Maternal SARS-CoV-2 Infection, Its Vertical Transmission and Impact on Overall Perinatal Outcomes: A Narrative Review

2021 ◽  
Vol 17 ◽  
Author(s):  
Naina Kumar ◽  
Vikas Bhatia

Background: : COVID-19 pandemic caused by single-stranded RNA containing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) started in early December 2019 from the Wuhan city of China and till date has affected millions of people including pregnant women worldwide. Research from all over the world has shown that the SARS-CoV-2 infection can be transmitted vertically from mother to fetus, but is very rare. Neonatal infection with COVID-19 accounts for only a small proportion of the total population infected. Furthermore, very few studies have observed the impact of maternal SARS-CoV-2 infection on neonatal outcomes. Thus, the literature about neonatal transmission and outcome in COVID-19 infected antenatal women is very scattered and limited. The present review briefs on the transmission of SARS-CoV-2 infection from mother to fetus and its impact on perinatal outcomes. Methodology: : English language articles from various databases including PubMed, Scopus, EMBASE, Scholar, MedRxiv, and Web of Science and from the World Health Organization site were searched from the beginning of the COVID-19 pandemic up to June 2021. The search terms used were “SARS-CoV-2 and pregnancy outcome, “COVID-19 and neonatal outcome”, “Placental changes in COVID-19 infected pregnant women”, “Vertical transmission of COVID-19”. Conclusion: : Maternal SARS-CoV-2 infection can be transmitted to the fetus, though uncommon, and can lead to adverse perinatal outcomes including preterm births, intrauterine growth restriction, NICU admission, stillbirths. The data on transmission and the adverse neonatal outcome is sparse and many more studies are needed to fully understand the mechanism by which maternal COVID-19 infection can affect fetuses and neonates.

Author(s):  
О.S. Shkolnyk ◽  
A.M. Shlemkevych ◽  
O.M. Malanchuk ◽  
Yе.B. Sharhorodska ◽  
H.R. Akopyan

Aim of the study: analysis of modern medical literature on risk factors for the pathological condition of the fetus in women who had COVID-19 during pregnancy. The authors analyzed the scientific medical literature on the study of the impact of COVID-19 infection on the course and complications of pregnancy and the condition of the fetus. The characteristics of the possible risks of a number of adverse consequences for the mother and child due to the postponed COVID-19 disease are given. In Ukraine, studies of genetic and demographic processes, which were carried out in recent years, have shown that the demographic crisis that is observed in the country is socially determined, significantly deepening due to reproductive losses, which is manifested in an increase in the frequency of lost pregnancies and the birth of inferior offspring in women with pathology of the reproductive system. The low level of reproductive health is largely due to the high level of perinatal losses. In Ukraine, the rate of perinatal and child mortality exceeds the data of European countries. Under these conditions, reducing perinatal mortality, preserving the life and health of newborns is a necessary condition for the demographic development of Ukraine and a factor of national security. COVID-19, a disease caused by Coronavirus 2 Severe Acute Respiratory Syndrome (SARS-CoV-2), has spread rapidly around the world. On March 12, 2020, the World Health Organization has designated the outbreak as a pandemic. Because pregnant women are at greater risk of complications and severe disease, they have been identified as “vulnerable groups”. Changes in the mother's immune system during pregnancy can influence the response to infections, particularly viruses. Pregnant women with COVID-19 may have risk factors for thrombosis, and the adaptation of the mother's vessels during pregnancy is critical for certain periods of pregnancy. The role of the placenta in COVID-19 infection is currently not well-researched. A number of potential mechanisms may be involved in the vertical transmission of viruses from the mother to the trophoblast. Scientists are conducting research on the likelihood of infection with SARS-CoV-2 in utero or during childbirth. The unintended consequences of the COVID-19 pandemic threaten the health of pregnant women. It is likely that the consequences of COVID-19 will be evident in the future for a number of years. Epidemiological information is critical for identifying differential responses of the population and analyzing data on the impact of COVID-19 in socio-economic and ethnic groups. In summary, it will be important to evaluate population-level data from these results to determine trends associated with the COVID-19 pandemic.


Author(s):  
Mounir Moukit ◽  
Assia El Ouardi ◽  
Abdellah Babahabib ◽  
El Mehdi El Hassani ◽  
Jaouad Kouach

The current pneumonia outbreak of COVID-19 has been declared a pandemic by the World Health Organization on March 11, 2020. With its indiscriminate spread across continents, authors are likely to see women with COVID-19 canvassed across all trimesters of pregnancy. To date, few reports have provided information about this disease in pregnant patients. Authors conducted a literature review to summarize the results concerning intrauterine transmission, diagnostic challenges and maternal-fetal outcomes of pregnant women with COVID-19 pneumonia.


2021 ◽  
Vol 10 (16) ◽  
pp. 3724
Author(s):  
Marcin Januszewski ◽  
Laura Ziuzia-Januszewska ◽  
Malgorzata Santor-Zaczynska ◽  
Alicja A. Jakimiuk ◽  
Tomasz Oleksik ◽  
...  

The COVID-19 pandemic affected the physical and mental health of people around the world and left unprepared health care systems struggling to mount an adequate response. Understanding the impact of COVID-19 on pregnancy in terms of perinatal and fetal outcomes is essential to propose strategies for mminimising viral transmission. Overall, 91 pregnant women in labour, or with indication for induction of labour, with COVID-19 were admitted to hospital. On the day of admission, each pregnant woman underwent a nasopharyngeal swab to validate SARS-CoV-2 infection. Whenever delivery was by caesarean section, an amniotic fluid sample was collected after uterus incision. Neonates were tested twice: first by nasopharyngeal swab at birth and secondly either at 24 h after (when babies were isolated) or at discharge (when rooming-in). All samples underwent rRT-PCR testing for SARS-CoV-2. The SARS-CoV-2 RNA tests by nasopharyngeal swab of the pregnant women produced positive results in 47 patients. This cohort gave birth to 48 infants who were double tested by nasopharyngeal swab and included in the prospective observational study. Moreover, in this same cohort, 39 amniotic fluid samples were taken during caesarean section. All samples underwent rRT-PCR testing for SARS-CoV-2 and came back negative. The study results suggest a low risk of vertical transmission of COVID-19 and favourable perinatal outcomes due to adequate preventative strategies. This approach may prove to be more beneficial in the new SARS-CoV-2 variants era.


2020 ◽  
pp. 276-289
Author(s):  
Mobina Fathi ◽  
Kimia Vakili ◽  
Niloofar Deravi

Around the end of December 2019, a new beta-coronavirus from Wuhan City, Hubei Province, China began to spread rapidly. The new virus, called SARS-CoV-2, which could be transmitted through respiratory droplets, had a range of mild to severe symptoms, from simple cold in some cases to death in others. The disease caused by SARS-CoV-2 was named COVID-19 by WHO and has so far killed more people than SARS and MERS. Following the widespread global outbreak of COVID-19, with more than 132758 confirmed cases and 4955 deaths worldwide, the World Health Organization declared COVID-19 a pandemic disease in January 2020. Earlier studies on viral pneumonia epidemics has shown that pregnant women are at greater risk than others. During pregnancy, the pregnant woman is more prone to infectious diseases. Research on both SARS-CoV and MERS-CoV, which are pathologically similar to SARS-CoV-2, has shown that being infected with these viruses during pregnancy increases the risk of maternal death, stillbirth, intrauterine growth retardation and, preterm delivery. With the exponential increase in cases of COVID-19 throughout the world, there is a need to understand the effects of SARS-CoV-2 on the health of pregnant women, through extrapolation of earlier studies that have been conducted on pregnant women infected with SARS-CoV, and MERS-CoV. There is an urgent need to understand the chance of vertical transmission of SARS-CoV-2 from mother to fetus and the possibility of the virus crossing the placental barrier. Additionally, since some viral diseases and antiviral drugs may have a negative impact on the mother and fetus, in which case, pregnant women need special attention for the prevention, diagnosis, and treatment of COVID-19.


Author(s):  
Pramukti Dian Setianingrum ◽  
Farah Irmania Tsani

Backgroud: The World Health Organization (WHO) explained that the number of Hyperemesis Gravidarum cases reached 12.5% of the total number of pregnancies in the world and the results of the Demographic Survey conducted in 2007, stated that 26% of women with live births experienced complications. The results of the observations conducted at the Midwife Supriyati Clinic found that pregnant women with hyperemesis gravidarum, with a comparison of 10 pregnant women who examined their contents there were about 4 pregnant women who complained of excessive nausea and vomiting. Objective: to determine the hyperemesis Gravidarum of pregnant mother in clinic. Methods: This study used Qualitative research methods by using a case study approach (Case Study.) Result: The description of excessive nausea of vomiting in women with Hipermemsis Gravidarum is continuous nausea and vomiting more than 10 times in one day, no appetite or vomiting when fed, the body feels weak, blood pressure decreases until the body weight decreases and interferes with daily activities days The factors that influence the occurrence of Hyperemesis Gravidarum are Hormonal, Diet, Unwanted Pregnancy, and psychology, primigravida does not affect the occurrence of Hyperemesis Gravidarum. Conclusion: Mothers who experience Hyperemesis Gravidarum feel nausea vomiting continuously more than 10 times in one day, no appetite or vomiting when fed, the body feels weak, blood pressure decreases until the weight decreases and interferes with daily activities, it is because there are several factors, namely, hormonal actors, diet, unwanted pregnancy, and psychology.


Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Saima Habeeb ◽  
Manju Chugani

: The novel coronavirus infection (COVID‐19) is a global public health emergency.Since its outbreak in Wuhan, China in December 2019, the infection has spread at an alarming rate across the globe and humans have been locked down to their countries, cities and homes. As of now, the virus has affected over 20million people globally and has inflicted over 7 lac deaths. Nevertheless, the recovery rate is improving with each passing day and over 14 million people have recuperated so far. The statistics indicate that nobody is immune to the disease as the virus continues to spread among all age groups; newborns to the elders, and all compartmentsincluding pregnant women. However, pregnant women may be more susceptible to this infection as they are, in general, highly vulnerable to respiratory infections. There is no evidence for vertical transmission of the COVID-19 virus among pregnant women, but an increased prevalence of preterm deliveries. Besides this, the COVID-19 may alter immune response at the maternal-fetal interface and affect the well-being of mothers as well as infants. Unfortunately, there is limited evidence available in the open literature regarding coronavirus infection during pregnancy and it now appears that certain pregnant women have infected during the present 2019-nCoV pandemic. In this short communication, we study the impact of the COVID-19 infection on vertical transmission and fetal outcome among pregnant women.


2020 ◽  
Author(s):  
Lukman Olagoke ◽  
Ahmet E. Topcu

BACKGROUND COVID-19 represents a serious threat to both national health and economic systems. To curb this pandemic, the World Health Organization (WHO) issued a series of COVID-19 public safety guidelines. Different countries around the world initiated different measures in line with the WHO guidelines to mitigate and investigate the spread of COVID-19 in their territories. OBJECTIVE The aim of this paper is to quantitatively evaluate the effectiveness of these control measures using a data-centric approach. METHODS We begin with a simple text analysis of coronavirus-related articles and show that reports on similar outbreaks in the past strongly proposed similar control measures. This reaffirms the fact that these control measures are in order. Subsequently, we propose a simple performance statistic that quantifies general performance and performance under the different measures that were initiated. A density based clustering of based on performance statistic was carried out to group countries based on performance. RESULTS The performance statistic helps evaluate quantitatively the impact of COVID-19 control measures. Countries tend show variability in performance under different control measures. The performance statistic has negative correlation with cases of death which is a useful characteristics for COVID-19 control measure performance analysis. A web-based time-line visualization that enables comparison of performances and cases across continents and subregions is presented. CONCLUSIONS The performance metric is relevant for the analysis of the impact of COVID-19 control measures. This can help caregivers and policymakers identify effective control measures and reduce cases of death due to COVID-19. The interactive web visualizer provides easily digested and quick feedback to augment decision-making processes in the COVID-19 response measures evaluation. CLINICALTRIAL Not Applicable


2020 ◽  
Author(s):  
Ahmed Youssef Kada

BACKGROUND Covid-19 is an emerging infectious disease like viral zoonosis caused by new coronavirus SARS CoV 2. On December 31, 2019, Wuhan Municipal Health Commission in Hubei province (China) reported cases of pneumonia, the origin of which is a new coronavirus. Rapidly extendable around the world, the World Health Organization (WHO) declares it pandemic on March 11, 2020. This pandemic reaches Algeria on February 25, 2020, date on which the Algerian minister of health, announced the first case of Covid-19, a foreign citizen. From March 1, a cluster is formed in Blida and becomes the epicentre of the coronavirus epidemic in Algeria, its total quarantine is established on March 24, 2020, it will be smoothly alleviated on April 24. A therapeutic protocol based on hydroxychloroquine and azithromycin was put in place on March 23, for complicated cases, it was extended to all the cases confirmed on April 06. OBJECTIVE This study aimed to demonstrate the effectiveness of hydroxychloroquin/azithromycin protocol in Algeria, in particular after its extension to all patients diagnosed COVID-19 positive on RT-PCR test. We were able to illustrate this fact graphically, but not to prove it statistically because the design of our study, indeed in the 7 days which followed generalization of therapeutic protocol, case fatality rate decrease and doubling time increase, thus confirming the impact of wide and early prescription of hydroxychloroquin/azithromycin protocol. METHODS We have analyzed the data collected from press releases and follow-ups published daily by the Ministry of Health, we have studied the possible correlations of these data with certain events or decisions having a possible impact on their development, such as confinement at home and its reduction, the prescription of hydroxychloroquine/azithromycin combination for serious patients and its extension to all positive COVID subjects. Results are presented in graphics, the data collection was closed on 31/05/2020. RESULTS Covid-19 pandemic spreads from February 25, 2020, when a foreign citizen is tested positive, on March 1 a cluster is formed in the city of Blida where sixteen members of the same family are infected during a wedding party. Wilaya of Blida becomes the epicentre of coronavirus epidemic in Algeria and lockdown measures taken, while the number of national cases diagnosed begins to increases In any event, the association of early containment measures combined with a generalized initial treatment for all positive cases, whatever their degree of severity, will have contributed to a reduction in the fatality rate of COVID 19 and a slowing down of its doubling time. CONCLUSIONS In Algeria, the rapid combination of rigorous containment measure at home and early generalized treatment with hydroxychloroquin have demonstrated their effectiveness in terms of morbidity and mortality, the classic measures of social distancing and hygiene will make it possible to perpetuate these results by reducing viral transmission, the only unknown, the reopening procedure which can only be started after being surrounded by precautions aimed at ensuring the understanding of the population. CLINICALTRIAL Algeria, Covid-19, pandemic, hydroxychloroquin, azithromycin, case fatality rate


Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1700
Author(s):  
Melissa Chalada ◽  
Charmaine A. Ramlogan-Steel ◽  
Bijay P. Dhungel ◽  
Christopher J. Layton ◽  
Jason C. Steel

Uveal melanoma (UM) is currently classified by the World Health Organisation as a melanoma caused by risk factors other than cumulative solar damage. However, factors relating to ultraviolet radiation (UVR) susceptibility such as light-coloured skin and eyes, propensity to burn, and proximity to the equator, frequently correlate with higher risk of UM. These risk factors echo those of the far more common cutaneous melanoma (CM), which is widely accepted to be caused by excessive UVR exposure, suggesting a role of UVR in the development and progression of a proportion of UM. Indeed, this could mean that countries, such as Australia, with high UVR exposure and the highest incidences of CM would represent a similarly high incidence of UM if UVR exposure is truly involved. Most cases of UM lack the typical genetic mutations that are related to UVR damage, although recent evidence in a small minority of cases has shown otherwise. This review therefore reassesses statistical, environmental, anatomical, and physiological evidence for and against the role of UVR in the aetiology of UM.


Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 853
Author(s):  
Sara Cruz Melguizo ◽  
María Luisa de la Cruz Conty ◽  
Paola Carmona Payán ◽  
Alejandra Abascal-Saiz ◽  
Pilar Pintando Recarte ◽  
...  

Pregnant women who are infected with SARS-CoV-2 are at an increased risk of adverse perinatal outcomes. With this study, we aimed to better understand the relationship between maternal infection and perinatal outcomes, especially preterm births, and the underlying medical and interventionist factors. This was a prospective observational study carried out in 78 centers (Spanish Obstetric Emergency Group) with a cohort of 1347 SARS-CoV-2 PCR-positive pregnant women registered consecutively between 26 February and 5 November 2020, and a concurrent sample of PCR-negative mothers. The patients’ information was collected from their medical records, and the association of SARS-CoV-2 and perinatal outcomes was evaluated by univariable and multivariate analyses. The data from 1347 SARS-CoV-2-positive pregnancies were compared with those from 1607 SARS-CoV-2-negative pregnancies. Differences were observed between both groups in premature rupture of membranes (15.5% vs. 11.1%, p < 0.001); venous thrombotic events (1.5% vs. 0.2%, p < 0.001); and severe pre-eclampsia incidence (40.6 vs. 15.6%, p = 0.001), which could have been overestimated in the infected cohort due to the shared analytical signs between this hypertensive disorder and COVID-19. In addition, more preterm deliveries were observed in infected patients (11.1% vs. 5.8%, p < 0.001) mainly due to an increase in iatrogenic preterm births. The prematurity in SARS-CoV-2-affected pregnancies results from a predisposition to end the pregnancy because of maternal disease (pneumonia and pre-eclampsia, with or without COVID-19 symptoms).


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