Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA.
Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
Am J Reprod Immunol. 2020 Nov;84(5):e13339. doi: 10.1111/aji.13339. Epub 2020 Sep 20.
The pandemic caused by COVID-19 is affecting populations and healthcare systems worldwide. As we gain experience managing COVID-19, more data become available on disease severity, course, and treatment in patients infected with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). However, data in pregnancy remain limited. This narrative review of COVID-19 during pregnancy underscores key knowledge gaps in our understanding of the impact of this viral infection on reproductive health. Current data suggest that pregnant people have similar disease course and outcomes compared to nonpregnant people, with the majority experiencing mild disease; however, pregnant people may have increased risk of hospitalization and intensive care unit (ICU) admission. Among patients who develop severe and critical disease, major maternal morbidity and mortality have been described including cardiomyopathy, mechanical ventilation, extracorporeal membrane oxygenation, and death. Many questions remain regarding maternal severity of disease in COVID-19. Further research is needed to better understand disease course in pregnancy. Additionally, the inclusion of pregnant patients in therapeutic trials will provide vital data on treatment options for patients. As we continue to treat more patients affected by SARS-CoV-2, multidisciplinary care and continued research are both needed to achieve optimal outcomes for mother and fetus.
由 COVID-19 引起的大流行正在影响全球的人口和医疗保健系统。随着我们在管理 COVID-19 方面经验的增加，越来越多的数据可用于了解严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染患者的疾病严重程度、病程和治疗。然而，关于妊娠的数据仍然有限。本综述重点介绍了我们对这种病毒感染对生殖健康影响的理解方面存在的关键知识空白。目前的数据表明，与非孕妇相比，孕妇的疾病过程和结局相似，大多数孕妇患有轻症；但是，孕妇住院和入住重症监护病房（ICU）的风险可能增加。在发生严重和危急疾病的患者中，已经描述了包括心肌病、机械通气、体外膜氧合和死亡在内的主要孕产妇发病率和死亡率。关于 COVID-19 中孕妇疾病严重程度的许多问题仍未得到解答。需要进一步研究以更好地了解妊娠期间的疾病病程。此外，将孕妇纳入治疗试验将为患者的治疗选择提供重要数据。随着我们继续治疗更多受 SARS-CoV-2 影响的患者，需要多学科护理和持续研究，以实现母婴的最佳结局。
