Is there an association between COVID-19 infection and fetuses with mirror-image dextrocardia?

Abstract I am excited to write a letter to share our findings.Coronavirus disease (COVID-19) is an acute respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which belongs to the family of severe acute respiratory syndrome coronaviruses [1]. On December 7, 2022, the Chinese government lifted the restrictions on controlling the COVID-19 pandemic, which resulted in an explosive increase in the SARS-CoV-2 infection rate among the Chinese population. The self-reported infection rate, as determined from an online survey, reached its peak (15.5%) between December 19 and 21, 2022, with an estimated 82.4% of individuals in China being infected as of February 7, 2023 [2]. Mirror-image dextrocardia is rare, with varying incidence among studies and countries. According to the literature, the incidence ranges from 1/8,000 to 2,0000[3]. In our recent routine prenatal screening of fetuses, we found 4 cases of fetal mirror dextrocardia within just one month. And The last menstrual period of these pregnant women was in November 2022. Is there an association between COVID-19 infection and fetuses with mirror-image dextrocardia? Therefore, we conducted an epidemiological investigation to analyze the incidence of mirror-image dextrocardia in pregnant women and fetuses before and after the lifting of coronavirus disease (COVID-19) control measures in China on December 7, 2022.