Why are pregnant women susceptible to COVID-19? An immunological viewpoint


The 2019 novel coronavirus disease (COVID-19) was first detected in December 2019 and became epidemic in Wuhan, Hubei Province, China. COVID-19 has been rapidly spreading out in China and all over the world. The virus causing COVID-19, SARS-CoV-2 has been known to be genetically similar to severe acute respiratory syndrome coronavirus (SARS-CoV) but distinct from it. Clinical manifestation of COVID-19 can be characterized by mild upper respiratory tract infection, lower respiratory tract infection involving non-life threatening pneumonia, and life-threatening pneumonia with acute respiratory distress syndrome. It affects all age groups, including newborns, to the elders. Particularly, pregnant women may be more susceptible to COVID-19 since pregnant women, in general, are vulnerable to respiratory infection. In pregnant women with COVID-19, there is no evidence for vertical transmission of the virus, but an increased prevalence of preterm deliveries has been noticed. The COVID-19 may alter immune responses at the maternal-fetal interface, and affect the well-being of mothers and infants. In this review, we focused on the reason why pregnant women are more susceptible to COVID-19 and the potential maternal and fetal complications from an immunological viewpoint.


Maternal-fetal interface

1. Introduction

Since December 2019, the outbreak of the 2019 novel coronavirus disease (COVID-19) in China has aroused great attention around the world. As of February 16th, 2020, a total of 70,548 cases has been confirmed in mainland China (Fig. 1https://www.bloomberg.com/graphics/2020-wuhan-novel-coronavirus-outbreak/), of which 58,182 cases are in Hubei province and 41,152 cases in Wuhan (National Health Commission of the People’s Republic of China, Feb 16, 2020). On February 12th, 2020, the number of new confirmed cases in Hubei Province increased by 14,840, which was mainly due to the amendments of diagnostic criteria. According to the “Guidelines for the Diagnosis and Treatment of COVID-19 Infection (Fifth Edition)” issued by the National Health Commission of the People’s Republic of China (National Health Commission of the People’s Republic of China, Feb 8, 2020), Hubei Province expanded the diagnostic criteria including clinically diagnosed cases for the first time (those with pneumonia images onComputed Tomography scan), in addition to the suspected and confirmed cases. The revision aimed to promote the early diagnosis and treatment of COVID-19. However, it also added more confusion concerning the epidemiology of COVID-19.

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Font: Journal of Reproductive Immunology – Elsevier

Why are pregnant women susceptible to COVID-19? An immunological viewpoint - D'Olhos Hospital Dia