The Impact of COVID-19 on Reproductive Health and Neurodevelopment: A Comprehensive Analysis

2023-06-17 07:02:51

Severe special infectious pneumonia (COVID-19) has entered the fourth year since the end of 2019, and at least 65 million people around the world suffer from itLong New Crown (Long COVID)sometimes referred to as the “Post-acute sequelae of COVID-19“; may occur in at least 10% of new coronavirus (SARS-CoV-2) infections, affecting the health of more than 200 symptoms and multiple organ systems.

According to the paper of “Nature Reviews Microbiology” (Nature Reviews Microbiology) in January of this year (2023), Hannah E. Davis and Eric J. Topol et al pointed out that currently There are at least five to six hypotheses for the pathogenesis of the new coronavirus, and the new coronavirus continues to remain in human tissues, includingimmune disorders、Microbiota disruption、autoimmunity、thrombusandendothelial abnormalities,as well asNerve signaling dysfunctionetc., there is currently no proven effective treatment.

Davis and Bai Yang et al. found that new crowns were associated with all ages and severity of acute disease,The proportion of diagnoses is highest between the ages of 36 and 50most of the new crowns occur in“mild”, “acute” “ambulatory” patientsmiddle.This study synthesizes the main advances in current scientific understanding of the new crown: including immunology and virology, vascular problems and organ damage, nervous and cognitive systems, myalgic encephalomyelitis (also known asChronic fatigue syndrome, ME/CFS) and autonomic dysfunction and related diseases, reproductive system, respiratory system and gastrointestinal system. Among them, the analysis of the impact on the reproductive system pointed out that such symptoms are frequently reported in new crowns, but few studies have documented the extent of the impact and the sex-specific pathophysiology.

Effects of SARS-CoV-2 and Long COVID on the reproductive system.Picture/provided by the author

The impact of the new crown on the reproductive system

The research of Davis, Bai Yang and others further explored the impact of the new crown on the reproductive system.

On the male side, the presence of the virus in the tissues of the reproductive organs increaseserectile dysfunctionrisk, which may be caused by endothelial dysfunction; and patients with new crownImpaired sperm count, semen volume, motility, sperm morphology, and sperm concentrationthese phenomena and Acts as a cell signalingElevated levels of cytokines,as well asApoptotic-associatedApoptotic protease (or caspase, caspase) relevant.

In terms of women, the current known impact of the new coronavirus includes:Menstruation and the week before menstruation are factors that trigger new crowns、follicle in ovarylibraryDeclining ovarian reserve,as well asReproductive Endocrine Disorderswait. SARS-CoV-2 infection can also affect ovarian hormone production and/or endometrial response,People who have both COVID-19 and menstrual irregularities are more likely to experience fatigue, headaches, body aches and shortness of breath。

The most common menstrual changes includeIrregular menstruation、increased premenstrual symptomsandinfrequent menstruationwait.Studies have also shown that ME/CFS andpremenstrual anxiety disorder、polycystic ovarian syndrome, PCOS、abnormal menstrual cycle、ovarian cyst、early menopauseandEndometriosisrelated. In addition, pregnancy, postpartum changes, menopause, and menstrual cycle fluctuations also affect ME/CFS and affect metabolic and immune system changes.

In terms of women, the currently known effects of the new coronavirus include: menstruation and the week before menstruation are factors that trigger the new crown, the stock of follicles in the ovary decreases, and reproductive endocrine disorders. Figure / envatoelements

Inflammation may play key role in menstrual-related symptoms

In April of this year, Time magazine in the United States comprehensively reported the impact of the new crown virus and the new crown on the reproductive health of men and women. The report analyzed the latest medical research, cases, and subsequent impact on people’s reproductive choices.

“Time” pointed out that according to the latest data from the U.S. Census Bureau (2023/3/22), about 25% of adults with new crowns of childbearing age (18-39 years old) have symptoms that last at least three months, And women have a higher risk of getting a new crown than men. “Time” interviewed female patients with new crowns and asked them to describe their conditions, such as the exacerbation of the original neurological disease due to extreme fatigue, most of the time they only had the strength to walk a short distance out of the house, or the strength to walk a short distance every week. Just enough energy to take a shower. They said it was hard for them to imagine caring for a pet, let alone a child.

On the other hand, the new crown may affect the reproductive choices of adults, and this result can be observed from another issue.The report once again emphasized that after the diagnosis of the new crown, for men, the new crown virus may damageMale sperm count and quality、testicular functionandhormone levelsand possibly in the short termreduced fertility,Appearerectile dysfunction, making it harder for women to get pregnant.For women, certain fertility indicators are low for at least a few months after diagnosis, and women diagnosed during pregnancy may haveaffect the menstrual cycle，Increased complications such as preeclampsia and premature birthChances of happening. For those with endometriosis, in addition to the increased risk of developing a new crown, pregnancy and ME/CFS may also be related.

Kate Clancy (Kate Clancy), a professor at the University of Illinois at Urbana-Champaign, explained in an interview with Time that the connection between new crowns, menstrual changes, and onset of menstrual symptoms may be related to “Inflammation” is relevant because “The uterus is largely an immune organ“, which keeps pathogens out while allowing the embryo to grow safely and shed and repair tissue on a regular basis, so the uterus is highly sensitive to inflammation and other immune responses.

So this also raises another question:If the new crown is diagnosed during pregnancy, will it affect the fetus?？

How does the new crown affect the fetus of pregnant women?

According to the study published in JAMA Network Open (2023/3/23), researchers found that boys born to mothers who were infected with the new coronavirus during pregnancy were more likely to develop respiratory infections after birth.neurodevelopmental disordersincreased suffering fromautismrisk.

Boys born to mothers infected with the new coronavirus during pregnancy are more likely to develop neurodevelopmental disorders after birth and increase the risk of autism, researchers have found. Figure / envatoelements

In earlier studies it has been established that “other infections during pregnancy“and”Neurodevelopmental Disorders in Children“There is a relationship between. But the part about the new coronavirus is further confirmed in this new study. Andrea Edlow, co-lead author of the paper from Massachusetts General Hospital and Harvard Medical School, said in an interview: “The neurodevelopmental risk associated with maternal new crown infection is disproportionately high in male infants, which means Consistent with the known increased vulnerability of men to adverse prenatal exposures.”

exacerbated challenges

Another co-lead author, Roy Perlis, pointed out that for the new crown, it is necessary to further investigate and evaluate this potential risk through larger studies and extended long-term monitoring. In addition, people generally lack the knowledge of COVID-19 infection, and there is also a lot of misinformation. In this regard, Davis, Bai Yang and others called at the end of the study that the lack of long-term research and nursing knowledge of COVID-19 is an urgent need to address urgent problem. The study also called for the impact of the new crown on the reproductive system, especially the lack of research on the mechanism of inflammatory diseases such as endometriosis, which should be paid attention to; in addition to providing education about the new crown to the biomedical community, more A mass awareness campaign is needed to educate the public about the risks and consequences of COVID-19.

The increasing clinical needs of patients with COVID-19 necessitate research, evaluation, and treatment; for many patients, COVID-19 is not just a medical problem, it affects work, relationships, and life plans, including when, how, and Whether to have children. The long-term new crown not only intensifies the challenge of the relationship between doctors and patients, but also affects the health of future generations.

refer toliterature

• Davis, H. E., McCorkell, L., Vogel, J. M., & Topol, E. J. (2023). Long COVID: major findings, mechanisms and recommendations. Nature Reviews Microbiology1-14.
• Jamie Ducharme, Long COVID Is Making Some People Choose Not to Have Kids, Time2023/04/04. https://time.com/6268429/long-covid-reproductive-health/
• SciTechDaily, COVID-19 Infection During Pregnancy Linked to Higher Risk of Neurodevelopmental Disorders. 2023/03/27. https://scitechdaily.com/covid-19-infection-during-pregnancy-linked-to-higher-risk-of-neurodevelopmental-disorders/

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