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International Journal of Molecular and Cellular Medicine، جلد ۹، شماره ۳، صفحات ۱۸۰-۱۸۷
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| عنوان فارسی |
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| چکیده فارسی مقاله |
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| کلیدواژه‌های فارسی مقاله |
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| عنوان انگلیسی |
An Experimental Model for Peri-conceptual COVID-19 Pregnancy Loss and Proposed Interventions to Optimize Outcomes |
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| چکیده انگلیسی مقاله |
Reports appear to give reassurance that vertical transmission near term is unlikely, but risks of incidental SARS-CoV-2 infection during fertility treatments, at embryo implantation, or in the first trimester remain unknown. If early pregnancy sequela in the current COVID-19 pandemic are modeled from the 2004 Coronavirus outbreak data, then SARS-CoV-2 infection proximate to blastocyst nidation is likely to cause implantation failure or spontaneous abortion. Our model explains why this outcome is less attributable to virus-associated maternal pulmonary distress and instead derives from systemic inflammation and interference with trophectoderm-endometrium molecular signaling required for implantation. COVID-19 is often accompanied by high levels of IL-6, IL-8, TNF-alpha and other cytokines, a process implicated in pulmonary collapse and systemic organ failure. Yet when regarded in an early reproductive context, this "cytokine storm" of COVID-19 triggers a pro-coagulative state hostile to normal in utero blastocyst/fetal development. Evidence from obstetrics is accumulating to show that mothers with SARS-CoV-2 deliver placentas with abnormal interstitial villi fibrin deposits, diffuse infarcts, and hemangiomatous changes. This model classifies such lesions as permissive at term but catastrophic near embryo implantation or early first trimester pregnancy, thus explaining the paucity of COVID-19 cases in early pregnancy where gestation remains viable. Clinical experience with recurrent pregnancy loss offers workable interventions to address this challenge, but success will depend on prompt and accurate SARS-CoV-2 diagnosis. Although no professional guidelines currently exist for SARS-CoV-2 in early pregnancy, this model would warrant a high-risk designation for such cases; these patients should receive priority access to screening and treatment resources. |
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| کلیدواژه‌های انگلیسی مقاله |
SARS-CoV-2, hypercoagulation, inflammation, implantation |
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| نویسندگان مقاله |
| Eric Scott Sills
Reproductive Research Section, FertiGen/CAG, San Clemente, California, USA; Department of Obstetrics and Gynecology, Palomar Medical Center; Escondido, California, USA.
| Samuel Horace Wood
Department of Obstetrics and Gynecology, Palomar Medical Center; Escondido, California, USA.
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| نشانی اینترنتی |
http://ijmcmed.org/browse.php?a_code=A-10-1788-2&slc_lang=en&sid=1 |
| فایل مقاله |
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| کد مقاله (doi) |
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| زبان مقاله منتشر شده |
en |
| موضوعات مقاله منتشر شده |
Infectious disease (Molecular and Cellular aspects) |
| نوع مقاله منتشر شده |
Mini-review |
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