Narjes Afrooz
1 
, Seyedeh Kosar Mahmoudi
2 , Mina Yazdizadeh
3 , Zahra Jahanshahiafshar
4 , Neda Sabernia
5* , Marzieh Rohaninasab
6* 1 Shahid AkbarAbadi Clinical Research Development Unit (SHACRDU), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
2 Department of Cellular and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
3 Department of Pediatric Dentistry, Dental School, Babol University of Medical Sciences, Babol, Iran
4 Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran
5 Department of Internal Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
6 Aestetic and Restorative Department, Dental School, International Campus, Tehran University of Medical Sciences, Tehran, Iran
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus originates from Wuhan, China; it has spread around the world. According to studies, the results of the SARS-CoV-2 test have been reported positive for some pregnant women. However, not much is known about the effect of this virus on pregnancy and the outcome of baby. The aim of this review study was to evaluate the molecular and diagnostic approach in evaluating the effect of coronavirus disease 2019 (COVID-19) on pregnancy loss. The entry of COVID-19 virus into the pregnant mother’s body through various channels, such as the angiotensin-converting enzyme receptor (ACE2) affects immune and coagulation systems and hormone levels. These changes include D-Dimer, platelets and antithrombin III (AT-III) raises and protein C (PC) decrement and also elevated levels of pro-inflammatory cytokines, including IL-6, followed by disruption of various signaling pathways such as JAK / STAT and PI3K. Additionally, decreased expression of cyclooxygenase 1 (COX1) and prostaglandin E2 (PGE2) and hormones such as progesterone were observed. These changes ultimately lead to serious pregnancy risks, including miscarriage. Therefore, identifying pathways by which COVID-19 impairs immune and coagulation systems of pregnant women can be a way to design abortion preventive strategies.
Keywords: COVID-19, Pregnancy loss, Pathogenesis, Diagnosis