Coronavirus disease 2019 (COVID-19) and pregnancy

Abstract

Women perhaps are more exposed to coronavirus disease 2019 (COVID-19), caused by the novel coronavirus (CoV) called as the severe acute respiratory syndrome-CoV-2 (SARS-CoV-2), as compared to men, due to their greater contribution in healthcare and social services. Globally, around 70% of health and social service providers constitute of female. The pandemic is also poising serious threat to female sexual and reproductive health. Particularly, pregnant women are at risk and need special antenatal care besides routine health services. SARS-CoV-2 infection leads to the path of an exaggerated immune reaction in an infected individual. This leads to ‘cytokine storm’ causing massive tissue damage, systemic inflammation, increased body temperature, and in turn, these may lead to multiple organ failure. The gonads are also susceptible to damage and impairment in reproductive functions. Thus, it is vital to acquire information on the impact of this virus on gestational changes and pregnancy outcome. Given the limitation of data on COVID-19 mediated changes in pregnant women, this article also reviews the effects of two previous coronavirus infections - severe acute respiratory syndrome (SARS) caused by SARS-CoV and the Middle East respiratory syndrome (MERS) caused by MERS-CoV to predict the possible impact of the novel SARS-CoV-2 on pregnancy outcomes. Analysis of available literature reveals that unlike coronavirus infections of pregnant women caused by SARS and MERS, COVID-19 seems less likely to cause maternal death. Importantly, alike SARS and MERS, there were no confirmed cases of intrauterine transmission of SARS-CoV-2 from mothers with COVID-19 to their fetuses. Further broad-spectrum research is necessary to reach a consensus regarding the vertical transmission of SARS-CoV-2 and whether it adopts any other mechanisms to affect pregnancy outcomes.