SARS-CoV-2 (COVID-19) as a possible risk factor for neurodevelopmental disorders

Area of Science:

• Neuroscience
• Immunology
• Maternal-Fetal Medicine

Background:

• Pregnant women are highly susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
• Coronavirus disease 2019 (COVID-19) in pregnancy poses risks to fetal neurodevelopment.
• Maternal SARS-CoV-2 infection can affect the fetus through various pathways.

Purpose of the Study:

• To review the potential mechanisms by which SARS-CoV-2 infection during pregnancy may impact fetal brain development.
• To explore both direct and indirect pathways of neurodevelopmental disruption.
• To highlight the need for further research into long-term outcomes.

Main Methods:

• Literature review of existing studies on SARS-CoV-2, pregnancy, and neurodevelopment.
• Analysis of proposed mechanisms including maternal-fetal transmission, placental dysfunction, and maternal immune activation.
• Synthesis of evidence on cytokine effects and hypothalamic-pituitary-adrenal (HPA) axis disruption.

Main Results:

• SARS-CoV-2 can transmit from mother to fetus, potentially leading to neuroinvasion.
• Placental issues like preeclampsia and intrauterine growth restriction can arise from infection.
• Maternal immune activation may cause fetal hypomyelination, microglial changes, and altered neurogenesis.
• Disruption of the maternal/fetal HPA axis and epigenetic alterations are potential consequences.

Conclusions:

• SARS-CoV-2 infection in pregnancy presents multiple risks for fetal neurodevelopment.
• Mechanisms include direct viral effects, placental compromise, and maternal immune responses.
• Long-term studies are essential to understand the full spectrum of neurodevelopmental disorders in affected children.