Protective potential of mesenchymal stem cells against COVID-19 during pregnancy

Figures & data

Table 1. Summary report highlighting the clinical outcomes of COVID-19 in pregnant females.

Study population (country)	Cases SARS-CoV-2 positive (N)	Age (years)	Age of pregnancy	Asymptomatic/mild/moderate	Symptomatic/severe symptoms	Outcomes on pregnancy	ICU admission	Delivery status	Neonatal SARS-CoV-2	Ref.
USA	4,145	27–35	<24 and >24 weeks	Recorded only critical cases	32	No maternal/fetal deaths, high preterm delivery, high cesarean delivery	32 cases	19 deliveries, 18 (94.7%) preterm, 11 (57.9%) delivered in ICU,	Not reported	[46]
USA	8207	15–44	Not reported	Asymptomatic (2.9%) similar to non-pregnant females	97.1% symptomatic similar to non-pregnant females (fever, cough, diarrhea, runny nose)	31.5% hospitalized 0.2% death, similar to non-pregnant females (0.2), no increase in mortality rate for pregnant females	1.5% pregnant vs 0.9% in non-pregnant females) with underlying conditions (diabetes, cardiovascular disease)	Not reported	Not reported	[47]
Japan	254	26–35	13–31 weeks	224 patients (88%) mild symptoms	30 patients (12%) severe symptoms	Moderate to severe infection in presence of comorbidities (diabetes, obesity, smoking, pre-eclampsia)	No admissions	Not reported	Not reported	[48]
Cross countries	295	20–44	5–41 weeks	Third of patients asymptomatic or mild symptoms	0–14% sever pneumonia	3% (9) deaths 1 neonatal death	4.7% cases	219 deliveries (78.1% cesarean)	8.7% (19 cases out of 219) positive SARS-CoV-2	[49]
China	118	28–34	75 (64%) in third trimester	Mild symptoms (fever, cough) 109 (92%)	Severe symptoms (hypoxemia) 9 (8%)	No deaths, 94% discharged	1 of 9 with severe symptoms	68 (58%) gave birth, 3 abortions, 2 ectopic pregnancies, 4 induced abortions	No positive SARS-CoV-2	[50]
UK	214	26–34	First trimester to delivery	Asymptomatic 63.7%	Symptomatic 36.3%, pre-eclampsia 2.8%	More caesarean recorded during pandemic	4 (1.9%)	Preterm birth in symptomatic patients, no neonatal death related to COVID-19	11% positive for SARS-CoV-2	[51]
Cross countries	26528	18–44	First to third trimester	7.5–32.6% asymptomatic	Symptoms (rates differ for symptoms, from 6% for myalgia to 87.5% for fever	1.4–12% likely to develop severe disease, maternal mortality <2% – neonatal mortality <3% – stillbirth <2.5%, neonatal ICU 3.1–76.9%	3–10% admissions. 1.4–5.5% mechanical ventilation rates neonatal ICU admission 3.1–76.9%	Caesarean (term and pre-term) 52.3–95.8%,	1.6–10% positive SARS-CoV-2	[52]
Sweden	155	13–>35	In labor	65% asymptomatic	35% symptomatic presented pre-eclampsia	Pre-eclampsia, gestational diabetes, preterm birth <37 weeks, post-partum hemorrhage, emergency cesarean 1 stillbirth,	No admissions	Spontaneous (69%), instrumental (9%), cesarean (planned 13.5%, emergency 9.7%)	Not reported	[56]
USA	241	18–47	Third trimester	61.4% asymptomatic	26.1% severe, 5% critical symptoms	Cesarean for symptomatic, mild, severe and critical cases (33.3%, 34.4% 52.4%, 91.7%, respectively) no maternal death	7.1%, admissions 3.7% intubation during delivery	99.2% successful delivery-	2.5% positive SARS-CoV-2	[57]
Singapore	55	23–40	Third trimester except for 2 (<28 weeks)	Mostly mild symptoms, fever, cough, dyspnea	2% severe COVID-19	No mortality, miscarriage (2%), preterm birth (43%) neonatal death (2%)	Mechanical ventilation (2%),	Miscarriage, preterm birth	4.4% (2 cases out of 46 neonates) positive SARS-CoV-2	[58]
China	30	30–34	Not reported	76.6% respiratory system injury (fever, cough, sputum)	Abnormal heart, liver digestive function (3.3–20%),	No deaths, 76.7% low respiratory system injury vs 92.5% in non-pregnant females terminated pregnancies 22 (73.3%), 8 (26.7%) continued	No admissions	Not reported	Not reported	[59]

ICU: Intensive care unit; N: Number; Ref.: Reference.

Figure 1. Factors putatively protecting COVID-19 pregnant females.

Maternal blood circulating fetal mesenchymal stem cells (MSCS), lactoferrin lead to reducing COVID-19-related symptoms.

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