Is pregnancy an immunological contributor to severe or controlled COVID-19 disease?

Nazeeh Hanna, Monica Hanna, Surendra Sharma

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Since its emergence in Wuhan as a novel coronavirus disease, it has taken only a few months since January 2020 for it to be recognized as a widespread COVID-19 pandemic which has contributed to global health devastation. As pointed out by health experts, it is a once in a century pandemic of our times. Clinical observations so far indicate that the older population and immune compromised individuals, particularly in African American and Hispanic/Latino communities, are at much higher risk for infection with this novel coronavirus. In this regard, pregnancy offers an altered immunity scenario which may allow severe COVID-19 disease. The literature is so far highly conflicting on this issue. This review will offer a conceptual basis for severe or controlled disease and address trepidations for pregnant women associated with COVID-19 pandemic, particularly in the comparative context of clinical consequences of other coronaviruses such as SARS and MERS. We will highlight the possible consequences of COVID-19 on the general health of pregnant women as well as its possible effects at the maternal-fetal interface. For the placenta-related pathology, we will focus our discussion on the temporal expression of ACE2 throughout gestation for possible propagation of SARS-CoV-2 in the placenta in infected women and ensuing consequences.

Original languageEnglish (US)
Article numbere13317
JournalAmerican Journal of Reproductive Immunology
Issue number5
StatePublished - Nov 1 2020
Externally publishedYes


  • angiotensin-converting enzyme-related carboxypeptidase 2
  • coronavirus disease
  • extravillous trophoblasts
  • middle east respiratory syndrome
  • severe acute respiratory syndrome
  • severe acute respiratory syndrome coronavirus-
  • syncytiotrophoblasts

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Reproductive Medicine
  • Obstetrics and Gynecology


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