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Analysis of the susceptibility to COVID-19 in pregnancy and recommendations on potential drug screening.
European Journal of Clinical Microbiology & Infectious Diseases ( IF 4.5 ) Pub Date : 2020-04-23 , DOI: 10.1007/s10096-020-03897-6
Xiaoxuan Zhao 1 , Yuepeng Jiang 2 , Yang Zhao 3 , Hongyan Xi 1 , Chang Liu 2 , Fan Qu 4 , Xiaoling Feng 5
Affiliation  

To analyze the susceptibility of SARS-CoV-2 in pregnancy and the drugs that can be used to treat pregnancy with COVID-19, so as to provide evidence for drug selection in clinic. By reviewing the existing literature, this paper analyzes the susceptibility of pregnant women to virus, especially to SARS-CoV-2, from the aspects of anatomical, reproductive endocrine and immune changes during pregnancy and screens effective and fetal-safe treatments from the existing drugs. The anatomical structure of the respiratory system is changed during pregnancy, and the virus transmitted by droplets and aerosols is more easily inhaled by pregnant women and is difficult to remove. Furthermore, the prognosis is worse after infection when compared with non-pregnancy women. And changes in reproductive hormones and immune systems during pregnancy collectively make them more susceptible to certain infections. More importantly, angiotensin-converting enzyme (ACE)-2, the SARS-CoV-2 receptor, has been proven highly increased during pregnancy, which may contribute to the susceptibility to SARS-CoV-2. When it comes to treatment, specific drugs for COVID-19 have not been found at present, and taking old drugs for new use in treating COVID-19 has become an emergency method for the pandemic. Particularly, drugs that show superior maternal and fetal safety are worthy of consideration for pregnant women with COVID-19, such as chloroquine, metformin, statins, lobinavir/ritonavir, glycyrrhizic acid, and nanoparticle-mediated drug delivery (NMDD), etc. Pregnant women are susceptible to COVID-19, and special attention should be paid to the selection of drugs that are both effective for maternal diseases and friendly to the fetus. However, there are still many deficiencies in the study of drug safety during pregnancy, and broad-spectrum, effective and fetal-safe drugs for pregnant women need to be developed so as to cope with more infectious diseases in the future.

中文翻译:

妊娠期 COVID-19 易感性分析及潜在药物筛查建议。

分析妊娠期SARS-CoV-2的易感性及可用于治疗COVID-19妊娠期的药物,为临床选药提供依据。本文通过查阅现有文献,从妊娠期解剖、生殖内分泌和免疫变化等方面分析孕妇对病毒,尤其是SARS-CoV-2的易感性,并从现有药物中筛选出对胎儿安全的有效治疗方法。 . 孕期呼吸系统的解剖结构发生变化,飞沫和气溶胶传播的病毒更容易被孕妇吸入,难以清除。此外,与未怀孕的女性相比,感染后的预后更差。怀孕期间生殖激素和免疫系统的变化共同使她们更容易受到某些感染。更重要的是,已证明 SARS-CoV-2 受体血管紧张素转换酶 (ACE)-2 在怀孕期间高度增加,这可能导致对 SARS-CoV-2 的易感性。在治疗方面,目前尚未发现针对 COVID-19 的特定药物,将旧药用于治疗 COVID-19 已成为应对大流行的紧急方法。特别是对于 COVID-19 孕妇来说,表现出优越的母婴安全性的药物值得考虑,如氯喹、二甲双胍、他汀类药物、洛比那韦/利托那韦、甘草酸和纳米颗粒介导的药物输送 (NMDD) 等。女性易感染 COVID-19,应特别注意选择既对母体疾病有效又对胎儿友好的药物。但孕期用药安全性研究还存在诸多不足,未来需要开发广谱、有效、胎儿安全的孕妇用药,以应对未来更多的传染病。
更新日期:2020-04-23
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