. Although there was a striking decrease in China a few weeks later, there was a rapid increase in other countries like Italy to more than 6000 per day as of the third week of March, 2020 [1] . As the disease spread, reports of the first cases of SARS-CoV-2 infection in pregnancy were documented [2, 3] but evidence is based only on a few hundred patients and mainly concerns the second and third trimester of pregnancy [4, 5] . Viral infections can be harmful to the fetus during the first trimester of pregnancy, and whether SARS-CoV-2 is one of them may worry obstetricians. SARS-CoV-2 is characterized by high infectivity and a substantial number of COVID-19 cases may be underdiagnosed [6] . Screening pregnant women has gained importance because of the high proportion of asymptomatic cases and because of the uncertainty about maternal and fetal outcomes related to COVID-19 [7] . The real prevalence of infection in early pregnancy remains to be defined, however. The combined use of virus-specific antibody detection for COVID-19 and nucleic acid testing not only reduces false-negative results of molecular testing but can also define previous and ongoing infection in a given population over a range of time [8] . The objective of this study was to evaluate the cumulative incidence of SARS-CoV-2 infection during the first trimester of pregnancy in a highly endemic region in northern Italy. Twelve week pregnant women attending Sant'Anna Hospital, Piedmont Region, Turin, Italy for fetal nuchal translucency measurement between April 16 and June 4, 2020 were invited to participate in the study. Blood tests for the detection of IgG/IgM non neutralizing The results for quantitative variables are expressed as the mean ± standard deviation (SD) and qualitative categorical variables are expressed as frequency and percentages. Quantitative variables were compared using the t-test based on normal distribution. Qualitative variables were compared using the chi-square test or Fisher's exact test, as appropriate. Statistical analyses were performed by SAS software ver. 9.4 for Windows (SAS Institute, Carey, NC, USA). A total of 138 women in the first trimester of pregnancy, attending our Institute, were County Level COVID-19 Tracking Map Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records Pre-labor anorectal swab for SARS-CoV-2 in COVID-19 patients: is it time to think about it? Coronavirus disease 2019 in pregnant women: a report based on 116 cases Clinical analysis of ten pregnant women with COVID-19 China: A retrospective study Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship Universal Screening for SARS-CoV-2 in Women Admitted for Delivery Antibody responses to SARS-CoV-2 in patients with COVID-19 COVID-19) Daily Data Summary. NYC Department of Health and Mental Hygiene This article is protected by copyright. All rights reserved.