Researchers conducted a systematic review of articles that analyzed the effect of medicine remedies used to treat COVID-19 during pregnancy.

Researchers conducted a systematic review of articles that analyzed the effect of medicine remedies used to treat COVID-19 during pregnancy.

RUDN physician Anna Borisova, in collaboration with colleagues from Italy, used effective searches and classified 123 articles on this research topic. A literature review was conducted by searching databases of medical and biological publications: PubMed, the U.S. National Library of Medicine, and Embase (Elsevier), a biomedical database.

Researchers conducted a search between 1st of January and 5th of May, 2020, using the keywords “COVID-19,” “SARS-CoV-2,” “pregnancy,” and “therapy.” The analysis covered only drugs with presumptive effects on COVID-19 whose safe use during pregnancy has been proven by clinical trials in other infectious diseases. Drugs contraindicated in pregnancy or with unknown side effects were not included in this review.

“Pregnant women are a high-risk group for coronavirus complications. The situation is also complicated by the fact that not all medications can be prescribed to pregnant women due to their possible teratogenic effect on the fetus, which poses new challenges for the development of effective and safe medications for this category of COVID-19 patients”, — Anna Borisova, Ph.D. in Medicine, assistant of the Department of Obstetrics and Gynecology, Institute of Medicine, RUDN.

As a result of the study, scientists identified groups of drugs that can be used to treat COVID-19 during pregnancy, as well as indications for their prescription:

  • Antiviral medications: lopinavir, ritonavir, remdesivir.
  • Antimalarial medications: hydroxychloroquine.
  • Anticoagulants medications: Low-molecular-weight heparin (due to increased risk of thromboembolic complications in patients with COVID-19).
  • Steroids medications: betamethasone (to accelerate fetal lung maturation, since SARS-CoV-2 infection during pregnancy, especially in the third trimester, may increase the risk of premature rupture of fetal membranes and premature birth).
  • Antibacterials medications: amoxicillin, azithromycin, ceftriaxone (must be prescribed only if a bacterial infection is suspected).
  • Metformin and statins (can be used as adjuvant therapy, to reduce the required dose of antiviral medication and, therefore, its side effects).
  • Reconvalescent plasma (antibodies contained in the plasma of convalescents reduce the viral load, the severity of the disease, and improve aeration).
  • Immunomodulators medications, such as tocilizumab.
  • Interferon type I.
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