Effect of a new coronavirus infection COVID-19 on the immunological status of pregnant women

Introduction. The ongoing pandemic caused by the new coronavirus infection SARS-CoV-2 requires the development of effective methods of diagnosis, treatment and prevention of the disease. The problem is particularly urgent in obstetric practice. Currently, the effect of SARS-CoV-2 on the course of pregnancy, delivery and the condition of newborns is poorly studied. The aim of the investigation was to review the foreign and domestic literature data on the immune system status of novel coronavirus infection COVID-19 during pregnancy, its effect on perinatal outcomes. Materials and methods. Scientific publications were searched by keywords in Web of Science, Scopus, and Medline (2020–2021) and Russian specialized journals in obstetrics and gynecology (2019–2021) science databases. Particular attention was paid to the effect of COVID-19 infection caused by SARSCoV-2 on the formation of the immune response in pregnant women, in particular pro- and anti-inflammatory cytokines. Results and discussion. Immunological interactions in the maternal-placental-fetal system are quite complex and cannot be considered fully understood to date. Infectious diseases during gestation, due to the immune tolerance of the body, are often more severe than outside pregnancy, and the presence of associated somatic diseases only aggravates the clinical picture. The analysis showed the importance of the role of local protective factors in the new SARS-CoV-2 coronavirus infection, and especially of the cytokine profile system, one of the leading factors of immunopathogenesis. In the initial stages of the infectious process, there is an increase in the production of pro-inflammatory cytokines in the formation of the body's defense in adverse infectious genesis, which may contribute to the kipping of inflammation in SARS-CoV-2. In the majority of cases, the occurrence of severe infection complications is accompanied by a systemic anti-inflammatory response syndrome; therefore, the evaluation of cytokine regulation during pregnancy is an important task. Conclusion. A detailed study of the cytokine profile will reveal an imbalance in the functional activity of immunocompetent cells and help to formulate predictive criteria affecting the resolution of inflammation in SARS-CoV-2, depending on the severity of the disease and gestational age, as well as predict the duration of immune response maintenance.

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