Pathways and mechanisms of effects of maternal COVID-19 infection on fetal nervous system development
Authors:   Bashkir State Medical University, Ufa, Russian Federation, Kapralova D.Yu. , Yangelbiev K.A. ,   Pirogov Russian National Research Medical University, Moscow, Russian Federation, Shlenkina O.A. ,   N.P.Ogarev National Research Mordovia State University, Saransk, Russian Federation, Esayan L.G. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Gusak N.N. ,   Bashkir State Medical University, Ufa, Russian Federation, Kandaurov D.R. ,   Almazov National Medical Research Centre, Saint Petersburg, Russian Federation, Aleshichev G.A. ,   Kirov State Medical University, Kirov, Russian Federation, Kvasnina E.A. ,   Kirov State Medical University, Kirov, Russian Federation, Pertseva A.V. ,   Mari State Medical University, Yoshkar-Ola, Russian Federation, Neverova D.A. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Muratshina G.V. ,   Bashkir State Medical University, Ufa, Russian Federation, Gilyazov D.D. ,   Bashkir State Medical University, Ufa, Russian Federation
Published: April 2024

Immunoneuropsychiatry is a field of science that reflects the influence of the immune system on the nervous system and acts, in addition to genetic and environmental factors, as a component of the etiopathogenesis of neuropsychiatric development. In this aspect, the impact of COVID-19 during pregnancy on the fetus may be expressed both as a direct effect of the infectious agent and as an indirect effect of the components of the maternal immune response to the infectious process on the fetal development. Objective. To review the research literature on the factors of susceptibility of pregnant women to viral infections, mechanisms of the immune defense in pregnant women and COVID-19 infection, neurological outcomes, and their impact on the development of the fetal nervous system and the impact of sexual dimorphism on these processes. Material and methods. Full-text scientific publications were searched in the electronic databases Russian Science Citation Index (RSCI), PubMed, Scopus, and Google Scholar using the following key words: COVID-19; SARS-CoV-2; immune system; immunopathology; pregnancy; neurodevelopmental pathology; neurological diseases; sex of the fetus. The authors independently analyzed relevant studies. In addition to the analysis of the main publications found, the authors analyzed the reference lists of review articles, the selection was made according to the scientific value, with the formation of the final reference list according to the relevance of the analyzed material. Results. Immunopathological reactions in pregnant women during the infectious process, in particular COVID-19, may have a negative impact on the development of the fetal nervous system, which is expressed in the development of neuropsychiatric disorders of varying severity, given the influence of numerous genetic factors, including sexual dimorphism. Key words: COVID-19, SARS-CoV-2, immune system, immunopathology, pregnancy, neurodevelopmental pathology, neurological diseases, sex of the fetus