The coronavirus conundrum - Countries better prepared to face the pandemic - The Omicron variant and mutations New vaccines? - The pregnant woman, the placenta, the fetus and the neonate

Abstract

Several western countries have initiated the return to pre-pandemic life with the reduction in the number of severe infections and deaths despite of the high infectivity of the Omicron B2 variant. This is occurring amid complaints from the population tired of the restrictions due to COVID-19, the consequent economic and labor problems and with an antivaccine sector with an important presence. SARS-CoV-2 will not disappear, new variants will emerge, and it will be necessary to be alert to its threats and design new vaccines. However, human beings are learning the measures to prevent infection, the importance of self-protection and of the family, and the surveillance of the virus. Imperfect vaccines have been developed that require boosters at relatively short intervals. However, many countries are not yet prepared to face the pandemic - now endemic - due to overconfidence in the eventual disappearance of the virus, lack of human and economic resources for better health care, and corruption. Women are more sensitive to viral infection and is getting vaccinated to avoid serious infection and death. Evidence finds that pregnant women with COVID-19 suffer more miscarriages, preterm deliveries, and intrauterine and perinatal death. The placenta is the unit most compromised in its defense of the fetus. The resulting placentitis causes placental insufficiency and fetal hypoxic-ischemic injury. Newborns are protected by the passage of maternal antibodies, with a longer duration of those originated by vaccines. Much remains to be known about the future of SARS-CoV-2 infection. But a complex and shocking problem resulting from the infection is already a reality - the prolongation of multi-organ damage, even with mild disease, mainly in the cardiovascular, pulmonary, and cerebral systems, as well as the alteration of mental health and shortening of life.