Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter June 30, 2021

COVID-19 in pregnancy: where are we now?

  • Nicola Volpe ORCID logo EMAIL logo , Giovanni Battista Luca Schera , Andrea Dall’Asta , Elvira Di Pasquo and Tullio Ghi

Corresponding author: Nicola Volpe, Department of Medicine and Surgery, Obstetrics and Gynecology Unit, University of Parma, Parma, Italy, Parma, Italy, E-mail:

  1. Research funding: None declared.

  2. Author contribution: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.


1. Zhu, N, Zhang, D, Wang, W, Li, X, Yang, B, Song, J, et al.. China novel coronavirus investigating and research team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727–33. in Google Scholar

2. ECDC Technical Report. Infection prevention and control for the care of patients with 2019-nCoV in healthcare settings [Internet]. Stockholm: ECDC; 2020. Available from: prevention-and-control-and-preparedness-covid-19- healthcare-settings.Search in Google Scholar

3. WHO coronavirus (COVID-19) dashboard. Available from: in Google Scholar

4. Byambasuren, O, Dobler, CC, Bell, K, Rojas, DP, Clark, J, McLaws, ML, et al.. Comparison of seroprevalence of SARS-CoV-2 infections with cumulative and imputed COVID-19 cases: systematic review. PLoS One 2021;16: e0248946. in Google Scholar

5. Attaway, A, Hatipoğlu, U. Management of patients with COPD during the COVID-19 pandemic. Cleve Clin J Med 2020. Epub ahead of print. PMID: 32393594. in Google Scholar

6. Abu-Rustum, RS, Akolekar, R, Sotiriadis, A, Salomon, LJ, Costa, FDS, Wu, Q, et al.. ISUOG Consensus Statement on organization of routine and specialist obstetric ultrasound services in context of COVID-19. Ultrasound Obstet Gynecol 2020;55:863–70. in Google Scholar

7. Vousden, N, Bunch, K, Morris, E, Simpson, N, Gale, C, O’Brien, P, et al.. The incidence, characteristics and outcomes of pregnant women hospitalized with symptomatic and asymptomatic SARS-CoV-2 infection in the UK from March to September 2020: a national cohort study using the UK Obstetric Surveillance System (UKOSS). PLoS One 2021;16: e0251123. in Google Scholar

8. Ellington, S, Strid, P, Tong, VT, Woodworth, K, Galang, RR, Zambrano, LD, et al.. Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status - United States, January 22-June 7, 2020. MMWR Morb Mortal Wkly Rep 2020;69:769–75. in Google Scholar

9. Jin, Y, Yang, H, Ji, W, Wu, W, Chen, S, Zhang, W, et al.. Virology, epidemiology, pathogenesis, and control of COVID-19. Viruses 2020;12:372. in Google Scholar

10. Hoffmann, M, Kleine-Weber, H, Schroeder, S, Krüger, N, Herrler, T, Erichsen, S, et al.. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020;181:271–80.e8. in Google Scholar

11. Di Mascio, D, Sen, C, Saccone, G, Galindo, A, Grünebaum, A, Yoshimatsu, J, et al.. Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19. J Perinat Med 2020;48:950–8. in Google Scholar

12. Siddiqi, HK, Mehra, MR. COVID-19 illness in native and immunosuppressed states: a clinical-therapeutic staging proposal. J Heart Lung Transplant 2020;39:405–7. in Google Scholar

13. Ji, HL, Zhao, R, Matalon, S, Matthay, MA. Elevated plasmin(ogen) as a common risk factor for COVID-19 susceptibility. Physiol Rev 2020;100:1065–75. in Google Scholar

14. Wastnedge, EAN, Reynolds, RM, van Boeckel, SR, Stock, SJ, Denison, FC, Maybin, JA, et al.. Pregnancy and COVID-19. Physiol Rev 2021;101:303–18. in Google Scholar

15. Di Renzo, GC, Giardina, I. Coronavirus disease 2019 in pregnancy: consider thromboembolic disorders and thromboprophylaxis. Am J Obstet Gynecol 2020;223:135. in Google Scholar

16. The Royal College of Obstetricians and Gynaecologists Information for healthcare professionals coronavirus (COVID-19) infection and abortion care (Online). Available from: in Google Scholar

17. Teuwen, LA, Geldhof, V, Pasut, A, Carmeliet, P. COVID-19: the vasculature unleashed. Nat Rev Immunol 2020;20:389–91. Erratum in: Nat Rev Immunol. 2020 Jun 4. in Google Scholar

18. Di Mascio, D, Khalil, A, Saccone, G, Rizzo, G, Buca, D, Liberati, M, et al.. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM 2020;2:100107. in Google Scholar

19. Della Gatta, AN, Rizzo, R, Pilu, G, Simonazzi, G. Coronavirus disease 2019 during pregnancy: a systematic review of reported cases. Am J Obstet Gynecol 2020;223:36–41. in Google Scholar

20. Villar, J, Ariff, S, Gunier, RB, Thiruvengadam, R, Rauch, S, Kholin, A, et al.. Maternal and neonatal morbidity and mortality among pregnant women with and without COVID-19 infection: the intercovid multinational cohort study. JAMA Pediatr. 2021: e211050. Epub ahead of print. PMID: 33885740; PMCID: PMC8063132. in Google Scholar

21. Di Mascio, D, Khalil, A, Saccone, G, Rizzo, G, Buca, D, Liberati, M, et al.. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM 2020;2:100107. in Google Scholar

22. Cosma, S, Carosso, AR, Cusato, J, Borella, F, Carosso, M, Bovetti, M, et al.. Coronavirus disease 2019 and first-trimester spontaneous abortion: a case-control study of 225 pregnant patients. Am J Obstet Gynecol 2021;224:391.e1–391.e7. in Google Scholar

23. Zeng, H, Xu, C, Fan, J, Tang, Y, Deng, Q, Zhang, W, et al.. Antibodies in infants born to mothers with COVID-19 pneumonia. J Am Med Assoc 2020;323:1848–9. in Google Scholar

24. WHO Breastfeeding and COVID-19 for healthcare workers (Online). Available from: in Google Scholar

25. Mullins, E, Evans, D, Viner, RM, O’Brien, P, Morris, E. Coronavirus in pregnancy and delivery: rapid review. Ultrasound Obstet Gynecol 2020;55:586–92. in Google Scholar

26. Bérard, A, Sheehy, O, Zhao, JP, Vinet, E, Quach, C, Kassai, B, et al.. Available medications used as potential therapeutics for COVID-19: what are the known safety profiles in pregnancy. PLoS One 2021;16: e0251746. in Google Scholar

27. RECOVERY Collaborative Group, Horby, P, Lim, WS, Emberson, JR, Mafham, M, Bell, JL, Linsell, L, et al.. Dexamethasone in hospitalized patients with covid-19. N Engl J Med 2021;384:693–704. in Google Scholar

28. Di Castelnuovo, A, Costanzo, S, Antinori, A, Berselli, N, Blandi, L, Bonaccio, M, et al.. Heparin in COVID-19 patients is associated with reduced in-hospital mortality: the multicenter Italian CORIST study. Thromb Haemostasis 2021. Epub ahead of print. PMID: 33412596. in Google Scholar

29. Tang, N, Bai, H, Chen, X, Gong, J, Li, D, Sun, Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemostasis 2020;18:1094–9. in Google Scholar

30. Wang, Y, Zhang, D, Du, G, Du, R, Zhao, J, Jin, Y, et al.. Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet 2020;395:1569–78. Erratum in: Lancet. 2020 May 30;395(10238): 1694. in Google Scholar

31. Spinner, CD, Gottlieb, RL, Criner, GJ, Arribas López, JR, Cattelan, AM, Soriano Viladomiu, A, et al.. GS-US-540-5774 investigators. Effect of remdesivir vs standard care on clinical status at 11 days in patients with moderate COVID-19: a randomized clinical trial. J Am Med Assoc 2020;324:1048–57. in Google Scholar

32. RECOVERY Collaborative Group. Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet 2021;397:605–12. in Google Scholar

33. PRINCIPLE Trial Collaborative Group. Azithromycin for community treatment of suspected COVID-19 in people at increased risk of an adverse clinical course in the UK (PRINCIPLE): a randomised, controlled, open-label, adaptive platform trial. Lancet 2021;397:1063–74. in Google Scholar

34. Self, WH, Semler, MW, Leither, LM, Casey, JD, Angus, DC, Brower, RG, et al.. Effect of hydroxychloroquine on clinical status at 14 Days in hospitalized patients with COVID-19: a randomized clinical trial. J Am Med Assoc 2020;324:2165–76. in Google Scholar

35. RECOVERY Collaborative Group. Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial. Lancet 2021;S0140-6736:00897–7. in Google Scholar

36. Gottlieb, RL, Nirula, A, Chen, P, Boscia, J, Heller, B, Morris, J, et al.. Effect of bamlanivimab as monotherapy or in combination with etesevimab on viral load in patients with mild to moderate COVID-19: a randomized clinical trial. J Am Med Assoc 2021;325:632–44. in Google Scholar

37. COVID-19 vaccines while pregnant or breastfeeding. Available from: in Google Scholar

38. Joint committee on vaccination and immunisation: advice on COVID-19 vaccination. 2021. Available from: in Google Scholar

39. ACOG. Vaccinating pregnant and lactating patients against COVID-19. Last updated June 9, 2021. Available from: in Google Scholar

40. RCOG. Updated advice on COVID-19 vaccination in pregnancy and women who are breastfeeding. Available from: in Google Scholar

41. SOGC statement on COVID-19 vaccination in pregnancy. Reaffirmed date May 25, 2021. Available from: in Google Scholar

42. Position Paper “Gravidanza e Vaccinazione anti COVID”. 2021. Available from: in Google Scholar

43. Munoz, FM, Bond, NH, Maccato, M, Pinell, P, Hammill, HA, Swamy, GK, et al.. Safety and immunogenicity of tetanus diphtheria and acellular pertussis (Tdap) immunization during pregnancy in mothers and infants: a randomized clinical trial. J Am Med Assoc 2014;311:1760–9. Erratum in: JAMA. 2017 Jan 24;317(4):442. Erratum in: JAMA. 2017 Jan 24;317(4):441-442. in Google Scholar

Received: 2021-06-17
Accepted: 2021-06-17
Published Online: 2021-06-30
Published in Print: 2021-07-27

© 2021 Walter de Gruyter GmbH, Berlin/Boston

Downloaded on 22.9.2023 from
Scroll to top button