The world has been suddenly affected by a devastating pandemia. The SARS-Cov-2 virus is spreading trough all the nations of the world attacking men and women. As OBGYN doctors it is our duty to keep updated on the latest scientific information about this disease and how it can affect our patients during pregnancy.
There are only 5 articles on Pubmed about this novel coronavirus infection and pregnancy, as we do not have many data to work with during this initial phase of the pandemia.
Four of of 5 are from China, where the outbreak started and where we can extrapolate more data from.
In summary the virus seems to attack more men than women, with no predilection for pregnancy; this mean that probably pregnancy is not a predisposing factor for the infection; this comes as good and unexpected news considering the vulnerable state of partial immunosuppression during gestation. In short, being pregnancy appears to be a risk factor for other type of viral and bacterial infection, but not for COVID-19 (the name of the disease officially chosen by WHO).
As of the course of the disease during pregnancy, having paucity of data for COVID-19, we have to base our assumptions on other similar diseases occurred in recent past such as SARS and MERS. It looks like there may be a more aggressive disease during pregnancy, with more frequent maternal illnesses such as DIC and respiratory failure, compared to not pregnant patients.
In utero transmission to the fetus has never been proven, with the lack of genetic viral material in fetal biological samples from infected mothers.
There are no drugs or vaccines available so far so the treatment remains symptomatic, with delivery recommended if maternal conditions deteriorate rapidly, as for any other disease.
1: Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, Li J, Zhao D, Xu D, Gong Q, Liao J, Yang H, Hou W, Zhang Y. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020 Mar 7;395(10226):809-815. doi: 10.1016/S0140-6736(20)30360-3. Epub 2020 Feb 12. PubMed PMID: 32151335. 2: Zhang L, Jiang Y, Wei M, Cheng BH, Zhou XC, Li J, Tian JH, Dong L, Hu RH. [Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province]. Zhonghua Fu Chan Ke Za Zhi. 2020 Mar 7;55(0):E009. doi: 10.3760/cma.j.cn112141-20200218-00111. [Epub ahead of print] Chinese. PubMed PMID: 32145714. 3: Liang H, Acharya G. Novel corona virus disease (COVID-19) in pregnancy: What clinical recommendations to follow? Acta Obstet Gynecol Scand. 2020 Mar 5. doi: 10.1111/aogs.13836. [Epub ahead of print] PubMed PMID: 32141062. 4: Li Y, Zhao R, Zheng S, Chen X, Wang J, Sheng X, Zhou J, Cai H, Fang Q, Yu F, Fan J, Xu K, Chen Y, Sheng J. Lack of Vertical Transmission of Severe Acute Respiratory Syndrome Coronavirus 2, China. Emerg Infect Dis. 2020 Jun 17;26(6). doi: 10.3201/eid2606.200287. [Epub ahead of print] PubMed PMID: 32134381. 5: Rasmussen SA, Smulian JC, Lednicky JA, Wen TS, Jamieson DJ. Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know. Am J Obstet Gynecol. 2020 Feb 24. pii: S0002-9378(20)30197-6. doi: 10.1016/j.ajog.2020.02.017. [Epub ahead of print] Review. PubMed PMID: 32105680.