Universal Testing of COVID-19 Infection on a New Orleans, LA Labor and Delivery Unit.

Background: The greater New Orleans area emerged as an early epicenter of the COVID-19 pandemic, with one of the highest infection and death rates per capita in the United States.1 The first case of COVID-19 in an obstetric patient at Tulane Lakeside Hospital occurred on March 22, 2020. Given increasing concern for asymptomatic carriers, the labor and delivery unit implemented universal testing of all patients and their support partners starting on April 1, 2020.

Methods: A retrospective chart review of all obstetric encounters was performed to determine the incidence of COVID-19, characterize the natural history of COVID-19 and evaluate obstetric and neonatal outcomes.

Results: Over a 5 week period of universal testing, there were 12/254 (4.72%) confirmed cases of COVID-19; 58% of COVID-positive patients were asymptomatic. The majority of the symptomatic COVID-19 patients had a mild course of the infection, similar to results from a previous study.2 As of completion of the study period, only 4 COVID-19-positive patients delivered; all of them had uncomplicated intra- and postpartum courses. There was no evidence of vertical transmission of COVID-19.

Conclusion: These results confirm the asymptomatic carrier rate is high and support the case for universal testing in high prevalence cities. Ultimately, universal testing allows for a timely identification of disease, initiation of isolation and contact precautions and appropriate allocation of personal protective equipment (PPE).