SARS-CoV-2 in diabetic pregnancies
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Diabetic pregnancies clearly need special care, but clinical implications and the complex interplay of diabetes and SARS-CoV-2 are currently less known.

Researchers carried out a systematic scoping review in MEDLINE (PubMed), EMBASE, CINAHL, Cochrane Library, and Web of Science Core Collection.

They found that the prognosis of pregnant women with diabetes mellitus and COVID-19 may be associated with potential underlying mechanisms such as a simplified viral uptake by ACE2, a higher basal value of pro-inflammatory cytokines, being hypoxemic as well as platelet activation, embolism, and preeclampsia.

In the context of “trans-generational programming” and COVID-19, life-long consequences may be “programmed” during gestation by pro-inflammation, hypoxia, over-or under-expression of transporters and enzymes, and epigenetic modifications based on changes in the intrauterine milieu. COVID-19 may cause new-onset diabetes mellitus, and that vertical transmission from mother to baby might be possible.

Given the challenges in clinical management, the complex interplay between COVID-19 and diabetic pregnancies, evidence-based recommendations are urgently needed. Digital medicine is a future-oriented and effective approach in the context of clinical diabetes management.

BMC Pregnancy and Childbirth