sibmedСибирский научный медицинский журналСибирский научный медицинский журнал2410-25122410-2520ИЦиГ СО РАН10.18699/SSMJ20240406sibmed-1613Research ArticleОБЗОРЫREVIEWSCOVID-19 и беременность: влияние, исходы, возможная терапияCOVID-19 and pregnancy: impact, outcomes, and potential therapyЩербаковВ. И.ShcherbakovV. I.

Щербаков Владимир Иванович, д.м.н.

630117, г. Новосибирск, ул. Тимакова, 2

Vladimir I. Shcherbakov, doctor of medical science

630117, Novosibirsk, Timakova st., 2

Scherbakov_VI@mail.ruhttps://orcid.org/0000-0002-0990-0078РябиченкоТ. И.RyabichenkoT. I.

Рябиченко Татьяна Ивановна, д.м.н.

630117, г. Новосибирск, ул. Тимакова, 2

630091, г. Новосибирск, Красный пр., 52

Tatyana I. Ryabichenko, doctor of medical science

630117, Novosibirsk, Timakova st., 2

630091, Novosibirsk, Krasny ave., 52

2925871@mail.ruhttps://orcid.org/0000-0002-9834-1799ОбуховаО. О.ObukhovaO. O.

Обухова Ольга Олеговна, д.м.н.,

630117, г. Новосибирск, ул. Тимакова, 2

Olga O. Obukhova, doctor of medical science

630117, Novosibirsk, Timakova st., 2

trio188@yandex.ruhttps://orcid.org/0000-0001-7007-1996КарцеваТ. В.KartsevaT. V.

Карцева Татьяна Валерьевна, д.м.н.

630091, г. Новосибирск, Красный пр., 52

Tatyana V. Kartseva, doctor of medical science

630091, Novosibirsk, Krasny ave., 52

kartseva-t@mail.ruhttps://orcid.org/0009-0007-1119-7258МенщиковаВ. Е.MenshchikovaV. E.

Менщикова Валерия Евгеньевна

630091, г. Новосибирск, Красный пр., 52

Valeria E. Menshchikova

630091, Novosibirsk, Krasny ave., 52

vaidurova_valerya@mail.ruhttps://orcid.org/0009-0006-9822-9349ЕлисееваД. В.EliseevaD. V.

Елисеева Дарья Владиславовна

630091, г. Новосибирск, Красный пр., 52

Daria V. Eliseeva

630091, Novosibirsk, Krasny ave., 52

Dancingviolin@mail.ruhttps://orcid.org/0000-0001-9425-413XВоеводаМ. И.VoevodaM. I.

Воевода Михаил Иванович, д.м.н., проф., акад. РАН

630117, г. Новосибирск, ул. Тимакова, 2

Mikhail I. Voevoda, doctor of medical science, professor, academician of the RAS

630117, Novosibirsk, Timakova st., 2

mvoevoda@ya.ruФИЦ фундаментальной и трансляционной медициныРоссияFederal Research Center of Fundamental and Translational MedicineRussian FederationФИЦ фундаментальной и трансляционной медицины; Новосибирский государственный медицинский университет Минздрава РоссииРоссияFederal Research Center of Fundamental and Translational Medicine; Novosibirsk State Medical University of Minzdrav of RussiaRussian FederationНовосибирский государственный медицинский университет Минздрава РоссииРоссияNovosibirsk State Medical University of Minzdrav of RussiaRussian Federation2024290820244446270Copyright © Щербаков В.И., Рябиченко Т.И., Обухова О.О., Карцева Т.В., Менщикова В.Е., Елисеева Д.В., Воевода М.И., 20242024Щербаков В.И., Рябиченко Т.И., Обухова О.О., Карцева Т.В., Менщикова В.Е., Елисеева Д.В., Воевода М.И.Shcherbakov V.I., Ryabichenko T.I., Obukhova O.O., Kartseva T.V., Menshchikova V.E., Eliseeva D.V., Voevoda M.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://sibmed.elpub.ru/jour/article/view/1613

Влияние новой коронавирусной инфекции COVID-19 на течение беременности, состояние здоровья матери и ребенка во многом неясно и противоречиво. В представленном литературном обзоре проанализированы изменения в иммунной, сердечно-сосудистой, эндокринной системах у женщин при физиологической беременности. Представлены особенности течения инфекции, вызванной вирусом SARS-CoV-2, при беременности в зависимости от варианта вируса, рассмотрены пути проникновения инфекции в иммунные и неиммунные клетки, в том числе в клетки плаценты, а также вопросы трансплацентарного переноса вируса – ключевого момента инфицирования эмбриона или плода, от которого также во многом зависит исход беременности. Представлены перспективные подходы к терапии COVID-19: применение ингибиторов трансмембранной сериновой протеазы-2, фурина, ангиотензин-превращающего фермента и РНК-зависимой РНК-полимеразы, эпителиальные клетки амниона и их экзосомы. Вместе с тем рассмотрены возможности применения мезенхимальных стволовых клеток у пациентов с тяжелой пневмонией, обусловленной COVID-19. Выделены сложности и вопросы в отношении применения перечисленных терапевтических методов у беременных. Рассмотрены аспекты применения препаратов сурфактанта у новорожденных из группы риска развития новой коронавирусной инфекции.

The impact of the new coronavirus COVID-19 infection on the course of pregnancy, maternal and child health is largely unclear and controversial. The presented literature review analyzes changes in the immune, cardiovascular, and endocrine systems in women in physiological pregnancy. The peculiarities of the course of infection caused by SARS-CoV-2 virus in pregnancy, depending on the virus variant, are presented, the issues of infection pathways into immune and non-immune cells, including placental cells, as well as the issues of transplacental transfer of the virus – the key moment of infection of the embryo or fetus, on which the outcome of pregnancy also largely depends, are considered. Promising approaches to COVID-19 therapy are presented: use of inhibitors of transmembrane serine protease 2 (TMPRSS2), furin, angiotensin-converting enzyme (ACE2) and RNA-dependent RNA polymerase, amnion epithelial cells and their exosomes. At the same time, the potential use of mesenchymal stem cells in patients with severe COVID-19 pneumonia is reviewed. Difficulties and questions regarding the use of the above therapeutic methods in pregnant women are highlighted. Aspects of the use of surfactant preparations in newborns at risk of new coronavirus infection are considered.

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The authors declare that there are no conflicts of interest present.