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Severity of COVID-19 in Pregnant Women: A Review on the Potential Role of Regulatory T Cells


Nafiseh Saghafi, Mahmoud Mahmoudi, Amir Abbas Momtazi-Borojeni, Sara Mirzaeian, Fataneh Tavasolian, Thozhukat Sathyapalan, Elham Abdollahi* and Amirhossein Sahebkar*   Pages 1 - 14 ( 14 )


As a physiological condition, pregnancy may cause temporary alterations in the hematological, cardiopulmonary, and immune responses, affecting the maternal susceptibility to viral infections. Pregnant women are vulnerable to infection with the influenza A virus, hepatitis E virus, MERS CoV, and SARS CoV. The agent of Coronavirus disease (COVID-19) is the SARS coronavirus (SARS CoV-2), which affects the cells upon binding to the angiotensin-converting enzyme-2 (ACE2). However, ACE2 expression is elevated in the placental tissue. However, surprisingly, COVID-19 infection in pregnant women tends to have a lower severity and mortality. Therefore, it is interesting to find the immunological mechanisms related to the severity of COVID-19 in pregnancy. Regulatory T cells (Tregs) are a subset of CD4+T cells that may play a central role in maintaining maternal tolerance by regulating immune responses. Pregnancy-induced Tregs are developed to control immune responses against paternal antigens expressed by the semi-allograft fetus. The role of uncontrolled immune responses in COVID-19 pathogenesis has already been identified. This review provides insight into whether pregnancy- induced regulatory T-cell functions could influence the severity of COVID-19 infection during pregnancy.


Regulatory T cells, pregnancy, COVID-19, infection, Tregs, SARS CoV.


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