A Spanish-translated clinical algorithm for management of suspected SARS-CoV-2 infection in pregnant women
Authors: Raigam J Martinez-Portilla, Anna Goncé, Ameth Hawkins-Villarreal, Francesc Figueras
Journal: The Lancet Infectious Diseases (2020)

With interest, we read the guidelines by Guillaume Favre and colleagues1Favre G Pomar L Qi X Nielsen-Saines K Musso D Baud D Guidelines for pregnant women with suspected SARS-CoV-2 infection.Lancet Infect Dis. 2020; (published online March 3.)https://doi.org/10.1016/S1473-3099(20)30157-2Summary Full Text Full Text PDF Scopus (155) Google Scholar on the management of pregnant women with suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We found the Correspondence and the proposed algorithm very helpful as we face the early and late phases of the coronavirus disease 2019 (COVID-19) pandemic worldwide. The clinical algorithm proposed by Favre and colleagues has provided us with a clear and understandable way of guiding our clinical practice. Recently, the US Centers for Disease Control and Prevention (CDC) provided recommendations for breastfeeding in special circumstances, specifically for COVID-19. The CDC suggests washing hands before touching the baby; wearing a face mask, if possible, while feeding at the breast; washing hands before touching the pump or bottle parts; and cleaning all parts after each use.2US CDCCoronavirus disease (COVID-19) and breatfeeding.https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/covid-19-and-breastfeeding.htmlDate: March 18, 2020Date accessed: March 23, 2020Google Scholar We think women should be permitted to breastfeed, if possible, unless future evidence suggests otherwise. Also, we believe the recommendation to use betamethasone for fetal lung maturation should be updated since many Latin American countries only have the option of using dexamethasone, which has been shown to be as effective as betamethasone.3Brownfoot FC Gagliardi DI Bain E Middleton P Crowther CA Different corticosteroids and regimens for accelerating fetal lung maturation for women at risk of preterm birth.Cochrane Database Syst Rev. 2013; 8CD006764PubMed Google Scholar No standardised guidelines for treating pregnant woman with SARS-CoV-2 infection are currently available in Spanish, a language with 537 million native speakers worldwide.4Eberhard DM Simons GF Fennig CD Ethnologue: languages of the world.23rd edn. SIL International, Dallas, TX2020https://www.ethnologue.com/guides/ethnologue200Date accessed: March 23, 2020Google Scholar Thus, we feel there is an urgent need to share the valuable information provided by Favre and colleagues to all countries where SARS-CoV-2 is spreading, especially Latin America. We feel this algorithm can be adequately adapted to Spanish-speaking countries where such information is urgently needed. Therefore, we propose a translated algorithm for Spanish-speaking countries (appendix). We also suggest that the new breastfeeding recommendations and the option to use dexamethasone as an alternative to betamethasone are adopted in Latin America. This information can be valuable for clinical practice as SARS-CoV-2 is spreading rapidly not only in Latin America but worldwide. We declare no competing interests. Download .pdf (.1 MB) Help with pdf files Supplementary appendix Guidelines for pregnant women with suspected SARS-CoV-2 infectionCoronaviruses responsible for severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) can cause severe adverse pregnancy outcomes, such as miscarriage, premature delivery, intrauterine growth restriction, and maternal death.1,2 Vertical transmission of the virus responsible for 2019 novel coronavirus disease (COVID-19), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has not yet been detected, whereas perinatal transmission has been suspected in one case. Full-Text PDF