COVID-19 and Pregnancy: Clinical Outcomes; Mechanisms, and Vaccine Efficacy

Authors

Deepak Kumar
Sonam Verma
Indira U Mysorekar

Publication Date

1-1-2023

Journal

Translational Research

DOI

10.1016/j.trsl.2022.08.007

PMID

35970470

PMCID

PMC9371980

PubMedCentral® Posted Date

8-12-2022

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Female, Humans, Pregnancy, COVID-19, COVID-19 Vaccines, Pandemics, Placenta, Proteomics, SARS-CoV-2, Vaccine Efficacy, Pregnancy Complications, Infectious

Abstract

As the COVID-19 pandemic continues into its third year, emerging data indicates increased risks associated with SARS-CoV-2 infection during pregnancy, including pre-eclampsia, intrauterine growth restriction, preterm birth, stillbirth, and risk of developmental defects in neonates. Here, we review clinical reports to date that address different COVID-19 pregnancy complications. We also document placental pathologies induced by SARS-CoV-2 infection, entry mechanisms in placental cells, and immune responses at the maternal-fetal interface. Since new variants of SARS-CoV-2 are emerging with characteristics of higher transmissibility and more effective immune escape strategies, we also briefly highlight the genomic and proteomic features of SARS-CoV-2 investigated to date. Vector and mRNA-based COVID-19 vaccines continue to be rolled out globally. However, because pregnant individuals were not included in the vaccine clinical trials, some pregnant individuals have safety concerns and are hesitant to take these vaccines. We describe the recent studies that have addressed the effectiveness and safety of the current vaccines during pregnancy. This review also sheds light on important areas that need to be carefully or more fully considered with respect to understanding SARS-CoV-2 disease mechanisms of concern during pregnancy.