COVID-19 Treatment: Drug Safety Prior to Conception and During Pregnancy and Breastfeeding

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.

Zusammenfassung

Im Dezember 2019 wurde erstmals eine neue virale Atemwegserkrankung, die den Namen Coronavirus-Erkrankung 2019 (COVID-19) bekam, in der chinesischen Stadt Wuhan diagnostiziert. COVID-19 verbreitete sich rasch über die ganze Welt, was die Weltgesundheitsorganisation veranlasste, am 11. März 2020 eine Pandemie auszurufen. Die neuartige Erkrankung wird von einem Virus aus der Familie der Coronaviridae hervorgerufen und wird SARS-CoV-2 (severe acute respiratory syndrome coronovirus type 2) genannt. SARS-CoV-2 trägt ähnliche Merkmale wie Viren, die bei anderen Epidemien als Erreger auftraten, z. B. SARS-CoV (severe acute respiratory syndrome coronavirus) und MERS-CoV (Middle East respiratory syndrome coronavirus). Epidemiologische Studien haben gezeigt, dass COVID-19 oft junge Erwachsene im fortpflanzungsfähigen Alter befällt und dass die Sterberaten bei älteren Menschen und Menschen mit chronischen Erkrankungen hoch sind. Über die Auswirkungen von COVID-19 während der Schwangerschaft und in der Stillzeit ist wenig bekannt. Die meisten Fälle mit COVID-19 haben milde grippeähnliche Symptome und benötigen Medikamente nur, um die Symptome zu bekämpfen. Andere Patienten hingegen müssen auf der Intensivstation behandelt werden. Es gibt derzeit keine spezifische, effektive Behandlung gegen COVID-19. Es werden aber eine ganze Reihe von Medikamenten eingesetzt, um gegen die Infektion mit SARS-CoV-2 zu kämpfen. Die Erfahrungen mit diesem therapeutischen Arsenal wurden über Jahrzehnte hinweg durch ihren Einsatz gegen andere virale, autoimmune, parasitäre und bakterielle Erkrankungen gesammelt. Wichtig ist, dass bei der Suche nach einer effektiven Behandlung gegen COVID-19 keine schwangeren Frauen mit SARS-CoV-2 den möglichen teratogenen Risiken dieser Therapeutika ausgesetzt werden. Es ist daher nötig, die Sicherheit von Anti-COVID-19-Therapien präkonzeptionell sowie während der Schwangerschaft und in der Stillzeit zu bestimmen.

Key words

COVID-19 - SARS-CoV-2 - antiviral - pregnancy - breastfeeding

Schlüsselwörter

COVID-19 - SARS-CoV-2 - antiviral - Schwangerschaft - Stillen

Publication History

Received: 19 June 2020

Accepted after revision: 25 August 2020

Article published online:
19 January 2021

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