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. 2020 Apr 23;1-12.
doi: 10.1007/s10096-020-03897-6. Online ahead of print.

Analysis of the Susceptibility to COVID-19 in Pregnancy and Recommendations on Potential Drug Screening

Free PMC article

Analysis of the Susceptibility to COVID-19 in Pregnancy and Recommendations on Potential Drug Screening

Xiaoxuan Zhao et al. Eur J Clin Microbiol Infect Dis. .
Free PMC article


To analyze the susceptibility of SARS-CoV-2 in pregnancy and the drugs that can be used to treat pregnancy with COVID-19, so as to provide evidence for drug selection in clinic. By reviewing the existing literature, this paper analyzes the susceptibility of pregnant women to virus, especially to SARS-CoV-2, from the aspects of anatomical, reproductive endocrine and immune changes during pregnancy and screens effective and fetal-safe treatments from the existing drugs. The anatomical structure of the respiratory system is changed during pregnancy, and the virus transmitted by droplets and aerosols is more easily inhaled by pregnant women and is difficult to remove. Furthermore, the prognosis is worse after infection when compared with non-pregnancy women. And changes in reproductive hormones and immune systems during pregnancy collectively make them more susceptible to certain infections. More importantly, angiotensin-converting enzyme (ACE)-2, the SARS-CoV-2 receptor, has been proven highly increased during pregnancy, which may contribute to the susceptibility to SARS-CoV-2. When it comes to treatment, specific drugs for COVID-19 have not been found at present, and taking old drugs for new use in treating COVID-19 has become an emergency method for the pandemic. Particularly, drugs that show superior maternal and fetal safety are worthy of consideration for pregnant women with COVID-19, such as chloroquine, metformin, statins, lobinavir/ritonavir, glycyrrhizic acid, and nanoparticle-mediated drug delivery (NMDD), etc. Pregnant women are susceptible to COVID-19, and special attention should be paid to the selection of drugs that are both effective for maternal diseases and friendly to the fetus. However, there are still many deficiencies in the study of drug safety during pregnancy, and broad-spectrum, effective and fetal-safe drugs for pregnant women need to be developed so as to cope with more infectious diseases in the future.

Keywords: Antiviral treatment; Fetal safety; New coronavirus disease; Pregnancy; Virus susceptibility.

Conflict of interest statement

The author declares that there are no conflicts of interest.


Fig. 1
Fig. 1
Schematic diagram of the structure of coronavirus

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    1. Organization. WH (2005) Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV)
    1. Kwon JY, Romero R, Mor G. New insights into the relationship between viral infection and pregnancy complications. Am J Reprod Immunol. 2014;71(5):387–390. doi: 10.1111/aji.12243. - DOI - PMC - PubMed
    1. Price ME, Fisher-Hoch SP, Craven RB, McCormick JB. A prospective study of maternal and fetal outcome in acute Lassa fever infection during pregnancy. BMJ. 1988;297(6648):584–587. doi: 10.1136/bmj.297.6648.584. - DOI - PMC - PubMed
    1. Jamieson DJ, Uyeki TM, Callaghan WM, Meaney-Delman D, Rasmussen SA. What obstetrician-gynecologists should know about Ebola: a perspective from the Centers for Disease Control and Prevention. Obstet Gynecol. 2014;124(5):1005–1010. doi: 10.1097/AOG.0000000000000533. - DOI - PubMed
    1. Fisk NM, Atun R. Systematic analysis of research underfunding in maternal and perinatal health. BJOG. 2009;116(3):347–356. doi: 10.1111/j.1471-0528.2008.02027.x. - DOI - PubMed

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