Consider pregnancy in COVID-19 therapeutic drug and vaccine trials

Whitehead, Clare; Walker, Susan

doi:10.1016/s0140-6736(20)31029-1

Cited by 88 publications

(95 citation statements)

References 3 publications

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“…Pregnant women are highly vulnerable to emerging diseases such as COVID-19 due to alterations in the immune system and other physiological systems that are associated with pregnancy. Therefore, in the event of successful vaccine development, pregnant women will not get access to the vaccines ( 361 ). Hence, it is recommended that pregnant women be included in the ongoing vaccine trials, since successful vaccination in pregnancy will protect the mother, fetus, and newborn.…”

Section: Vaccines Therapeutics and Drugsmentioning

confidence: 99%

Coronavirus Disease 2019–COVID-19

et al. 2020

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SUMMARY In recent decades, several new diseases have emerged in different geographical areas, with pathogens including Ebola virus, Zika virus, Nipah virus, and coronaviruses (CoVs). Recently, a new type of viral infection emerged in Wuhan City, China, and initial genomic sequencing data of this virus do not match with previously sequenced CoVs, suggesting a novel CoV strain (2019-nCoV), which has now been termed severe acute respiratory syndrome CoV-2 (SARS-CoV-2). Although coronavirus disease 2019 (COVID-19) is suspected to originate from an animal host (zoonotic origin) followed by human-to-human transmission, the possibility of other routes should not be ruled out. Compared to diseases caused by previously known human CoVs, COVID-19 shows less severe pathogenesis but higher transmission competence, as is evident from the continuously increasing number of confirmed cases globally. Compared to other emerging viruses, such as Ebola virus, avian H7N9, SARS-CoV, and Middle East respiratory syndrome coronavirus (MERS-CoV), SARS-CoV-2 has shown relatively low pathogenicity and moderate transmissibility. Codon usage studies suggest that this novel virus has been transferred from an animal source, such as bats. Early diagnosis by real-time PCR and next-generation sequencing has facilitated the identification of the pathogen at an early stage. Since no antiviral drug or vaccine exists to treat or prevent SARS-CoV-2, potential therapeutic strategies that are currently being evaluated predominantly stem from previous experience with treating SARS-CoV, MERS-CoV, and other emerging viral diseases. In this review, we address epidemiological, diagnostic, clinical, and therapeutic aspects, including perspectives of vaccines and preventive measures that have already been globally recommended to counter this pandemic virus.

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Section: Vaccines Therapeutics and Drugsmentioning

confidence: 99%

Coronavirus Disease 2019–COVID-19

et al. 2020

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“…Testing treatments is problematic because pregnant women are excluded from most trials. 254 It is known that azithromycin doubles innate IFN production from virus-infected lung cells. 255 It is safe for all trimesters of pregnancy 256 and has been shown effective in highquality clinical trials of virus-induced lung disease.…”

Section: Are There Specific Treatments For Pregnant Women In Case Omentioning

confidence: 99%

A compendium answering 150 questions on COVID‐19 and SARS‐CoV‐2

Riggioni

Comberiati

Giovannini

et al. 2020

Allergy

128

130

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In December 2019, China reported the first cases of the coronavirus disease 2019 (COVID-19). This disease, caused by the severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2), has developed into a pandemic. To date, it has resulted in ~9 million confirmed cases and caused almost 500 000 related deaths worldwide. Unequivocally, the COVID-19 pandemic is the gravest health and socioeconomic crisis of our time. In this context, numerous questions have emerged in demand of basic scientific information and evidence-based medical advice on SARS-CoV-2 and COVID-19. Although the majority of the patients show a very mild, self-limiting viral respiratory disease, many clinical manifestations in severe patients are unique to COVID-19, such as severe lymphopenia and eosinopenia, extensive pneumonia, a "cytokine storm" leading to acute respiratory distress syndrome, endothelitis, | 2505 RIGGIONI et al.

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“…For policymakers to make informed decisions about immunisation programmes, reliable data are essential. It is therefore vital that pregnant women are included in immunisation trials, yet they are often systematically excluded ( 77 ). A recent media report suggested that the first two COVID-19 vaccines to enter large-scale testing in the US will not include pregnant women ( 78 ), similarly pregnant women or those planning to become pregnant are currently excluded from both national vaccine trials in the UK ( 79 ).…”

Section: Lessons Learnedmentioning

confidence: 99%

Lessons learned from the A (H1N1) influenza pandemic

Vousden

Knight

2021

Best Practice & Research Clinical Obstetrics & Gynaecol

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Influenza in pregnancy is a common condition that is associated with increased risk of hospital admission. Women with comorbidities are at greater risk of severe outcomes. There are substantial gaps in our knowledge of the impact of severe influenza on perinatal outcomes, especially in low and middle-income countries, but preterm birth, fetal death, infant respiratory infection and hospital admission may be increased. Thus, influenza is major burden on health services. Immunisation is cost-effective, safe and effective at preventing influenza in pregnant women and their infants but policies and uptake vary worldwide. Operational challenges and concern over the safety, efficacy and necessity of the immunisation are common and there is a lack of evidence on how to overcome these barriers. This review identifies learning points relevant to the current COVID-19 pandemic through describing the epidemiology and impact of seasonal and A(H1N1)pdm09 influenza in pregnancy, alongside the effectiveness and use of immunisation.

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Consider pregnancy in COVID-19 therapeutic drug and vaccine trials

Abstract: Consider pregnancy in COVID-19 therapeutic drug and vaccine trials

Cited by 88 publications

References 3 publications

Coronavirus Disease 2019–COVID-19

Coronavirus Disease 2019–COVID-19

A compendium answering 150 questions on COVID‐19 and SARS‐CoV‐2

Lessons learned from the A (H1N1) influenza pandemic

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