*Dominika Dunder1, Julia Nosko1, Olga Grabowska1, Lukasz Szarpak2
COVID-19 and pregnancy
1Student’s Journal Club, Lazarski University, Warsaw, Poland
2Faculty of Medicine, Lazarski University, Warsaw, Poland
To the Editor
Coronavirus disease 2019 (COVID-19) is an acute infectious respiratory disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The novel coronavirus disease was first diagnosed and described in December 2019 in central China (city of Wuhan, Hubei province) (1). COVID-19 infection may range from mild infection of the upper respiratory tract, lower respiratory tract with life-threatening pneumonia with acute respiratory failure syndrome (1). This virus is broadly susceptible to all age, from the youngest newborns to the oldest. Pregnant women and their fetuses are at high risk to infect with a virus during outbreaks of infectious diseases (2). They are also more exposed to respiratory pathogens, so on that account they may be more susceptible to COVID-19 infection than the general population (1). Therefore, the epidemic has raised concerns about the possibility of vertical transmission of the virus from mother to fetus (3).
SARS-CoV-2 is the seventh member of the family of CoVs that infect humans. The genetic sequence of SARS-CoV-2 is ≥ 70% similar to that SARS-CoV, and SARS-CoV-2 is capable of using the same cell entry receptor (ACE2) as SARS-CoV to infect humans. However, SARS-CoV-2 spike (surface spike glycoprotein) binds to human ACE2 with approximately 10-20-fold higher affinity than the SARS-CoV spike, making it easier to spread from human to human (4).
At the present time, there is only little data available about the risk of vertical transmission from mother to child due to the small number of published cases. Preliminary information suggests that pregnant women are not more severely affected than the general population (5), however the available research results show that there is a theoretical risk of vertical transmission, as the ACE2 receptor is widely expressed in the placenta. In the limited number of available cases in which newborns were born from mothers with COVID-19, there have been 2 neonates tested positive for SARS-CoV-2 from COVID-19-infected mothers. However, there have been no confirmed cases of vertical transmission among the 46 other neonates, born to COVID-19-infected mothers reported thus far (2).
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