key: cord-0854001-5m1zzr0v authors: Pérez-López, Faustino R.; Savirón-Cornudella, Ricardo; Chedraui, Peter; Genazzani, Andrea R. title: Severe acute respiratory syndrome coronavirus 19 and human pregnancy date: 2020-04-09 journal: Gynecol Endocrinol DOI: 10.1080/09513590.2020.1747426 sha: 71584a027fa1400543a480e8250a43bbec7b9bd0 doc_id: 854001 cord_uid: 5m1zzr0v nan Pregnant women can be infected by SARS-CoV (1 and 2) or MERS; however, COVID-19 disease seems less aggressive than the other viral infections. Despite this, available data linking COVID-19 disease with adverse maternal and perinatal outcomes are limited; however, infected pregnants do not appear to be more susceptible than individuals of the general population [19] and fetal involvement will depend, to a great extent, on maternal well-being. Vertical transmission has not been demonstrated in pregnant women with SARS-CoV-1 and MERS-CoV infection [20] . In this same sense, although COVID-19 infections have been reported in few pregnant women, no vertical transmission has yet been documented [21] [22] [23] . The effects of COVID-19 infection on maternal and fetal health will be defined with the outcome of current positive pregnant women. If one takes into consideration outcomes of other viruses of the same family, and the available evidence, it is less likely that the infection is a determinant factor for adverse reproductive outcomes. The problem in pregnant women may, however, depend on the general complications related per se to the infection. Nevertheless, most pregnancy cases are expected to be mild or moderate [19] although COVID-19 pneumonia pregnancy cases have been reported [22, 24] . It seems premature to determine a possible risk of miscarriage or second trimester loss due to COVID-19 based on case reports of SARS-CoV-1 and MERS that were not later confirmed [19, 25] . As with SARS-CoV-1 and MERS, fatality has been observed in cases of COVID-19 pneumonia. Despite this, fatality rate among pregnants seems to be similar to that of non-pregnants [20] [21] [22] . Current obstetric recommendations are based mainly on outcomes observed in Chinese pregnant women; however, quality of healthcare is not homogeneous in Asian and non-Asian countries. Hence, outcomes worldwide will differ which will probably be related to organization/clinical services, quality of care and the available resources of each country. Fortunately, within this scenario, it seems that the placenta protects fetal growth and development although outcome data of women acquiring the infection during early phases of pregnancy is still lacking. One cannot omit the fact that to fight pandemics there is an urgent need for international collaboration with the overcoming of political barriers. Depending on the political organization of some countries, regions or communities bureaucracy may increase and condemn individuals to be exempt of benefits on equal terms and effectiveness. This situation must serve as a lesson to be learned in the mediate future. The current SARS-CoV-2 pandemia is global although the prevalence of the infection cannot be assessed due to the lack of sufficiently precise tests to be offered to all possible suspected patients. For now, 'flattening the curve' of cases seems to be the best strategy. Although this seems simple, in fact, it is difficult to be carried out and may be delayed or never achieved for some countries. In any case, this is not the final solution but may provide us time until an effective anti-viral agent or vaccine is developed. To date, the prevention of contagion is the best treatment for the current scenario. Outcomes of pregnants delivering in the upcoming months will provide more information on this particular new disease and its relation to pregnancy. In the meantime, it seems best that women should be encouraged to delay becoming pregnant until more evidence related to risks associated to COVID-19 infection during pregnancy is available. In addition, women susceptible to be submitted to assisted reproductive technology should take some additional precautions as recently recommended by La Marca et al. [26] . Finally, the current pandemic has revealed a new phenomenon or scenario in scientific communication that is now carried out in real time and without barriers, with the sharing of scientific information between technological centers/hospitals and the general population. Faustino R. P erez-L opez Instituto de Investigaci on Sanitaria de Arag on and University of Zaragoza Faculty of Medicine, Zaragoza, Spain faustino.perez@unizar.es Ricardo Savir on-Cornudella Servicio de Ginecolog ıa y Obstetricia, Hospital General de Villaba, Madrid, Spain An interactive web-based dashboard to track COVID-19 in real time Coronavirus COVID-19 global cases by the Center for Systems Science and End Engineering (CSSE) at Johns Hopkins Identification of coronavirus isolated from a patient in Korea with COVID-19. Osong Public Health Res Perspect The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: estimation and application Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study Clinical characteristics of coronavirus disease 2019 in China Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study Europe's doctors repeat errors made in Wuhan, China medics say UK failures over COVID-19 will increase death toll, says leading doctor COVID-19 and Italy: what next? Lancet WHO statement regarding cluster of pneumonia cases in Wuhan FIGO. COVID-19 (Coronavirus) Statement Oxford COVID-19 Evidence Service Coronavirus (COVID-19) infection and pregnancy Updated Society of Obstetricians and Gynaecologists of Canada (SOGC) Committee Opinion -COVID-19 in pregnancy Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records Clinical manifestations and outcome of SARS-CoV-2 infection during pregnancy Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia Infants born to mothers with a new coronavirus (COVID-19). Front Pediatr Clinical analysis of pregnancy in second and third trimesters complicated severe acute respiratory syndrome COVID-19: lessons from the Italian reproductive medical experience The first draft of this contribution was performed by FRPL, then all authors contributed to the final editing of the manuscript. All authors approved the final version. The authors report no potential conflicts of interest.