Is There an Effect of Fetal Mesenchymal Stem Cells in the Mother–Fetus Dyad in COVID-19 Pregnancies and Vertical Transmission?

Abstract

Because of the polysystemic nature of coronavirus disease 2019 (COVID-19), during the present pandemic, there have been serious concerns regarding pregnancy, vertical transmission, and intrapartum risk. The majority of pregnant patients with COVID-19 infection present with mild or asymptomatic course of the disease. Some cases were hospitalized, and few needed intensive care unit admission, or mechanical ventilation. There have also been scarce case reports where neonates required mechanical ventilation post COVID-19 pregnancies. Without approved therapies other than dexamethasone, advanced mesenchymal cell therapy is one immunomodulatory therapeutic approach that is currently explored and might hold great promise. We suggest that the circulating fetal stem cells might have an immune-protective effect to mothers and contribute to the often mild and even asymptomatic post-COVID-19 pregnancies. Thus, COVID-19 pregnancies come forth as a paradigm to be further and more comprehensively approached, to understand both the mechanism and action of circulating stem cells in immunoprotection and hypoxia in microcirculation.

Protective potential of mesenchymal stem cells against COVID-19 during pregnancy

“…There anti-inflammatory actions are mediated by modulating Treg cells and macrophages as well as alleviating cytokines proliferation [ 32 ]. They attenuate the recruitment of macrophages and mononuclear cells to the lungs together with increased IL10 levels [ 18 ]. The MSCs stimulate the transition of the inflammatory macrophage phenotype M1 to the anti-inflammatory and wound-healing M2 phenotype [ 34 ].…”

“…The latter reported that pregnant women have higher risk of dying, being admitted to an intensive care unit, needing invasive ventilation and needing extracorporeal membrane oxygenation than non-pregnant women [ 43 ]. Thus far, the prevalence of neonatal COVID-19 positivity did not exceed the 5% [ 18 ]. It is interesting to note that in the majority of COVID-19-pregnancy instances, SARS-CoV-2 mother-to-fetus transmission has not been identified which might be due to the presence of lactoferrin in the placenta, amniotic fluid and lacteal secretions.…”

“…There are a number of ongoing clinical trials exploring the use of MSCs for the treatment of coronavirus infection. It has been demonstrated that pregnant females with COVID-19 are less symptomatic and their intensive care unit (ICU) admission and respiratory distress rates are lower compared with non-pregnant females with COVID-19 [ 18 ].…”

COVID-19 y placenta: afectación histopatológica y materno fetal

“…Se ha reportado títulos elevados de IgM contra el SARS-CoV-2 en un recién nacido. Como la IgM no se puede transferir a través de la placenta y solo puede ser producida por el feto en respuesta al virus, este resultado y las lesiones hepáticas del recién nacido sugieren indirectamente la posibilidad de transmisión vertical (84).…”

A Review on the Role of Stem Cells against SARS-CoV-2 in Children and Pregnant Women

“…The fetal cells that transfer through the placenta are from specific cell types, including hematopoietic stem cells and MSCs [93]. Samara et al recently suggested that fetal MSCs circulating in the maternal blood may have an immunosuppressive effect on mothers, causing COVID-19 in pregnant women to be often mild and even asymptomatic [94]. Pietras et al have neatly characterized the cell cycle regulation in hematopoietic stem cells from fetal, adult, and aged sources.…”