Immunological environment shifts during pregnancy may affect the risk of developing severe complications in COVID‐19 patients

Sarapultsev, Alexey; Sarapultsev, Petr

PROBLEM: The 2019 novel coronavirus disease (COVID‐19) has been rapidly spreading out in China and all over the world. Because of the immune reaction severity, 20.3% of COVID‐19 patients required intensive care unit, and 32.8% presented with acute respiratory distress syndrome (ARDS). In this regard, the urgent question that needs to be addressed promptly includes whether pregnant women with COVID‐19 will develop distinct symptoms from non‐pregnant and what are the reasons for that. RESULTS: According to the literature data, clinical characteristics of pregnant women with COVID‐19 were similar to those of non‐pregnant adults and no significant differences in gestational age, postpartum hemorrhage, and perineal resection rates between pregnant women with and without COVID‐19 were found. There is also a tendency that COVID‐19 disease progresses slowly in pregnant women and does not often result in fatal pregnancy complications. CONCLUSIONS: The predominant Th2‐type immunity and the action of T‐regs can play an important role in preventing the excess systemic inflammatory reaction and the development of life‐threatening complications as ARDS and MODS in COVID‐19 patients. This suggests a search for new drugs aimed at the suppression of effector functions and induction of tolerance, which will reduce the frequency of life‐threatening complications, including ARDS.