Pregnancy and COVID-19
Preeclampsia is a pregnancy complication characterized as hypertension, proteinuria and usually begins after 20 weeks gestation period which is a major cause of maternal deaths and fetal morbidity and mortality and Lumbers et al. reported that the RAAS system undergoes major changes during preeclampsia (Lumbers & Pringle, 2014). Levels of Ang II and aldosterone increase after 20 weeks of gestation in women that causes preeclampsia. To counteract this, there is compensatory up-regulation of 2 to produce Ang (1-7), a vasodilator and reduces the aldosterone production (Bharadwaj et al., 2011; Levy, Yagil, Bursztyn, Barkalifa, Scharf & Yagil, 2008). The reports on Zika, H1N1 and SARS-CoV infection during pregnancy linked these infections with preterm birth, maternal death and abortions (Ksiezakowska, Laszczyk, WilczyƄski & Nowakowska, 2008; Rasmussen, Smulian, Lednicky, Wen & Jamieson, 2020). Till now, the implications of maternal SARS-CoV-2 infection on the fetal health are unknown, however. reports shows that during pregnancy and preeclampsia 2 is highly expressed in the placenta, maternal-fetal interface, fetal tissues such as liver, heart, and lung which may facilitate the SARS-CoV-2 transmission from infected mother to fetus which may increase the risk to neonates (Levy, Yagil, Bursztyn, Barkalifa, Scharf & Yagil, 2008; Li, Chen, Zhang, Xiong & Li, 2020; Yang, Shang, Zhang, Li & Liu, 2013). Reports also showed that pregnant females infected with virus experienced decreased fetal movement, anemia, dyspnea, intrauterine growth restriction and newborn is infected with SARS-CoV-2 (Chen et al., 2020a; Dashraath et al., 2020; Di Mascio et al., 2020). Hence, there is a reason for the worry as SARS-CoV-2 might interact with highly expressed ACE 2 in pregnancy and may be responsible for fetal morbidity and mortality.