COVID-19 susceptibility in pregnancy: Immune/inflammatory considerations, the role of placental ACE-2 and research considerations

Malinowski, Ann Kinga; Noureldin, Abdelrahman; Othman, Maha

doi:10.1016/j.repbio.2020.10.005

Cited by 30 publications

(31 citation statements)

References 40 publications

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“…The viral agent responsible for coronavirus disease 2019 (COVID‐19), SARS‐CoV‐2 enters host cells by interacting with the angiotensin‐converting‐enzyme receptor, the levels of which are increased in the pregnant uterus and placenta, making the latter a potential target for the infection 9,10 . This assumption has been subsequently strengthened by the reported increased prevalence of signs of decidual arteriopathy in pregnant women with SARS‐CoV‐2 infection, suggesting a potential connection between infection and impaired placental function 11‐13 .…”

Section: Introductionmentioning

confidence: 99%

Effect of SARS‐CoV‐2 infection during the second half of pregnancy on fetal growth and hemodynamics: A prospective study

Rizzo

Mappa

Maqina

et al. 2021

Acta Obstet Gynecol Scand

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Introduction: Our objective was to compare the fetal growth velocity and fetal hemodynamics in pregnancies complicated and in those not complicated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Material and methods: Prospective case-control study of consecutive pregnancies complicated by SARS-CoV-2 infection during the second half of pregnancy matched with unaffected women. The z scores of head circumference, abdominal circumference, femur length, and estimated fetal weight were compared between the two groups. Fetal growth was assessed by analyzing the growth velocity of head circumference, abdominal circumference, femur length, and estimated fetal weight between the second-and third-trimester scans. Similarly, changes in the pulsatility index of uterine, umbilical, and middle cerebral arteries, and their ratios were compared between the two study groups. Results: Forty-nine consecutive pregnancies complicated, and 98 not complicated, by SARS-CoV-2 infection were included. General baseline and pregnancy characteristics were similar between pregnant women with and those without SARS-CoV-2 infection. There was no difference in head circumference, abdominal circumference, femur length, and estimated fetal weight z scores between pregnancies complicated and those not complicated by SARS-CoV-2 infection at both the second-and thirdtrimester scans. Likewise, there was no difference in the growth velocity of all these body parameters between the two study groups. Finally, there was no difference in the pulsatility index of both maternal and fetal Doppler scans throughout gestation between the two groups. Conclusions: Pregnancies complicated by SARS-CoV-2 infection are not at higher risk of developing fetal growth restriction through impaired placental function. The findings from this study do not support a policy of increased fetal surveillance in these women.

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Section: Introductionmentioning

confidence: 99%

Effect of SARS‐CoV‐2 infection during the second half of pregnancy on fetal growth and hemodynamics: A prospective study

Rizzo

Mappa

Maqina

et al. 2021

Acta Obstet Gynecol Scand

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“…disease. This has been demonstrated in recent past studies (Cavalcante et al, 2021;Da Silva et al, 2020;Figuero et al, 2020;Malinowski et al, 2020). In addition, pregnancy has been reported to increase the progression of COVID-19 disease (Dashraath et al, 2020).…”

Section: Discussionmentioning

confidence: 52%

Correlation between Pregnancy Status and Severe Corona-Virus Disease Characterized by Cytokine Storm: Systematic Review and Meta-Analysis

Muthuka

Kiptoo

Oluoch

et al. 2021

Preprint

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Background. Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SAR2-COV-2) that identified first in Wuhan, China, in December 2019, rapidly spreading to the rest of the globe, becoming a pandemic. Some studies have eluded to an association between pregnancy status and severe COVID-19 cytokine storm, some, in contrast, have demonstrated such. The aim of the current study was to find the relationship between pregnancy status and clinical COVID-19 severity characterized by cytokine storm through a systematic review and meta-analysis approach. Methods. We searched Google Scholar, PubMed, Scopus, Web of Science, and Embase databases to identify clinical studies suitable for inclusion in this meta-analysis. Studies reporting pregnancy status and comparing the COVID-19 severity cytokine storm outcome were included. The COVID-19 severity characterized by cytokine storm was described using parameters such as; Intensive Care Unit Admission, Invasive Mechanical Ventilation, Mechanical Ventilation, Hospital Admission, Pro and Inflammatory cytokine levels, consolidation on chest CT scan, pulmonary infiltration, extreme fevers as characteristic of cytokine storm, syndromic severity, higher neutrophil count indicative of cytokine storm and severe COVI-19 presentation. Results. A total of 17 articles detailing 840332 COVID-19 women were included. Our meta-analysis revealed a relationship between positive pregnancy status and severe COVID-19 cytokine storm case (random effect model, OR=2.47; 95% CI: 1.63-3.73; P < 0.0001), with a cumulative incidence of 6432 (14.1%) among the pregnant women with COVID-19 and 24352 (3.1%) among the non-pregnant women with COVI-19. Further to this, we found that the sub-analysis between Single Centre and Multiple Centre studies demonstrated seemingly the same as heterogeneity (I2 = 72 and (I2 = 98), respectively. Sensitivity analysis on each sub-group revealed that pregnancy was significantly related to severe COVID-19 with cytokine storm from single Centre studies, (fixed effect model, OR= 3.97; 95% CI: 2.26-6.95; P< 0.00001) with very low heterogeneity (I2 = 2 %; P = 0.42). Conclusion. Being pregnant is clearly associated with experiencing a severe COVID-19 characterized by a cytokine storm. The SARS-COV-2 epidemic should serve as an impetus for pregnant women diagnosed with COVID-19, and map out salient risk factors associated with its severity. The trial is registered with the International Prospective Register of Systematic Reviews (PROSPERO) CRD42021242011.

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“…Fever and cough were the most common symptoms reported in the literature [ 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 ], but lymphopenia and increased levels of C-reactive protein were also frequent [ 119 , 120 , 121 , 122 , 123 , 125 , 127 , 128 , 129 , 130 , 131 ]. Other laboratory findings showed increased concentrations of alanine aminotransferase and aspartate aminotransferase (AST) [ 120 ], increased neutrophil count, and no differences in IL-6 levels [ 128 ].…”

Section: Pregnancy and Sars-cov-2 Infectionmentioning

confidence: 99%

SARS-CoV-2 Infection in Pregnant Women: Neuroimmune-Endocrine Changes at the Maternal-Fetal Interface

Granja

Oliveira

Figueiredo

et al. 2021

Neuroimmunomodulation

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Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) has devastating effects on the population worldwide. Given this scenario, the extent of the impact of the disease on more vulnerable individuals, such as pregnant women, is of great concern. Although pregnancy may be a risk factor in respiratory virus infections, there are no considerable differences regarding COVID-19 severity observed between pregnant and nonpregnant women. In these circumstances, an emergent concern is the possibility of neurodevelopmental and neuropsychiatric harm for the offspring of infected mothers. Currently, there is no stronger evidence indicating vertical transmission of SARS-CoV-2; however, the exacerbated inflammatory response observed in the disease could lead to several impairments in the offspring’s brain. Furthermore, in the face of historical knowledge on possible long-term consequences for the progeny’s brain after infection by viruses, we must consider that this might be another deleterious facet of COVID-19. In light of neuroimmune interactions at the maternal-fetal interface, we review here the possible harmful outcomes to the offspring brains of mothers infected by SARS-CoV-2.

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COVID-19 susceptibility in pregnancy: Immune/inflammatory considerations, the role of placental ACE-2 and research considerations

Cited by 30 publications

References 40 publications

Effect of SARS‐CoV‐2 infection during the second half of pregnancy on fetal growth and hemodynamics: A prospective study

Effect of SARS‐CoV‐2 infection during the second half of pregnancy on fetal growth and hemodynamics: A prospective study

Correlation between Pregnancy Status and Severe Corona-Virus Disease Characterized by Cytokine Storm: Systematic Review and Meta-Analysis

SARS-CoV-2 Infection in Pregnant Women: Neuroimmune-Endocrine Changes at the Maternal-Fetal Interface

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