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Is pregnancy an immunological contributor to severe or controlled COVID-19 disease?
American Journal of Reproductive Immunology ( IF 3.6 ) Pub Date : 2020-08-05 , DOI: 10.1111/aji.13317
Nazeeh Hanna 1 , Monica Hanna 2 , Surendra Sharma 3
Affiliation  

Since its emergence in Wuhan as a novel coronavirus disease, it has taken only a few months since January 2020 for it to be recognized as a widespread COVID‐19 pandemic which has contributed to global health devastation. As pointed out by health experts, it is a once in a century pandemic of our times. Clinical observations so far indicate that the older population and immune compromised individuals, particularly in African American and Hispanic/Latino communities, are at much higher risk for infection with this novel coronavirus. In this regard, pregnancy offers an altered immunity scenario which may allow severe COVID‐19 disease. The literature is so far highly conflicting on this issue. This review will offer a conceptual basis for severe or controlled disease and address trepidations for pregnant women associated with COVID‐19 pandemic, particularly in the comparative context of clinical consequences of other coronaviruses such as SARS and MERS. We will highlight the possible consequences of COVID‐19 on the general health of pregnant women as well as its possible effects at the maternal‐fetal interface. For the placenta‐related pathology, we will focus our discussion on the temporal expression of ACE2 throughout gestation for possible propagation of SARS‐CoV‐2 in the placenta in infected women and ensuing consequences.

中文翻译:

怀孕是导致严重或受控 COVID-19 疾病的免疫因素吗?

自从它作为一种新型冠状病毒疾病在武汉出现以来,自 2020 年 1 月以来仅用了几个月的时间就被认为是一种广泛的 COVID-19 大流行,导致全球健康受到破坏。正如卫生专家指出的那样,这是我们这个时代百年一遇的流行病。迄今为止的临床观察表明,老年人群和免疫受损个体,特别是在非洲裔美国人和西班牙裔/拉丁裔社区,感染这种新型冠状病毒的风险要高得多。在这方面,怀孕提供了一种改变的免疫情况,可能导致严重的 COVID-19 疾病。迄今为止,文献在这个问题上存在高度冲突。该审查将为严重或受控疾病提供概念基础,并解决与 COVID-19 大流行相关的孕妇的恐惧,特别是在比较其他冠状病毒(例如 SARS 和 MERS)的临床后果的情况下。我们将重点介绍 COVID-19 对孕妇整体健康的可能影响及其对母胎界面的可能影响。对于胎盘相关病理学,我们将重点讨论 ACE2 在整个妊娠期间的时间表达,以了解 SARS-CoV-2 在受感染妇女胎盘中的可能传播及其后果。
更新日期:2020-08-05
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