Samara Athina, Khalil Asma, O'Brien Patrick, Herlenius Eric
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
iScience. 2022 May 20;25(5):104295. doi: 10.1016/j.isci.2022.104295. Epub 2022 Apr 25.
A greater proportion of pregnant women with COVID-19 have mild disease compared with their non-pregnant counterparts. Paradoxically, however, they are at higher risk of developing severe disease, requiring respiratory support and admission to intensive care. The delta SARS-Cov-2 variant is associated with increased risk of hospitalization and morbidity in unvaccinated pregnant populations. However, it is not known whether the worse pregnancy outcomes associated with the delta variant are due to a direct effect of the virus on the pregnancy, or whether this effect is mediated through more severe maternal infection. Here, we synthesize studies of COVID-19 pregnancies, focusing on the different routes of SARS-CoV-2 infection of lung and placenta, and the mechanisms of syncytial formation for each SARS-CoV-2 variant. To delineate COVID-19 complications in pregnant women, future studies should explore whether the delta variant causes greater placental infection compared to other variants and contributes to increased syncytial formation.
与未怀孕的女性相比,感染新冠病毒的孕妇中轻症患者的比例更高。然而,矛盾的是,她们患重症的风险更高,需要呼吸支持并入住重症监护病房。在未接种疫苗的孕妇群体中,新冠病毒德尔塔变异株与住院风险和发病率增加有关。然而,与德尔塔变异株相关的更糟糕的妊娠结局是由于病毒对妊娠的直接影响,还是这种影响是通过更严重的母体感染介导的,目前尚不清楚。在此,我们综合了关于新冠病毒感染孕妇的研究,重点关注新冠病毒感染肺部和胎盘的不同途径,以及每种新冠病毒变异株形成合体滋养层的机制。为了明确孕妇新冠病毒感染的并发症,未来的研究应探讨德尔塔变异株与其他变异株相比是否会导致更严重的胎盘感染,并促进合体滋养层形成增加。