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.