Is pregnancy a risk factor of COVID-19?

Eur J Obstet Gynecol Reprod Biol. 2020 Sep:252:605-609. doi: 10.1016/j.ejogrb.2020.06.058. Epub 2020 Jun 27.

Abstract

This review evaluates whether pregnancy is a risk factor for COVID-19 by looking at the expression of immune markers such as immune cells and cytokines in order to have a better understanding on the pathophysiology of the disease, thus reducing maternal deaths. Pregnant women are more at risk of contracting COVID-19 due to their weakened immune system. Studies demonstrate that COVID-19 is an immune condition which is marked by reduced lymphocytes and elevated selected proinflammatory cytokines. Similar immune expression has been demonstrated in pregnancy by several studies. In addition, the placenta has been shown to possess ACE2 receptors on the villous cytotrophoblast and the syncytiotrophoblast and findings suggest that the coronavirus enters the host cells via these ACE2 receptors. The immune response in pregnancy increases the risk of contracting COVID-19. Both normal pregnancy and COVID-19 are marked by decreased lymphocytes, NKG2A inhibitory receptors, and increased ACE2, IL-8, IL-10, and IP-10 it therefore safer to conclude that pregnancy is a risk factor for COVID-19 development. Furthermore, the presence of the ACE2 receptors in the placenta may increase the risk of mother to baby transmission of the virus. Therefore, more studies investigating the link between pregnancy and COVID-19 are needed.

Keywords: Corona virus; Immune markers; Lymphocytes; Natural killer cells; Pregnancy.

Publication types

  • Review

MeSH terms

  • Angiotensin-Converting Enzyme 2
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / immunology*
  • Coronavirus Infections / transmission
  • Coronavirus Infections / virology
  • Cytokines / blood
  • Female
  • Humans
  • Infectious Disease Transmission, Vertical
  • Pandemics
  • Peptidyl-Dipeptidase A / immunology
  • Placenta / immunology
  • Placenta / virology
  • Pneumonia, Viral / immunology*
  • Pneumonia, Viral / transmission
  • Pneumonia, Viral / virology
  • Pregnancy
  • Pregnancy Complications, Infectious / blood
  • Pregnancy Complications, Infectious / immunology*
  • Pregnancy Complications, Infectious / virology
  • Risk Factors
  • SARS-CoV-2

Substances

  • Cytokines
  • Peptidyl-Dipeptidase A
  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2