COVID-19 and Pregnancy: An Updated Review about Evidence-Based Therapeutic Strategies

Author:

Favilli Alessandro1ORCID,Mattei Gentili Marta1,De Paola Francesca1,Laganà Antonio Simone2ORCID,Vitagliano Amerigo3ORCID,Bosco Mariachiara4,Cicinelli Ettore3ORCID,Chiantera Vito2,Uccella Stefano4ORCID,Parazzini Fabio5,Gerli Sandro1ORCID,Garzon Simone4ORCID

Affiliation:

1. Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy

2. Unit of Gynecologic Oncology, ARNAS “Civico–Di Cristina–Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy

3. Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, University of Bari, 70121 Bari, Italy

4. Unit of Obstetrics and Gynecology-Department of Surgery, Dentistry, Pediatrics, and Gynecology, AOUI Verona-University of Verona Piazzale A. Stefani 1, 37126 Verona, Italy

5. Department of Clinic and Community Science, Mangiagalli Hospital, University of Milan, 20122 Milan, Italy

Abstract

The COVID-19 pandemic posed a significant challenge for clinicians in managing pregnant women, who were at high risk of virus transmission and severe illness. While the WHO declared in May 2023 that COVID-19 is no longer a public health emergency, it emphasized that it remains a global health threat. Despite the success of vaccines, the possibility of new pandemic waves due to viral mutations should be considered. Ongoing assessment of the safety and effectiveness of pharmacological therapies is crucial in clinical practice. This narrative review summarizes the evidence-based therapeutic strategies for pregnant women with COVID-19, considering over three years of pandemic experience. The review discusses the safety and effectiveness of various drug regimens (antivirals, anticoagulants, corticosteroids, immunoglobulins, monoclonal antibodies, and therapeutic gases) and procedures (prone positioning and extracorporeal membrane oxygenation). Drugs with contraindications, inefficacy during pregnancy, or unknown adverse effects were excluded from our evaluation. The aim is to provide healthcare professionals with a comprehensive guide for managing pregnant women with COVID-19 based on lessons learned from the pandemic outbreak.

Publisher

MDPI AG

Subject

Medicine (miscellaneous)

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