Coronavirus disease 2019 and its controversial results during pregnancy

To the Editors:

It is with great interest that we read the article "Coronavirus Disease 2019 (COVID-19) and pregnancy: what obstetricians need to know," written by Rasmussen et al.¹ The article reported that, despite limited available data on the treatment of pregnant women with COVID-19, the serious clinical course of this disease might be avoided if the management of COVID-19 by healthcare professionals is based on the recommendations for the initial pregnancy care of women with severe acute respiratory syndrome or Middle East respiratory syndrome.

The article indicated that pregnant women and their fetuses are particularly susceptible to poor outcomes, owing to the physiological changes that occur during pregnancy, which render pregnant women more vulnerable to serious infections.¹ This information is corroborated by a systematic review of 108 cases, in which it was found that although the majority of mothers were discharged without major complications, serious maternal morbidity rates were reported.² However, these 2 publications differ from another article in which it was concluded that there were no serious complications—in the observed pregnant women—in addition to those complications already described in the nonpregnant female population.³ To date, the susceptibility of pregnant women to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and its associated complications has been a very controversial topic that remains unresolved.

The authors characterized the current pandemic as an unprecedented global health crisis. As a consequence of this situation, academic circles try to gather as much information about SARS-CoV-2 as possible. The lack of conclusive information regarding the prevention and treatment of SARS-CoV-2 infections prevents the development of a single strategy for the management of the infected population, whether pregnant or not.

However, taking into account that the basis of care for any pregnant woman is to prevent the disease spread by standard interventions, basic health measures must be put in place to prevent minor respiratory complications from becoming fatal. This requires aggressive implementation of an outbreak control and management model as soon as the virus reaches the community.⁴ In addition, surveillance of COVID-19 cases should include more detailed information on the health status of pregnant women in addition to maternal and fetal outcomes to ensure accurate data collection.