Mounting evidence suggests that pregnant people have an elevated risk of severe COVID-19-related complications compared with their non-pregnant counterparts, underscoring the need for effective prevention and treatment strategies. However, despite progress in innovative and flexible trial designs during the COVID-19 pandemic, regressive policies excluding pregnant and breastfeeding people from biomedical research persist. Remdesivir, a broad-spectrum antiviral, was the first drug licensed for the treatment of COVID-19, based on data showing it reduced the time to recovery in hospitalized patients. Pregnant and breastfeeding people were specifically excluded from all clinical trials of remdesivir in COVID-19, but data are accumulating from post-marketing registries, compassionate use programmes and case series/reports. In this review we synthesize these data and highlight key knowledge gaps to help inform clinical decision-making about its use in pregnancy and lactation.

中文翻译：

---

瑞德西韦在妊娠期和哺乳期治疗 COVID-19 的综述

越来越多的证据表明，与非孕妇相比，孕妇出现严重的 COVID-19 相关并发症的风险更高，这凸显了有效预防和治疗策略的必要性。然而，尽管在 COVID-19 大流行期间创新和灵活的试验设计取得了进展，但将孕妇和哺乳期人群排除在生物医学研究之外的倒退政策仍然存在。瑞德西韦 (Remdesivir) 是一种广谱抗病毒药物，是第一个获得许可用于治疗 COVID-19 的药物，数据显示它缩短了住院患者的康复时间。孕妇和哺乳期人群被明确排除在瑞德西韦治疗 COVID-19 的所有临床试验之外，但数据正在从上市后登记、同情使用计划和病例系列/报告中积累。在这篇综述中，我们综合了这些数据并强调了关键的知识差距，以帮助为临床决策提供有关其在妊娠和哺乳期使用的信息。