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Analysis of the susceptibility to COVID-19 in pregnancy and recommendations on potential drug screening.
Eur J Clin Microbiol Infect Dis. 2020 Jul; 39(7):1209-1220.EJ

Abstract

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.

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Authors+Show Affiliations

Zhao X
Heilongjiang University of Chinese Medicine, Harbin, 150040, China.
Jiang Y
Zhejiang Chinese Medical University, Hangzhou, 310053, China.
Zhao Y
Hebei College of Traditional Chinese Medicine, Shijiazhuang, 050000, China.
Xi H
Heilongjiang University of Chinese Medicine, Harbin, 150040, China.
Liu C
Zhejiang Chinese Medical University, Hangzhou, 310053, China.
Qu F
Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China. syqufan@zju.edu.cn.
Feng X
First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, 150040, China. Doctorfxl@163.com.

MeSH

Angiotensin-Converting Enzyme 2Anti-Inflammatory AgentsAntimalarialsAntiviral AgentsBasal MetabolismBetacoronavirusCOVID-19Cardiovascular Physiological PhenomenaChloroquineCongenital AbnormalitiesCoronavirus InfectionsDisease SusceptibilityDrug CombinationsDrug Delivery SystemsFemaleFunctional Residual CapacityGlycyrrhizic AcidHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypoglycemic AgentsInterferon Type ILopinavirMetforminNanoparticlesOxygen ConsumptionPandemicsPeptidyl-Dipeptidase APneumonia, ViralPregnancyPregnancy Complications, InfectiousProgesteronePrognosisRespiratory Physiological PhenomenaRitonavirSARS-CoV-2Spike Glycoprotein, CoronavirusStillbirthVentilation-Perfusion RatioCOVID-19 Drug Treatment

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32328850

Citation

Zhao, Xiaoxuan, et al. "Analysis of the Susceptibility to COVID-19 in Pregnancy and Recommendations On Potential Drug Screening." European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology, vol. 39, no. 7, 2020, pp. 1209-1220.
Zhao X, Jiang Y, Zhao Y, et al. Analysis of the susceptibility to COVID-19 in pregnancy and recommendations on potential drug screening. Eur J Clin Microbiol Infect Dis. 2020;39(7):1209-1220.
Zhao, X., Jiang, Y., Zhao, Y., Xi, H., Liu, C., Qu, F., & Feng, X. (2020). Analysis of the susceptibility to COVID-19 in pregnancy and recommendations on potential drug screening. European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology, 39(7), 1209-1220. https://doi.org/10.1007/s10096-020-03897-6
Zhao X, et al. Analysis of the Susceptibility to COVID-19 in Pregnancy and Recommendations On Potential Drug Screening. Eur J Clin Microbiol Infect Dis. 2020;39(7):1209-1220. PubMed PMID: 32328850.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Analysis of the susceptibility to COVID-19 in pregnancy and recommendations on potential drug screening. AU - Zhao,Xiaoxuan, AU - Jiang,Yuepeng, AU - Zhao,Yang, AU - Xi,Hongyan, AU - Liu,Chang, AU - Qu,Fan, AU - Feng,Xiaoling, Y1 - 2020/04/23/ PY - 2020/3/11/received PY - 2020/4/2/accepted PY - 2020/4/25/pubmed PY - 2020/7/1/medline PY - 2020/4/25/entrez KW - Antiviral treatment KW - Fetal safety KW - New coronavirus disease KW - Pregnancy KW - Virus susceptibility SP - 1209 EP - 1220 JF - European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology JO - Eur J Clin Microbiol Infect Dis VL - 39 IS - 7 N2 - 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. SN - 1435-4373 UR - https://www.unboundmedicine.com/medline/citation/32328850/Analysis_of_the_susceptibility_to_COVID_19_in_pregnancy_and_recommendations_on_potential_drug_screening_ DB - PRIME DP - Unbound Medicine ER -