女性COVID-19病程的特殊性

V. Moskaliuk, O. Yuzko, L. Dubyk, N. Chernetska
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引用次数: 0

摘要

目前最关键的话题之一是由SARS-CoV-2冠状病毒引起的病毒感染,这不仅具有医学意义,当然也具有社会意义。COVID-19大流行给世界各地的卫生保健系统带来了挑战。孕妇和老年人是最脆弱的人群。由于免疫反应性低,他们比其他人更容易出现严重的并发症,这使得COVID-19患者的妊娠问题成为一个紧迫的问题。成功怀孕需要改变孕妇的免疫系统,使其能够耐受基因外来的胎儿。免疫系统以及心脏、肺和其他系统的这些变化可导致妊娠期间感染引起的易感性增加或发病率和死亡率增加。考虑到与妊娠相关的生理适应,我们发现维持正常宫内发育的高代谢需求增加了妊娠期间氧化应激的负担。在怀孕期间,与母胎界面急性期反应相关的细胞内氧化还原变化可能会增强。值得注意的是,在大多数COVID-19妊娠中未检测到SARS-CoV-2的母婴传播。这种垂直传播的相对缺失可能是由于胎盘、羊水和乳腺分泌物中存在乳铁蛋白。然而,在covid -19相关妊娠期间诱导的细胞因子风暴可对胎儿造成严重的炎症损伤,如果不加以控制,可能随后导致自闭症谱系障碍和新生儿大脑发育异常。鉴于这种对儿童生长发育的严重健康威胁,在怀孕期间预防COVID-19应成为优先事项。我们旨在研究感染COVID-19的妇女的危险因素并评估其妊娠过程。本研究是在“脏腑综合病理分化治疗的临床与病理依据”研究工作(0122U002209)的框架内进行的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
PECULIARITIES OF THE COURSE OF THE DISEASE IN WOMEN WITH COVID-19
One of the most crucial topics at the moment is the viral infection caused by the SARS-CoV-2 coronavirus, which has acquired not only medical, but also, of course, social significance. The COVID-19 pandemic has challenged healthcare systems around the world.Pregnant women are the most vulnerable category of people, along with the elderly. Due to low immune reactivity, they are more susceptible to severe complications than others, which makes the problem of pregnancy in patients with COVID-19 a pressing issue.A successful pregnancy requires changes in the immune system of the pregnant woman to tolerate a genetically foreign fetus. These changes in the immune system, as well as in the cardiac, pulmonary, and other systems, can lead to increased susceptibility or increased morbidity and mortality due to infection during pregnancy. Considering the physiological adaptations associated with pregnancy, we found that the high metabolic demand to maintain normal intrauterine development increases the burden of oxidative stress during pregnancy. Intracellular redox changes associated with acute phase reactions at the maternal-fetal interface may be enhanced during pregnancy. Notably, mother-to-fetal transmission of SARS-CoV-2 has not been detected in most COVID-19 pregnancies. This relative absence of vertical transmission may be due to the presence of lactoferrin in the placenta, amniotic fluid, and breast secretions. However, the cytokine storm induced during COVID-19-associated pregnancies can cause severe inflammatory damage to the fetus and, if left uncontrolled, can subsequently lead to autism spectrum disorders and brain developmental abnormalities in newborns. Given this serious health threat to a child's growth and development, preventing COVID-19 during pregnancy should be a priority.We aimed to study risk factors and assess the course of pregnancy in women with COVID-19.The study was carried out within the framework of the research work "Clinical and pathogenetic substantiation of differentiated treatment of combined pathology of internal organs" (№0122U002209).
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