2. Pontifical Catholic University of Paraná, Curitiba, Brazil.
3. Federal University of Paraná, Curitiba, Brazil.
4. Mackenzie Evangelical College of Paraná, Curitiba, Brazil.
Based on previous knowledge of other epidemics such as SARS, MERS and H1N1, it is proposed that pregnant women may have a severe clinical outcome in some situations. It is not different for COVID-19. The control of SARS-CoV-2 infection among pregnant women and their potential risk of vertical transmission are a concern to the medical and scientific community. However, the maternal organism does not behave the same way during those forty weeks. Here we show the differences in pathophysiology of COVID-19 in pregnant women as a consequence of physiological and immunological changes related to each gestational period, in order to guide an appropriate therapy and care for this population. We observed that these women are in a transient physiological condition in which ACE-2 is highly expressed and, despite its protective mechanism for pregnancy, it is also used by the virus as a route of entry. Moreover, their physiological immunosuppression associated with cytokines increased levels, may lead to a cytokine storm, especially in the first trimester and at the end of pregnancy (pro-inflammatory stages). Therefore, we found in this review that individualization of each gestational period should be practiced not considering pregnancy as a unique status.
Keywords: Maternal Physiological Changes, Pathophysiology, COVID-19