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COVID-19治疗:孕前、孕期及哺乳期用药安全

COVID-19 Treatment: Drug Safety Prior to Conception and During Pregnancy and Breastfeeding.

作者信息

Cavalcante Marcelo Borges, Cavalcante Candice Torres de Melo Bezerra, Braga Ana Catherine Sampaio, Andrade Dennyse Araújo, Montenegro Mariana Albuquerque, Santos Paula Andrade Neiva, Motoyama Paula Vitória Pereira, Rocha Marcelo Gondim, Dib Luciana Azôr, Araujo Júnior Edward

机构信息

Department of Obstetrics and Gynecology, University of Fortaleza (UNIFOR), Fortaleza-CE, Brazil.

CONCEPTUS - Reproductive Medicine, Fortaleza-CE, Brazil.

出版信息

Geburtshilfe Frauenheilkd. 2021 Jan;81(1):46-60. doi: 10.1055/a-1247-5271. Epub 2021 Jan 19.

Abstract

In December 2019, a new viral respiratory infection known as coronavirus disease 2019 (COVID-19) was first diagnosed in the city of Wuhan, China. COVID-19 quickly spread across the world, leading the World Health Organization to declare it a pandemic on March 11, 2020. The disease is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a similar virus to those involved in other epidemics such as severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). Epidemiological studies have shown that COVID-19 frequently affects young adults of reproductive age and that the elderly and patients with chronic disease have high mortality rates. Little is known about the impact of COVID-19 on pregnancy and breastfeeding. Most COVID-19 cases present with mild flu-like symptoms and only require treatment with symptomatic relief medications, whereas other cases with COVID-19 require treatment in an intensive care unit. There is currently no specific effective treatment for COVID-19. A large number of drugs are being used to fight infection by SARS-CoV-2. Experience with this therapeutic arsenal has been gained over the years in the treatment of other viral, autoimmune, parasitic, and bacterial diseases. Importantly, the search for an effective treatment for COVID-19 cannot expose pregnant women infected with SARS-CoV-2 to the potential teratogenic risks of these drugs. Therefore, it is necessary to determine and understand the safety of anti-COVID-19 therapies prior to conception and during pregnancy and breastfeeding.

摘要

2019年12月,一种名为2019冠状病毒病(COVID-19)的新型病毒性呼吸道感染首次在中国武汉市被确诊。COVID-19迅速在全球传播,导致世界卫生组织于2020年3月11日宣布其为大流行病。该疾病由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起,这是一种与其他疫情中涉及的病毒类似的病毒,如严重急性呼吸综合征冠状病毒(SARS-CoV)和中东呼吸综合征冠状病毒(MERS-CoV)。流行病学研究表明,COVID-19经常影响育龄年轻成年人,而老年人和慢性病患者的死亡率较高。关于COVID-19对妊娠和母乳喂养的影响知之甚少。大多数COVID-19病例表现为轻度流感样症状,仅需使用缓解症状的药物进行治疗,而其他COVID-19病例则需要在重症监护病房接受治疗。目前尚无针对COVID-19的特效治疗方法。大量药物正在用于对抗SARS-CoV-2感染。多年来在治疗其他病毒、自身免疫、寄生虫和细菌疾病方面积累了使用这些治疗药物的经验。重要的是,寻找COVID-19的有效治疗方法不能使感染SARS-CoV-2的孕妇面临这些药物潜在的致畸风险。因此,有必要在受孕前以及妊娠和母乳喂养期间确定并了解抗COVID-19疗法的安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fa1/7815333/3004e8c3e9f2/10-1055-a-1247-5271-igf01.jpg

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