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Severe acute respiratory syndrome coronavirus-2 and the deduction effect of angiotensin-converting enzyme 2 in pregnancy.
Lai, Yu-Ju; Chang, Chia-Ming; Lin, Chi-Kung; Yang, Yi-Ping; Chien, Chian-Shiu; Wang, Peng-Hui; Chang, Cheng-Chang.
  • Lai YJ; Department of Obstetrics and Gynecology, Tri-service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
  • Chang CM; Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
  • Lin CK; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
  • Yang YP; Department of Obstetrics and Gynecology, Tri-service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
  • Chien CS; Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
  • Wang PH; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
  • Chang CC; Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc ; 83(9): 812-816, 2020 09.
Article in English | MEDLINE | ID: covidwho-752078
Semantic information from SemMedBD (by NLM)
1. angiotensin converting enzyme 2 AFFECTS Pregnancy
Subject
angiotensin converting enzyme 2
Predicate
AFFECTS
Object
Pregnancy
2. Symptoms PROCESS_OF Pregnant Women
Subject
Symptoms
Predicate
PROCESS_OF
Object
Pregnant Women
3. receptor PART_OF 2019 novel coronavirus
Subject
receptor
Predicate
PART_OF
Object
2019 novel coronavirus
4. Therapeutic immunosuppression PREDISPOSES Pneumonia
Subject
Therapeutic immunosuppression
Predicate
PREDISPOSES
Object
Pneumonia
5. Antiviral Agents INTERACTS_WITH RNA
Subject
Antiviral Agents
Predicate
INTERACTS_WITH
Object
RNA
6. remdesivir TREATS 2019 novel coronavirus
Subject
remdesivir
Predicate
TREATS
Object
2019 novel coronavirus
7. chloroquine TREATS 2019 novel coronavirus
Subject
chloroquine
Predicate
TREATS
Object
2019 novel coronavirus
8. Antibiotics PREVENTS Secondary Infections
Subject
Antibiotics
Predicate
PREVENTS
Object
Secondary Infections
9. Adrenal Cortex Hormones TREATS Disease
Subject
Adrenal Cortex Hormones
Predicate
TREATS
Object
Disease
10. angiotensin converting enzyme 2 AFFECTS Pregnancy
Subject
angiotensin converting enzyme 2
Predicate
AFFECTS
Object
Pregnancy
11. Symptoms PROCESS_OF Pregnant Women
Subject
Symptoms
Predicate
PROCESS_OF
Object
Pregnant Women
12. receptor PART_OF 2019 novel coronavirus
Subject
receptor
Predicate
PART_OF
Object
2019 novel coronavirus
13. Therapeutic immunosuppression PREDISPOSES Pneumonia
Subject
Therapeutic immunosuppression
Predicate
PREDISPOSES
Object
Pneumonia
14. Antiviral Agents INTERACTS_WITH RNA
Subject
Antiviral Agents
Predicate
INTERACTS_WITH
Object
RNA
15. remdesivir TREATS 2019 novel coronavirus
Subject
remdesivir
Predicate
TREATS
Object
2019 novel coronavirus
16. chloroquine TREATS 2019 novel coronavirus
Subject
chloroquine
Predicate
TREATS
Object
2019 novel coronavirus
17. Antibiotics PREVENTS Secondary Infections
Subject
Antibiotics
Predicate
PREVENTS
Object
Secondary Infections
18. Adrenal Cortex Hormones TREATS Disease
Subject
Adrenal Cortex Hormones
Predicate
TREATS
Object
Disease
ABSTRACT
The 2019 novel coronavirus (2019-nCoV, later named SARS-CoV-2) is a pandemic disease worldwide. The spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is continuing at a rapid speed. Till May 4, 2020, there have been 3,407,747 confirmed cases and 238,198 deaths globally. The common symptoms in pregnant women are fever, cough, and dyspnea. Angiotensin-converting enzyme 2 (ACE2) has transient overexpression and increased activity during pregnancy, which is now confirmed as the receptor of SARS-CoV-2 and plays essential roles in human infection and transmission. There is no evidence that pregnant women are more susceptible to SARS-CoV-2. To date, there is no valid medication or vaccination. The immune suppression or modulation during pregnancy increases the risk of severe pneumonia. Remdesivir is an antiviral medication targeting ribonucleic acid (RNA) synthesis that has clinical improvement in the treatment of SARS-CoV-2. Chloroquine is controversial in its effectiveness and safety to treat SARS-CoV-2. Remdesivir is safe in pregnancy. Chloroquine has not been formally assigned to a pregnancy category by the Food and Drug Administration (FDA). The management strategy includes monitoring fetal heart rate and uterine contractions; early oxygenation if O2 saturation is less than 95%; empiric antibiotics for prevention of secondary infection; corticosteroid to treat maternal SARS-CoV-2 disease routinely is not suggested, only for fetal lung maturation in selected cases; and consideration of delivery is according to the obstetric indication, gestational age, and severity of the disease. During epidemics, delivery at 32-34 weeks is considered. The indication for the Cesarean section should be flexible to minimize the risk of infection during the delivery. The newborn should be in isolation ward immediately after birth; breastfeeding is not contraindicated but should avoid direct transmission infection.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Pregnancy Complications, Infectious / Coronavirus Infections / Peptidyl-Dipeptidase A / Betacoronavirus Type of study: Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Female / Humans / Infant, Newborn / Pregnancy Language: English Journal: J Chin Med Assoc Journal subject: Medicine Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Pregnancy Complications, Infectious / Coronavirus Infections / Peptidyl-Dipeptidase A / Betacoronavirus Type of study: Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Female / Humans / Infant, Newborn / Pregnancy Language: English Journal: J Chin Med Assoc Journal subject: Medicine Year: 2020 Document Type: Article