Pregnancy, Viral Infection, and COVID-19

Abstract

Pregnancy comprises a unique immunological condition, to allow fetal development and to protect the host from pathogenic infections. Viral infections during pregnancy can disrupt immunological tolerance and may generate deleterious effects on the fetus. Despite these possible links between pregnancy and infection-induced morbidity, it is unclear how pregnancy interferes with maternal response to some viral pathogens. In this context, the novel coronavirus (SARS-CoV-2) can induce the coronavirus diseases-2019 (COVID-19) in pregnant women. The potential risk of vertical transmission is unclear, babies born from COVID-19-positive mothers seems to have no serious clinical symptoms, the possible mechanisms are discussed, which highlights that checking the children's outcome and more research is warranted. In this review, we investigate the reports concerning viral infections and COVID-19 during pregnancy, to establish a correlation and possible implications of COVID-19 during pregnancy and neonatal's health.

Frequencies of CD33+CD11b+HLA-DR–CD14–CD66b+ and CD33+CD11b+HLA-DR–CD14+CD66b– Cells in Peripheral Blood as Severity Immune Biomarkers in COVID-19

“…Moreover, lactate dehydrogenase, a well-known marker for persistent viral infections may be of relevance as a potential biomarker for COVID-19 (10). Several manuscripts have highlighted the influence of comorbities in COVID-19 such as old age, systemic arterial hypertension, pregnancy and obesity (11)(12)(13)(14). Previous reports verified an immune dysregulation in circulating immune cells in the blood of COVID-19 patients, with a significant increase in neutrophil-to-lymphocyte ratio in COVID-19, and a further increase in severe COVID-19 (6).…”

Assessment of Maternal and Neonatal SARS-CoV-2 Viral Load, Transplacental Antibody Transfer, and Placental Pathology in Pregnancies During the COVID-19 Pandemic

“…While pregnancy-specific immunological and physiological changes may predispose women to increased morbidity in the setting of respiratory viruses, 4 data are lacking regarding biological correlates of maternal disease severity in SARS-CoV-2 and have largely been extrapolated from nonpregnant populations or from pregnant women with SARS-CoV-1 or Middle East respiratory syndrome infection. 5 , 6 , 7 Data regarding the maternal immune response, vertical transmission, and placental infection have been limited largely to case reports, small case series, and systematic reviews. 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 Here, we report key biological data from a large prospective cohort study of SARS-CoV-2 infection in pregnancy regarding viral load, antibody response, transplacental antibody transfer, and placental pathology.…”

Pregnancy and Childbirth in the COVID-19 Era—The Course of Disease and Maternal–Fetal Transmission

“…Pregnancy is a specific immunological state that requires the development of tolerance to the allogeneic fetus while maintaining the ability to protect against pathogenic infection [ 16 ], which may increase the susceptibility of pregnant women to infections [ 17 , 18 ]. The period of pregnancy is associated with significant changes in the areas of innate, cellular, and adaptive immune responses.…”

“…Moreover, the level of natural killer (NK) cells, which play an important role in angiogenesis and vessel formation in the first trimester and which subsequently constitute nearly 70% of deciduous leukocytes in early pregnancy, decrease in the circulating blood. In the third trimester, the number of B lymphocytes also decreases [ 18 ]. These changes create an increased sensitivity to develop infections, especially in the first trimester, but at any point in pregnancy, infections by virus can negatively affect pregnant women [ 19 ].…”