COVID-19 susceptibility in pregnancy: Immune/inflammatory considerations,the role of placental ACE-2 and research considerations |
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| Institution: | 1. Department of Obstetrics and Gynaecology, Division of Maternal-Fetal Medicine, Lunenfeld-Tanenbaum Research Institute, Mt. Sinai Hospital, Canada;2. Department of Obstetrics & Gynaecology, University of Toronto, Canada;3. Department of Biomedical and Molecular Sciences, School of Medicine, Queen’s University, Kingston, Canada;4. School of Baccalaureate Nursing, St. Lawrence College, Kingston, Canada |
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| 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. |
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| Keywords: | Pregnancy COVID-19 ACE-2 Inflammation Immune response |
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