SARS-CoV-2 Infection in Pregnant Women: Neuroimmune-Endocrine Changes at the Maternal-Fetal Interface

Neuroimmunomodulation. 2021;28(1):1-21. doi: 10.1159/000515556. Epub 2021 Apr 28.

Abstract

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) has devastating effects on the population worldwide. Given this scenario, the extent of the impact of the disease on more vulnerable individuals, such as pregnant women, is of great concern. Although pregnancy may be a risk factor in respiratory virus infections, there are no considerable differences regarding COVID-19 severity observed between pregnant and nonpregnant women. In these circumstances, an emergent concern is the possibility of neurodevelopmental and neuropsychiatric harm for the offspring of infected mothers. Currently, there is no stronger evidence indicating vertical transmission of SARS-CoV-2; however, the exacerbated inflammatory response observed in the disease could lead to several impairments in the offspring's brain. Furthermore, in the face of historical knowledge on possible long-term consequences for the progeny's brain after infection by viruses, we must consider that this might be another deleterious facet of COVID-19. In light of neuroimmune interactions at the maternal-fetal interface, we review here the possible harmful outcomes to the offspring brains of mothers infected by SARS-CoV-2.

Keywords: Coronavirus disease 2019; Maternal-fetal interface; Neurodevelopment; Neuroimmune interactions; Pregnancy; Severe acute respiratory syndrome-related coronavirus 2.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • COVID-19 / immunology*
  • COVID-19 / metabolism
  • COVID-19 / physiopathology
  • Cytokine Release Syndrome / immunology
  • Decidua / immunology
  • Female
  • Humans
  • Immune Tolerance / immunology
  • Infectious Disease Transmission, Vertical
  • Neurodevelopmental Disorders / physiopathology*
  • Neuroimmunomodulation / immunology*
  • Neuroimmunomodulation / physiology
  • Placenta / immunology
  • Pregnancy
  • Pregnancy Complications, Infectious / immunology*
  • Pregnancy Complications, Infectious / metabolism
  • Pregnancy Complications, Infectious / physiopathology
  • Prenatal Exposure Delayed Effects / physiopathology*
  • SARS-CoV-2
  • Umbilical Cord / immunology