7, 8 Although initial reports of pregnant women infected with COVID-19 in the third trimester raised a concern for an increased risk for premature delivery, 9, 10 recent larger cohorts of 116 women in China and 427 women in the United Kingdom suggest that pregnant women are not at an increased risk of spontaneous abortion or spontaneous preterm birth but have higher rates of cesarean delivery (CD). The first and third trimesters of pregnancy can be considered periods of increased inflammatory activity, whereas the second trimester is a period of overall decreased immune activity. Pregnant patients are a potentially vulnerable group to COVID-19 infection. 6 However, the effects of COVID-19 on pregnancy and the fetus are still largely unknown because of the recent nature of the outbreak. The presence of COVID-19 infection in a pregnant patient raises concerns given that infections with other coronaviruses such as SARS and MERS have been associated with severe maternal and neonatal morbidity and mortality and adverse pregnancy outcomes including miscarriage, preterm birth, and stillbirth. There is evidence of SARS-CoV-2 vertical transmission when the infection occurs in the third trimester of pregnancy. 3, 4 Case fatality rates range from 1% to 2%, which is substantially less than the case fatality rates for other coronavirus infections including the severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) (10% and 35%, respectively). 2 After 2 to 7 days of incubation, most symptomatic patients typically experience fever, cough, or loss of taste or smell, with some cases developing into life-threatening pneumonia and acute respiratory distress syndrome. Although there are many coronaviruses, the particular coronavirus that is responsible for this pandemic is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Coronaviruses are single-stranded RNA viruses. 1 As of June 1, 2020, there have been more than 6,300,000 confirmed cases and more than 370,000 deaths worldwide. The coronavirus disease 2019 (COVID-19) has spread from isolated cases of pneumonia in Wuhan, Hubei province, China, to become a worldwide pandemic as declared by the World Health Organization on March 11, 2020.

S and s transmission