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. 2020 Dec;20(4):568-572.
doi: 10.1016/j.repbio.2020.10.005. Epub 2020 Nov 6.

COVID-19 susceptibility in pregnancy: Immune/inflammatory considerations, the role of placental ACE-2 and research considerations

Ann Kinga Malinowski  1 , Abdelrahman Noureldin  2 , Maha Othman  3
Affiliations

COVID-19 susceptibility in pregnancy: Immune/inflammatory considerations, the role of placental ACE-2 and research considerations

Ann Kinga Malinowski et al. Reprod Biol. 2020 Dec.

Abstract

SARS-CoV-2 is a new virus, to which herd immunity has not yet developed and both molecular and serological testing are not without flaws. The virus evokes a state of severe and widespread inflammation, and stimulates both innate and adaptive immune response. The angiotensin-converting enzyme 2 (ACE2), which acts as the SARS-CoV-2 receptor, is present in endothelial cells and has been noted within the human placenta. There are questions about whether pregnancy would increase the susceptibility of pregnant women to COVID-19 and disease severity within this population. In this report, we highlight physiological and immune/inflammatory considerations that may explain the susceptibility and disease pathology in response to SARS CoV-2 during pregnancy, explore testing considerations in asymptomatic individuals, discuss the potential role and of placental ACE2 receptor in the pathogenesis of COVID-19 in pregnancy and in pregnancy outcomes, and finally share our perspective with respect to an urgently needed change concerning involvement of pregnant women in research addressing COVID-19.

Keywords: ACE-2; COVID-19; Immune response; Inflammation; Pregnancy.

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Conflict of interest statement

Declaration of Competing Interest The authors report no declarations of interest.

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