Pharmacological management of COVID-19 in pregnancy

Coronavirus disease 2019 (COVID-19) as a severe and rapid spread disease is a global health emergency since December 2019. During the outbreak of COVID-19, infected pregnant women were treated with different pharmacological regimens; however, trial studies are still investigating their safety and effectiveness. In the present study, we reviewed all recently published studies related to the pharmaceutical management of COVID-19 in pregnancy to discuss the rapid evolving pattern of administered medications. A review study was conducted to investigate the pharmacological management of COVID-19 in pregnancy. All types of full English and recent articles through detailed research on Cochrane Library, PubMed, UpToDate, ScienceDirect and Google Scholar databases were collected. Several medical sites were also investigated. The implemented keywords for the search were COVID-19, SARS-CoV-2, coronavirus, pregnancy, management, treatment, medication, drug, antiviral, teratogenicity, possible effect, therapeutic effect, adverse effect and pregnancy outcome. There are no definitely specific approved pharmacological treatments for COVID-19 in pregnancy. Evaluating published literature showed that different treatment options, including chloroquine, favipiravir and ribavirin, convalescent plasma, interferons and remdesivir, have been used to stop or decline viral replication. We reviewed published evidence for drug selection and its safety during pregnancy, but conflicting results associated with numbers of trials show that we need further investigation for newer antiviral drugs for use in pregnancy. It seems that management of COVID-19 needs a multidisciplinary approach, and a consultant medical team should be arranged to decide about medications for the management of COVID-19-infected pregnant women.