Pharmacological consideration of COVID-19 infection and vaccines in pregnancy

Abstract

COVID-19 is a pandemic of the 21st century that recorded 234 809 103 confirmed cases and more than 4 800 375 deaths. Many studies report the effect of COVID-19 in the overall population; nevertheless, there is information scarceness related to pharmacological management and pregnancy and fetal outcomes during the epidemic. Pregnancy is a state of change in immune physiology and anatomy modulation in preference to immune suppression. Additionally, manifold interactions with the health care system during pregnancy increases the chance of infection, and managing, pregnant population poses a more significant challenge. This review will summarize the available data on pharmacological considerations and vaccines in pregnancy and their adverse effects on fetal outcomes. Several drug choices include but are not limited to antivirals and antimalarial and combinations, corticosteroids, nonsteroidal anti-inflammatory drugs, and antipyretics. Approved vaccines for pregnancy include Pfizer/BioNTech and mRNA-1273 Moderna/National Institutes of Health. COVID-19 treatment approaches vary across different countries; the WHO and the Centers for Disease Control and Prevention guidelines and country regulators advise managing adverse effects on pregnancy and fetal outcome. But the efficacy of these drugs is questionable. There is no adequate literature to demonstrate the safety of these drugs in pregnant and lactating women. Hence, well-conducted studies that assess the safety of anti-COVID-19 medications and vaccines in pregnancy and lactating women are needed.

3º Congresso Interdisciplinar Da Área Médica

“…Sobre a quantidade de doses, a recomendação é de duas. Posto isto, ainda é crucial a realização de estudos rigorosos a longo prazo e que incluam as gestantes, com o objetivo de adquirir confirmação mais consistente sobre a eficácia e segurança das vacinas voltadas a esse público 13,21,24,25,27,30,31,32,33,34,35,36 .…”

Encourage women to receive COVID-19 vaccination before, during and after pregnancy

“…Therefore, the recent publication of the May issue of the Journal of the Chinese Medical Association entitled "Pharmacological consideration of COVID-19 infection and vaccines in pregnancy" is worthy of further discussion. 9 In this review, the authors have mentioned that both Pfizer/ BioNTech and mRNA-1273 Moderna/National Institute of Health have been approved as vaccines for pregnancy. 9 The authors also mentioned that US Food and Drug Administration, the Advisory Committee on Immunization Practices, and other regulatory professional authorities left open the choice for pregnant and lactating women to take the vaccine.…”

“…Therefore, the recent publication of the May issue of the Journal of the Chinese Medical Association entitled “Pharmacological consideration of COVID-19 infection and vaccines in pregnancy” is worthy of further discussion. 9…”

“…32.2%; aRR 0.92; 95% CI, 0.89–0.95), neonatal intensive care unit admission (11.0% vs. 13.3%; aRR 0.85; 95% CI, 0.80–0.90), or low Apgar score (1.8% vs. 2.0%; aRR 0.84; 95% CI, 0.72–0.97). 9 Based on the aforementioned finding, the authors highly recommended that COVID-19 vaccinations received during pregnancy were primarily mRNA vaccines administered in the second and third trimester. 11…”

COVID-19 vaccination in patients with Multiple Sclerosis: A Practical guide for Neurologists

“…There is no data regarding COVID-19 vaccination during lactation. Besides, we should follow pamphlets or monographs of different vaccines according to the future global or local guidelines (34).…”