Title:Severity of COVID-19 in Pregnant Women: A Review on the Potential
Role of Regulatory T Cells
Volume: 31
Issue: 26
Author(s): Nafiseh Saghafi, Mahmoud Mahmoudi, Amir Abbas Momtazi-Borojeni, Sara Mirzaeian, Fataneh Tavasolian, Thozhukat Sathyapalan, Elham Abdollahi*Amirhossein Sahebkar*
Affiliation:
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences,
Mashhad, Iran
- Department of Immunology and Allergy, School of Medicine, Mashhad University of Medical
Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University
of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical
Sciences, Mashhad, Iran
Keywords:
Regulatory T cells, pregnancy, COVID-19, infection, Tregs, SARS CoV.
Abstract: 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.