INTRODUCTION
In December, 2019, a number of cases resembling viral pneumonia of
unknown cause emerged in the city of Wuhan (Hubei, China). Deep and
rapid sequencing analysis from lower respiratory tract samples revealed
the presence of a novel coronavirus species that was later named severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2)1. As of
7th May 2020, there’s been a total of 3,836,183
verified cases around the globe with 265,364 deaths and 1,307,608
patients recovering from the infection2.
SARS-CoV-2, severe acute respiratory syndrome coronavirus (SARS-CoV) and
Middle East respiratory syndrome coronavirus (MERS-CoV), belongs to the
Betacoronavirus genus. Although initial reports suggest SARS-CoV-2 to be
less virulent than the two previous zoonotic coronaviruses infections
SARS-CoV and MERS-CoV, it has proved to be far more efficient in terms
of transmission between close
contacts3,
4. Over the last two decades, SARS-CoV
and MERS-CoV infected > 10 000 persons worldwide. The
mortality rate of SARS-CoV infection was 10%, of which the mortality
rate in pregnant women was 25%, and the mortality rate of MERS-CoV
infection till November 2019 was 34.4% of which the mortality rate in
pregnant women was up to 37% 5-7.
The recent viral Ebola epidemic and SARS pandemics showed that pregnant
women suffer worse outcomes than non-pregnant individuals. This is
attributed to the increased oxygen consumption and decreased functional
residual capacity during pregnancy, hence COVID-19 may levy a greater
risk in pregnant women as compared to the non-pregnant adult cohort.
Moreover, pregnancy is an immunosuppressive state, and a weakened immune
system makes women more susceptible to adverse infection outcomes. Even
though there’s no evidence yet, however there’s a high suspicion that
SARS-CoV-2 might be transmitted vertically from mother to fetus and
cause clinically significant infection 8-10.
This systematic review analyzes the recent literature in an attempt to
help clinicians in making decisions on treating pregnant females who are
suspected or a confirmed case of COVID-19. With the evolving situation
and scarcity of literature, it’s imperative to bring together authentic
published literature on the pathogenesis of the infection, maternal and
external risk factors, diagnosis and management of such patients.