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新型冠状病毒肺炎与妊娠:基于证据的治疗策略最新综述

COVID-19 and Pregnancy: An Updated Review about Evidence-Based Therapeutic Strategies.

作者信息

Favilli Alessandro, Mattei Gentili Marta, De Paola Francesca, Laganà Antonio Simone, Vitagliano Amerigo, Bosco Mariachiara, Cicinelli Ettore, Chiantera Vito, Uccella Stefano, Parazzini Fabio, Gerli Sandro, Garzon Simone

机构信息

Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy.

Unit of Gynecologic Oncology, ARNAS "Civico-Di Cristina-Benfratelli", Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy.

出版信息

J Pers Med. 2023 Jun 23;13(7):1035. doi: 10.3390/jpm13071035.

Abstract

The COVID-19 pandemic posed a significant challenge for clinicians in managing pregnant women, who were at high risk of virus transmission and severe illness. While the WHO declared in May 2023 that COVID-19 is no longer a public health emergency, it emphasized that it remains a global health threat. Despite the success of vaccines, the possibility of new pandemic waves due to viral mutations should be considered. Ongoing assessment of the safety and effectiveness of pharmacological therapies is crucial in clinical practice. This narrative review summarizes the evidence-based therapeutic strategies for pregnant women with COVID-19, considering over three years of pandemic experience. The review discusses the safety and effectiveness of various drug regimens (antivirals, anticoagulants, corticosteroids, immunoglobulins, monoclonal antibodies, and therapeutic gases) and procedures (prone positioning and extracorporeal membrane oxygenation). Drugs with contraindications, inefficacy during pregnancy, or unknown adverse effects were excluded from our evaluation. The aim is to provide healthcare professionals with a comprehensive guide for managing pregnant women with COVID-19 based on lessons learned from the pandemic outbreak.

摘要

新冠疫情给临床医生管理孕妇带来了重大挑战,因为孕妇面临着病毒传播和重症的高风险。虽然世界卫生组织在2023年5月宣布新冠疫情不再构成突发公共卫生事件,但强调它仍然是全球健康威胁。尽管疫苗取得了成功,但应考虑到病毒变异引发新一波疫情的可能性。在临床实践中,持续评估药物治疗的安全性和有效性至关重要。本叙述性综述总结了基于三年多疫情经验的新冠孕妇循证治疗策略。该综述讨论了各种药物方案(抗病毒药物、抗凝剂、皮质类固醇、免疫球蛋白、单克隆抗体和治疗性气体)和程序(俯卧位通气和体外膜肺氧合)的安全性和有效性。我们的评估排除了有禁忌证、孕期无效或不良反应不明的药物。目的是根据疫情爆发的经验教训,为医护人员提供管理新冠孕妇的全面指南。

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本文引用的文献

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Coronavirus Disease 2019 (COVID-19) Vaccination in Pregnancy.新型冠状病毒病 2019(COVID-19)孕期疫苗接种。
Obstet Gynecol. 2023 Mar 1;141(3):473-482. doi: 10.1097/AOG.0000000000005100. Epub 2023 Jan 16.
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Pregnancy and COVID-19.妊娠与新型冠状病毒肺炎
J Clin Med. 2022 Nov 9;11(22):6645. doi: 10.3390/jcm11226645.

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