COVID-19 Treatment: Drug Safety Prior to Conception and During Pregnancy and Breastfeeding

Abstract

In December 2019, a new viral respiratory infection known as coronavirus disease 2019 (COVID-19) was first diagnosed in the city of Wuhan, China. COVID-19 quickly spread across the world, leading the World Health Organization to declare it a pandemic on March 11, 2020. The disease is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a similar virus to those involved in other epidemics such as severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). Epidemiological studies have shown that COVID-19 frequently affects young adults of reproductive age and that the elderly and patients with chronic disease have high mortality rates. Little is known about the impact of COVID-19 on pregnancy and breastfeeding. Most COVID-19 cases present with mild flu-like symptoms and only require treatment with symptomatic relief medications, whereas other cases with COVID-19 require treatment in an intensive care unit. There is currently no specific effective treatment for COVID-19. A large number of drugs are being used to fight infection by SARS-CoV-2. Experience with this therapeutic arsenal has been gained over the years in the treatment of other viral, autoimmune, parasitic, and bacterial diseases. Importantly, the search for an effective treatment for COVID-19 cannot expose pregnant women infected with SARS-CoV-2 to the potential teratogenic risks of these drugs. Therefore, it is necessary to determine and understand the safety of anti-COVID-19 therapies prior to conception and during pregnancy and breastfeeding.

COVID-19 en el embarazo y la lactancia materna

“…En diciembre de 2019, se diagnosticó por primera vez una nueva infección respiratoria viral conocida como enfermedad por coronavirus 2019 (COVID-19) en la ciudad de Wuhan, China [1]. La cual es causada por el Síndrome Respiratorio Agudo Severo Coronavirus 2 (SARS-CoV-2), un virus similar a los involucrado en otras epidemias como el síndrome respiratorio agudo severo coronavirus (SARS-CoV) y el síndrome respiratorio coronavirus de Oriente Medio (MERS-CoV) [2].…”

“…Los estudios epidemiológicos han demostrado que COVID-19 afecta con frecuencia a adultos jóvenes en edad reproductiva y especialmente con altas tasas de mortalidad en personas de edad adulta y pacientes con otros factores de comorbilidad como enfermedades crónicas (diabetes mellitus, hipertensión crónica, enfermedades respiratorias, insuficiencia renal, etc.) [1]. Sin embargo, existe la preocupación de que la enfermedad pueda afectar de manera desproporcionada a mujeres embarazadas y periodo de lactancia.…”

Pharmacological Treatments against COVID-19 in Pregnant Women

“…Several episodes of pneumonia of unknown origin were reported in December 2019 in Wuhan province, China, and these were assigned to a new coronavirus linked to the 2003 severe acute respiratory syndrome-CoV (SARS-CoV), and thus designated SARS 2 (SARS-CoV-2) [ 1 , 2 , 3 ].…”

“…By early 2020, SARS-CoV-2 had caused more than 85 million cases of coronavirus disease 2019 (COVID-19) and about 2 million deaths worldwide [ 4 ]. The rapid spread of the virus led the World Health Organization (WHO) to proclaim this outbreak a pandemic on 11 March 2020 [ 2 , 3 , 5 ].…”

Antiviral Treatment on Pregnancy with COVID-19 Infection : A Systematic Review

“…Coronavirus disease 2019 (COVID- 19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China, is now a global outbreak of disease. 1,2 Treatments are rapidly evolving during the time of this deadly pandemic and several drugs remain under investigation as potential therapies for critically ill COVID-19 patients. 3 Proposed potential antiviral effect treatment options include, drugs such as chloroquine, metformin, remdesivir, and lopinavir/ritonavir for pregnant women with SARS CoV-2 are worth considering.…”