ABSTRACT
SUMMARY The battle against human viral infections has historically relied on two medical strategies, namely vaccines to protect from contagion and antivirals to treat infected patients. In the absence of vaccines, antivirals have occasionally been used as peri-exposure prophylaxis, given either before (pre-exposure prophylaxis) or right after (post-exposure prophylaxis). In an unprecedented way, the use of antiretrovirals as chemoprophylaxis has triumphed in the HIV field. Indeed, oral antiretrovirals given either daily or at demand to HIV-uninfected individuals engaged in high-risk behaviors protect from contagion. More recently, the advent of long-acting formulations has allowed HIV protection following intramuscular injections every three months. Can we envision a similar prophylactic strategy for other human viral infections? The advent of such ‘chemical vaccines’ would fill an unmet need when classical vaccines do not exist, cannot be recommended, immune responses are suboptimal, escape mutants emerge or immunity wanes. In this review, we discuss the opportunities for antiviral chemoprophylaxis for viral hepatitis B and C, retroviruses HTLV-1 and HIV-2, and respiratory viruses influenza and SARS-CoV-2, among others.
ABSTRACT
The current situation of the COVID-19 pandemic should not make us forget oth- er non-infectious epidemics that cause disease, disability, and death worldwide, such as smoking. This epidemic s preventable and silently responsible for nearly 8 million deaths per year (World Health Organization [WHO], 2019). Smoking is a significant factor in reducing quality of life and life expectancy by 14 years on average (European Comission, 2021).
ABSTRACT
OBJETIVO: recopilar y contrastar la información científica disponible respecto al SARS-CoV-2 durante el proceso gestacional y sus efectos en la paciente obstétrica durante el parto, puerperio y en el recién nacido. MÉTODO: se realizó una revisión bibliográfica de la evidencia disponible en tres bases de datos internacionales: PubMed, Science Direct y Cochrane. Se utilizaron términos estandarizados, lenguaje libre, sinónimos y truncamientos, combinándolos con operadores booleanos en función de la capacidad de cada base de datos. Asimismo se han consultado las páginas web de organismos oficiales y sociedades científicas que abordaban el tema de embarazo y la COVID-19. RESULTADOS: se seleccionaron un total de 14 artículos y nueve guías de práctica clínica e informes técnicos procedentes de distintas organizaciones científicas nacionales e internacionales. La bibliografía es escasa y con poca evidencia científica dada la novedad de la pandemia por este coronavirus, pero se encontraron documentos científicos que abordaban el embarazo y feto, parto, puerperio y recién nacido. Se cree que el virus SARS-CoV-2 tiene reacciones menos adversas en la mujer embarazada y su recién nacido que otros virus de la misma familia. Cada mujer gestante infectada y su neonato deben ser identificados y valorados precozmente, de manera individual y multidisciplinar, para prevenir resultados adversos y complicaciones. No existe evidencia de la transmisión vertical del virus SARS-CoV-2. Hay discrepancias acerca del manejo del recién nacido de la mujer gestante infectada por COVID-19. CONCLUSIÓN: existen muchas lagunas de conocimiento en relación al manejo de la mujer gestante, parto, puerperio y recién nacido, ya que hay poca evidencia disponible OBJECTIVE: to collect and confirm the scientific information available regarding SARS-CoV-2 during the gestational process and its effects on the obstetric patient during delivery and puerperium, and on the newborn. METHOD: a bibliographic review of the evidence available was conducted in three international databases: PubMed, Science Direct and Cochrane. Standardized terms were used, as well as free language, synonyms and truncation, combining them with Boolean operators based on the capacity of each database. Likewise, the webpages of official organizations and scientific societies addressing the matter of pregnancy and COVID-19 were also consulted. RESULTS: in total, 14 articles and 9 clinical practice guidelines were selected, as well as technical reports from different national and international organizations. There is limited bibliography, and with low scientific evidence, given the novelty of the pandemic caused by this coronavirus, but scientific documents were retrieved which addressed pregnancy and fetus, delivery, puerperium and newborns. It is believed that the SARS-CoV-2 virus has less adverse reactions in the pregnant woman and her newborn than other viruses from the same class. Each pregnant woman infected and her newborn should be subject to early identification and evaluation, in an individual and multidisciplinary way, in order to prevent adverse results and complications. There is no evidence of the vertical transmission of the SARS-CoV-2 virus. There are discrepancies regarding the management of newborns of pregnant women infected by COVID-19. CONCLUSION: there are many knowledge gaps regarding the management of pregnant women, delivery, puerperium and newborns, because there is limited evidence available