COVID-19 and fetal brain: Affectation and sequelae

ABSTRACT

Introduction: Viral infections in pregnant mothers can result in neurological disorders. Because of this, it is important to establish that there is fetal brain affectation due to COVID-19. Objective: To establish a direct and indirect relationship between SARS-CoV-2 infection during pregnancy, and adverse results on perinatalneurologicaldevelopment, as much as psychological long-term results. Material and methods: A narrative review of available evidence linked to the placenta and SARS-CoV-2 relationship, fetal brain physiopathology, and neuropsychiatric affectation was performed using PubMed, LILACS, and Google Scholar databases, on the time lapse between January 1997 to June 2022. Results: 66 studies with methodology, qualitative representability, and citation impact, according to the present research´s objective, were reviewed. Evidence review over COVID-19 and fetal central nervous system (CNS), establishes that chronic histiocytic intervillositis and trophoblast necrosis are risk factors for placental infection by SARS-CoV-2, viral vertical transmission, and breach of the maternal barrier-fetal. Fetal brain expression of protein S receptors suggests fetal brain incursion of SARS-CoV-2 in infected pregnancies, especially during the second and third trimesters of pregnancy. Infections during critical periods of early fetal neurodevelopment have been shown to increase the likelihood of neurodegenerative and neurobehavioral disorders, including autism or autism spectrum disorders (ASDs), and psychiatric illnesses in offspring. Conclusion: Evidence supports the possibility to establish a direct and indirect relationship between SARS-CoV-2 infection during pregnancy, and adverse results on perinatalneurologicaldevelopment, as much as psychological long-term results. © 2022 Academia Nacional de Medicina. All rights reserved.