Department of Medicine, University of Patras, 26504 Patras, Greece.
Department of Infectious Diseases, University General Hospital of Patras, 26504 Patras, Greece.
Viruses. 2023 Mar 19;15(3):787. doi: 10.3390/v15030787.
The clinical management of COVID-19 in pregnant women, who are considered a vulnerable population, remains uncertain even as the pandemic subsides. SARS-CoV-2 affects pregnant individuals in multiple ways and has been associated with severe maternal morbidity and mortality, as well as neonatal complications. The unique anatomy and physiology of gestation make managing COVID-19 in this population a complex and challenging task, emphasizing the importance of spreading knowledge and expertise in this area. Therapeutic interventions require distinct clinical consideration, taking into account differences in pharmacokinetics, vertical transmission, drug toxicities, and postnatal care. Currently, there is limited data on antiviral and immunomodulating COVID-19 pharmacotherapy in pregnancy. Some medication has been shown to be safe and well tolerated among pregnant women with COVID-19; however, the lack of randomized clinical trials and studies in this patient population is evident. Available vaccines are considered safe and effective, with no evidence of harm to the fetus, embryo development, or short-term postnatal development. Pregnant women should be counseled about the risks of SARS-CoV-2 infection and informed of available ways to protect themselves and their families. Effective treatments for COVID-19 should not be withheld from pregnant individuals, and more research is needed to ensure the best outcomes.
即使大流行有所缓解,对于 COVID-19 孕妇(被认为是弱势群体)的临床管理仍然存在不确定性。SARS-CoV-2 以多种方式影响孕妇,并与严重的孕产妇发病率和死亡率以及新生儿并发症有关。妊娠的独特解剖和生理学使得在这一人群中管理 COVID-19 成为一项复杂且具有挑战性的任务,强调了在这一领域传播知识和专业知识的重要性。治疗干预需要独特的临床考虑,要考虑到药代动力学、垂直传播、药物毒性和产后护理方面的差异。目前,关于 COVID-19 孕期抗病毒和免疫调节药物治疗的数据有限。一些药物已被证明在 COVID-19 孕妇中安全且耐受良好;然而,在这一患者群体中缺乏随机临床试验和研究是显而易见的。现有的疫苗被认为是安全有效的,没有证据表明对胎儿、胚胎发育或短期产后发育有危害。应向孕妇提供有关 SARS-CoV-2 感染风险的咨询,并告知她们保护自己和家人的方法。不应拒绝为孕妇提供 COVID-19 的有效治疗方法,需要进行更多的研究以确保最佳结果。