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COVID-19 Treatment: Drug Safety Prior to Conception and During Pregnancy and Breastfeeding
Marcelo Borges Cavalcante1,2, Candice Torres de Melo Bezerra Cavalcante3, Ana Catherine Sampaio Braga1
1Department of Obstetrics and Gynecology, University of Fortaleza (UNIFOR), Fortaleza-CE, Brazil.
Insights
The safety of COVID-19 treatments during pregnancy and breastfeeding is largely unknown. Research is needed to ensure therapies for pregnant women do not pose teratogenic risks.
Area of Science:
- Infectious Diseases
- Maternal-Fetal Medicine
- Pharmacology
Background:
- Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, emerged in late 2019 and was declared a pandemic in March 2020.
- While COVID-19 primarily affects the elderly and those with chronic conditions, it also impacts young adults of reproductive age.
- Limited information exists regarding COVID-19's effects on pregnancy and breastfeeding.
Purpose of the Study:
- To highlight the critical need for understanding the safety of anti-COVID-19 therapies in pregnant and breastfeeding women.
- To emphasize the potential teratogenic risks associated with drugs used to treat SARS-CoV-2 infections.
- To advocate for the determination of safe therapeutic options prior to conception, during pregnancy, and postpartum.
Main Methods:
- Review of existing literature on COVID-19 epidemiology and treatment.
- Analysis of drug safety profiles in the context of pregnancy and breastfeeding.
- Identification of knowledge gaps concerning anti-COVID-19 therapies in reproductive-aged women.
Main Results:
- COVID-19 presents with a range of symptoms, from mild to severe, requiring diverse treatment approaches.
- Numerous drugs are being repurposed for SARS-CoV-2 treatment, drawing from experience with other diseases.
- The potential teratogenic effects of these drugs on pregnant women are a significant concern.
Conclusions:
- There is currently no specific effective treatment for COVID-19.
- The safety of anti-COVID-19 medications for pregnant and breastfeeding individuals requires thorough investigation.
- Prioritizing the safety of expectant and nursing mothers is essential in the development and application of COVID-19 treatments.
Abstract:
In December 2019, a new viral respiratory infection known as coronavirus disease 2019 (COVID-19) was first diagnosed in the city of Wuhan, China. COVID-19 quickly spread across the world, leading the World Health Organization to declare it a pandemic on March 11, 2020. The disease is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a similar virus to those involved in other epidemics such as severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). Epidemiological studies have shown that COVID-19 frequently affects young adults of reproductive age and that the elderly and patients with chronic disease have high mortality rates. Little is known about the impact of COVID-19 on pregnancy and breastfeeding. Most COVID-19 cases present with mild flu-like symptoms and only require treatment with symptomatic relief medications, whereas other cases with COVID-19 require treatment in an intensive care unit. There is currently no specific effective treatment for COVID-19. A large number of drugs are being used to fight infection by SARS-CoV-2. Experience with this therapeutic arsenal has been gained over the years in the treatment of other viral, autoimmune, parasitic, and bacterial diseases. Importantly, the search for an effective treatment for COVID-19 cannot expose pregnant women infected with SARS-CoV-2 to the potential teratogenic risks of these drugs. Therefore, it is necessary to determine and understand the safety of anti-COVID-19 therapies prior to conception and during pregnancy and breastfeeding.
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