New coronavirus infection and pregnancy

The novel coronavirus infection (COVID-19), first reported in Wuhan, China in December 2019, is dangerous for pregnant women, and the probability of infection is the same as in the general population. COVID-19 may be transmitted from person to person through two different routes: airborne and direct contact. Diagnosis of COVID-19 requires the detection of SARS-CoV-2 RNA by reverse transcription polymerase chain reaction. The main biomaterial for laboratory research is discharge from the nasopharynx and (or) oropharynx. The incubation period for COVID-19 is thought to last from 2 to 14 days, with a median time of 4-5 days. The causative agent of COVID-19 can be detected in the upper respiratory tract 1-2 days before and within 7-14 days after the onset of symptoms. The disease can occur with mild-to-moderate severity, and manifests itself as a respiratory infection (runny nose, sore throat, low-grade fever, with no viral pneumonia and hypoxia). Severe COVID-19 may develop pneumonia, respiratory distress syndrome, sepsis, septic shock, cardiomyopathy, arrhythmia, renal failure, and other complications up to multiple organ failure. Pregnant women with COVID-19 may have complications of pregnancy, such as miscarriage, premature discharge of amniotic fluid, and premature birth. There are no reports of vertical transmission, but some newborns develop intrauterine growth retardation and life-threatening gastrointestinal complications. Thus, pregnant women with a confirmed diagnosis or suspicion of COVID-19 are at high risk for developing pregnancy complications and adverse perinatal outcomes. Currently, information is being collected on COVID-19 cases in pregnant women, the course of infection, and perinatal outcomes. Новая коронавирусная инфекция (COVID-19), впервые зарегистрированная в г. Ухань в Китае в декабре 2019 г., представляет опасность для беременных: вероятность их заражения такая же, как у населения в целом. Существует два пути передачи COVID-19: воздушно-капельный и контактно-бытовой. Для диагностики COVID-19 необходимо обнаружить РНК SARS-CoV-2 методом обратной транскрипционной полимеразной цепной реакции. Основным биоматериалом для лабораторного исследования служат выделения из носоглотки и/или ротоглотки. Инкубационный период COVID-19 длится от 2 до 14 дней, в среднем - 4-5 дней. Возбудителя COVID-19 можно обнаружить за 1-2 дня до появления симптомов заболевания и в течение 7-14 дней после появления симптомов в отделяемом верхних дыхательных путей. Болезнь может протекать с легкой и средней степенью тяжести и проявляется как респираторная инфекция (насморк, боли в горле, невысокая температура, при этом отсутствуют вирусная пневмония и гипоксия). При тяжелом течении COVID-19 могут развиться пневмония, респираторный дистресс-синдром, сепсис, септический шок, кардиомиопатия, аритмия, почечная недостаточность и другие осложнения вплоть до полиорганной недостаточности. У беременных с COVID-19 возможны осложнения течения беременности, такие как выкидыш, преждевременное излитие околоплодных вод, преждевременные роды. Отсутствуют сообщения о вертикальной передаче инфекции, но у некоторых новорожденных развивается задержка внутриутробного развития и угрожающие жизни желудочно-кишечные осложнения. Таким образом, беременные с подтвержденным диагнозом или подозрением на COVID-19 входят в группу высокого риска по развитию осложнений течения беременности и неблагоприятных перинатальных исходов. В настоящее время продолжается сбор информации о случаях COVID-19 у беременных, течении инфекции и перинатальных исходах.

Analysis of the Spectrum of ACE2 Variation Suggests a Possible Influence of Rare and Common Variants on Susceptibility to COVID-19 and Severity of Outcome.

OBJECTIVES: In March 2020, the World Health Organization declared that an infectious respiratory disease caused by a new severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2, causing coronavirus disease 2019 (COVID-19)] became a pandemic. In our study, we have analyzed a large publicly available dataset, the Genome Aggregation Database (gnomAD), as well as a cohort of 37 Russian patients with COVID-19 to assess the influence of different classes of genetic variants in the angiotensin-converting enzyme-2 (ACE2) gene on the susceptibility to COVID-19 and the severity of disease outcome. RESULTS: We demonstrate that the European populations slightly differ in alternative allele frequencies at the 2,754 variant sites in ACE2 identified in the gnomAD database. We find that the Southern European population has a lower frequency of missense variants and slightly higher frequency of regulatory variants. However, we found no statistical support for the significance of these differences. We also show that the Russian population is similar to other European populations when comparing the frequencies of the ACE2 variants. Evaluation of the effect of various classes of ACE2 variants on COVID-19 outcome in a cohort of Russian patients showed that common missense and regulatory variants do not explain the differences in disease severity. At the same time, we find several rare ACE2 variants (including rs146598386, rs73195521, rs755766792, and others) that are likely to affect the outcome of COVID-19. Our results demonstrate that the spectrum of genetic variants in ACE2 may partially explain the differences in severity of the COVID-19 outcome.