Background

During pregnancy, the maternal immune system must create and sustain tolerance to the allogeneic fetus while maintaining the ability to protect against microbial assaults.

Objectives

Ascertain the immunological differences in immune cells of pregnant women that may influence SARS-CoV-2 infection.

Study design

Systematic review conducted in accordance with PRISMA guidelines and registered within PROSPERO CRD42020189735.

A systematic search was undertaken across ISI, PubMed, Scopus, Embase, Cochrane Library and clinical trials.gov from January 2019 up until June 2020.

Eligibility criteria included COVID-19 infection, pregnancy, and availability of immune characteristics for the pregnant women. Two authors independently screened for the suitability of inclusion.

Main outcome measures

Information was manually extracted from full-text articles and efforts were made to identify overlapping data. Variables extracted and analysed included the quantification of white blood cells (WBC), lymphocytes, and C-reactive protein (CRP).

Results

The literature search yielded 162 studies, of which 11 were considered appropriate for selection. Only four were used in this systematic review.

Our research showed that pregnant women with COVID-19 only differ from other pregnant women in their lower WBC count. The proportion of reduced lymphocyte cases is similar in both groups, as is the case of C-reactive protein levels.

Conclusions

In line with previous coronavirus infections, severe maternal morbidity and perinatal death with COVID-19 infection were more likely to be expected in pregnancy.

Our research showed that pregnant women with COVID-19 in terms of immunity only differ from other pregnant women in their lower WBC count.

中文翻译：

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怀孕期间的免疫力会影响 SARS-CoV-2 感染吗？– 系统回顾

背景

在怀孕期间，母体免疫系统必须产生并维持对同种异体胎儿的耐受性，同时保持防止微生物攻击的能力。

目标

确定孕妇免疫细胞中可能影响 SARS-CoV-2 感染的免疫学差异。

学习规划

根据 PRISMA 指南进行系统审查并在 PROSPERO CRD42020189735 中注册。

从 2019 年 1 月到 2020 年 6 月，我们在 ISI、PubMed、Scopus、Embase、Cochrane Library 和 Clinical Trials.gov 上进行了系统检索。

资格标准包括 COVID-19 感染、怀孕以及孕妇是否具有免疫特征。两位作者独立筛选纳入的适宜性。

主要观察指标

从全文文章中手动提取信息，并努力识别重叠数据。提取和分析的变量包括白细胞 (WBC)、淋巴细胞和 C 反应蛋白 (CRP) 的定量。

结果

文献检索共获得 162 项研究，其中 11 项被认为适合选择。本次系统评价仅使用了四种。

我们的研究表明，患有 COVID-19 的孕妇与其他孕妇的唯一不同之处在于其白细胞计数较低。两组淋巴细胞减少的比例相似，C 反应蛋白水平也相似。

结论

与之前的冠状病毒感染一样，怀孕期间更有可能因感染 COVID-19 而出现严重的孕产妇发病率和围产期死亡。

我们的研究表明，患有 COVID-19 的孕妇在免疫力方面与其他孕妇的唯一不同之处在于其白细胞计数较低。