Download PDF
CC BY 4.0 · Rev Bras Ginecol Obstet 2020; 42(06): 305-309
DOI: 10.1055/s-0040-1713795
Editorial
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

COVID-19 and Assisted Reproduction: A Point of View on the Brazilian Scenario

Bruno Ramalho de Carvalho 
1   Hospital Sírio-Libanês, Brasília, DF, Brazil
,
Ana Carolina Japur de Sá Rosa-e-Silva 
2   Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
Rui Alberto Ferriani 
2   Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
Rosana Maria dos Reis 
2   Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
Marcos Felipe Silva de Sá 
2   Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
› Author Affiliations
Further Information

Publication History

Publication Date:
30 June 2020 (online)

   Permissions and Reprints

The Epidemic of COVID-19 in Brazil and Worldwide

The world is experiencing a pandemic with no recent similar events, caused by the new coronavirus (SARS-CoV-2). Since December 31, 2019, when the World Health Organization (WHO) was informed about the first cases of pneumonia in the city of Wuhan, Hubei province, China,[1] the disease (COVID-19) spread rapidly through the whole planet. According to the WHO, on May 24, 2020, the world had already confirmed 5,204,508 COVID-19 cases, with a total of 337,687 deaths.[2] In Brazil, on that date, the Ministry of Health had already registered more 363,211 confirmed cases and 22,666 deaths.[3]

Indeed, the WHO warns of the need for caution in interpreting available data, since the sources of information are diverse, as well as the inclusion criteria and other variables may diverge, ultimately resulting in eventual underestimations of the numbers of cases and deaths in each country.[2] However, based on observations from previous epidemics caused by other respiratory viruses, and using specific indicators to measure the transmissibility of the new coronavirus and the clinical severity of COVID-19, preliminary data released in China appear to be sufficient to place the current pandemic on the scale of major epidemics recorded in history, comparable only to the 1918 influenza pandemic, also known as the Spanish flu pandemic.[4]

In order to predict an epidemiological behavior to the COVID-19 pandemic, mathematical projections appear as a forecasting tool, far from perfect, but viable and perfectly acceptable in a time of uncertainty. It is understood that the projections allow authorities and health services to prepare initial action plans, with due attention being paid to frequent monitoring, given the potentially mutable dynamics of SARS-CoV-2 and the rapid change of scenarios. Of note, such characteristics hinder the extrapolation of information from one country to another.

According to the Institute for Health Metrics and Evaluation (IHME), the curve of the epidemic in Brazil is on a plateau and the country will have more than 190 thousand new infections daily by SARS-CoV-2 between May 14 and June 21, 2020. Consequently, it is estimated that we will have at least 800 deaths per day by COVID-19 between May 23 and July 30, 2020. Undeniably, the projection of that institute draws attention to the total number of deaths from the disease in the country, estimated to be of 88,305 until August 4, 2020, varying from about 33 thousand in the best scenario to more than 190 thousand lost lives in the worst perspective. That is an estimative greater than the sum of projected deaths for Italy and Spain together, which is to be expected, once the number of intensive care beds demanded (more than 8 thousand) already exceeds the number of beds offered in the country for treatment of COVID-19 (about 4 thousand).[5]

 

  • References

  • 1 World Health Organization. Pneumonia of unknown cause – China [Internet]. 2020 [cited 2020 May 19]. Available from: https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/
    PubMedGoogle Scholar
  • 2 World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report – 125 [Internet]. 2020 [cited 2020 May 25]. Available from: https://apps.who.int/iris/bitstream/handle/10665/332230/nCoVsitrep24May2020-eng.pdf?sequence=1&isAllowed=y
    PubMedGoogle Scholar
  • 3 Ministério da Saúde. Covid 19: Painel Coronavírus [Internet]. 2020 [cited 2020 May 25]. Available from: https://covid.saude.gov.br
    PubMedGoogle Scholar
  • 4 Freitas ARR, Napimoga M, Donalisio MR. Assessing the severity of COVID-19. Epidemiol Serv Saude 2020; 29 (02) e2020119 . Doi: 10.5123/s1679-49742020000200008
    CrossrefPubMedGoogle Scholar
  • 5 Institute for Health Metrics and Evaluation. COVID-19 Projections: Brazil [Internet]. 2020 [cited 2020 May 22]. Available from: https://covid19.healthdata.org/brazil
    PubMedGoogle Scholar
  • 6 World Health Organization. Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations [Internet]. 2020 [cited 2020 May 19]. Available from: https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations
    PubMedGoogle Scholar
  • 7 Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19): social distancing [Internet]. 2020 [cited 2020 May 19]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html
    PubMedGoogle Scholar
  • 8 Lu J, Gu J, Li K, Xu C, Su W, Lai Z. , et al. COVID-19 outbreak associated with air conditioning in restaurant, Guangzhou, China, 2020. Emerg Infect Dis 2020; 26 (07) DOI: 10.3201/eid2607.200764. [ahead of print]
    CrossrefPubMedGoogle Scholar
  • 9 Park SY, Kim YM, Yi S, Lee S, Na BJ, Kim CB. , et al. Coronavirus disease outbreak in call center, South Korea. Emerg Infect Dis 2020; 26 (08) DOI: 10.3201/eid2608.201274. [ahead of print]
    CrossrefPubMedGoogle Scholar
  • 10 Ghinai I, Woods S, Ritger KA, McPherson TD, Black SR, Sparrow L. , et al. Community transmission of SARS-CoV-2 at two family gatherings – Chicago, Illinois, February-March 2020. MMWR Morb Mortal Wkly Rep 2020; 69 (15) 446-450 . Doi: 10.15585/mmwr.mm6915e1
    CrossrefPubMedGoogle Scholar
  • 11 Koo JR, Cook AR, Park M, Sun Y, Sun H, Lim JT. , et al. Interventions to mitigate early spread of SARS-CoV-2 in Singapore: a modelling study. Lancet Infect Dis 2020; 20 (06) 678-688 . Doi: 10.1016/S1473-3099(20)30162-6
    CrossrefPubMedGoogle Scholar
  • 12 Prem K, Liu Y, Russell TW, Kucharski AJ, Eggo RM, Davies N. , et al; Centre for the Mathematical Modelling of Infectious Diseases COVID-19 Working Group. The effect of control strategies to reduce social mixing on outcomes of the COVID-19 epidemic in Wuhan, China: a modelling study. Lancet Public Health 2020; 5 (05) e261-e270 . Doi: 10.1016/S2468-2667(20)30073-6
    CrossrefPubMedGoogle Scholar
  • 13 Jarvis CI, Van Zandvoort K, Gimma A, Prem K. ; CMMID COVID-19 working group, Klepac P, et al; CMMID COVID-19 working group. Quantifying the impact of physical distance measures on the transmission of COVID-19 in the UK. BMC Med 2020; 18 (01) 124 . Doi: 10.1186/s12916-020-01597-8
    CrossrefPubMedGoogle Scholar
  • 14 World Health Organization. Coronavirus disease 2019: strategy and planning [Internet]. 2020 [cited 2020 May 19]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/strategies-and-plans
    PubMedGoogle Scholar
  • 15 Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC. , et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol 2004; 191 (01) 292-297 . Doi: 10.1016/j.ajog.2003.11.019
    CrossrefPubMedGoogle Scholar
  • 16 Alfaraj SH, Al-Tawfiq JA, Memish ZA. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection during pregnancy: Report of two cases & review of the literature. J Microbiol Immunol Infect 2019; 52 (03) 501-503 . Doi: 10.1016/j.jmii.2018.04.005
    CrossrefPubMedGoogle Scholar
  • 17 Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W. , et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020; 395 (10226): 809-815 . Doi: 10.1016/S0140-6736(20)30360-3
    CrossrefPubMedGoogle Scholar
  • 18 Liu D, Li L, Wu X, Zheng D, Wang J, Yang L. , et al. Pregnancy and perinatal outcomes of women with Coronavirus Disease (COVID-19) pneumonia: a preliminary analysis. AJR Am J Roentgenol 2020; •••: 1-6 . Doi: 10.2214/AJR.20.23072. [ahead of print]
    PubMedGoogle Scholar
  • 19 Yu N, Li W, Kang Q, Xiong Z, Wang S, Lin X. , et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. Lancet Infect Dis 2020; 20 (05) 559-564 . Doi: 10.1016/S1473-3099(20)30176-6
    CrossrefPubMedGoogle Scholar
  • 20 Schwartz DA. An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes. Arch Pathol Lab Med 2020; ••• DOI: 10.5858/arpa.2020-0901-SA. [ahead of print]
    CrossrefPubMedGoogle Scholar
  • 21 Rasmussen SA, Smulian JC, Lednicky JA, Wen TS, Jamieson DJ. Coronavirus Disease 2019 (COVID-19) and pregnancy: what obstetricians need to know. Am J Obstet Gynecol 2020; 222 (05) 415-426 . Doi: 10.1016/j.ajog.2020.02.017
    CrossrefPubMedGoogle Scholar
  • 22 Di Mascio D, Khalil A, Saccone G, Rizzo G, Buca D, Liberati M. , et al. Outcome of Coronavirus spectrum infections (SARS, MERS, COVID 1 -19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM 2020; 2 (02) 100107 . Doi: 10.1016/j.ajogmf.2020.100107
    CrossrefPubMedGoogle Scholar
  • 23 Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G. , et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Transl Pediatr 2020; 9 (01) 51-60 . Doi: 10.21037/tp.2020.02.06
    CrossrefPubMedGoogle Scholar
  • 24 Algarroba GN, Rekawek P, Vahanian SA, Khullar P, Palaia T, Peltier MR. , et al. Visualization of SARS-CoV-2 virus invading the human placenta using electron microscopy. Am J Obstet Gynecol 2020; ••• DOI: 10.1016/j.ajog.2020.05.023. [ahead of print]
    CrossrefPubMedGoogle Scholar
  • 25 Penfield CA, Brubaker SG, Limaye MA, Lighter J, Ratner AJ, Thomas KM. , et al. Detection of SARS-COV-2 in placental and fetal membrane samples. Am J Obstet Gynecol MFM 2020; 100133: 100133 . Doi: 10.1016/j.ajogmf.2020.100133. [ahead of print]
    CrossrefPubMedGoogle Scholar
  • 26 Baud D, Greub G, Favre G, Gengler C, Jaton K, Dubruc E. , et al. Second-trimester miscarriage in a pregnant woman with SARS-CoV-2 infection. JAMA 2020; 323 (21) 2198-2200 . Doi: 10.1001/jama.2020.7233
    CrossrefPubMedGoogle Scholar
  • 27 Hosier H, Farhadian S, Morotti R, Deshmukh U, Lu-Culligan A, Campbell K. , et al. SARS-CoV-2 infection of the placenta. medRxiv [Preprint] 2020; DOI: 10.1101/2020.04.30.20083907.
    CrossrefPubMedGoogle Scholar
  • 28 Vivanti A, Vauloup-Fellous C, Prevot S, Zupan V, Suffee C, Cao JD. , et al. Transplacental transmission of SARS-CoV-2 infection. Res Squ 2020; . Preprint DOI: 10.21203/rs.3.rs-28884/v1.
    CrossrefPubMedGoogle Scholar
  • 29 Chen D, Yang H, Cao Y, Cheng W, Duan T, Fan C. , et al. Expert consensus for managing pregnant women and neonates born to mothers with suspected or confirmed novel coronavirus (COVID-19) infection. Int J Gynaecol Obstet 2020; 149 (02) 130-136 . Doi: 10.1002/ijgo.13146
    CrossrefPubMedGoogle Scholar
  • 30 Ministério da Saúde. Agência Nacional de Vigilância Sanitária (ANVISA). Nota Técnica no. 23/2020/SEI/GSTCO/DIRE1/ANVISA [Internet]. Diretrizes para a realização de procedimentos de Reprodução Humana Assistida face a pandemia de coronavírus (SARS-CoV-2). 2020 [cited 2020 May 19]. Available from: https://www.sbrh.org.br/wp-content/uploads/2020/05/Nota-Técnica-Anvisa-RHA-e-Covid.pdf
    PubMed
  • 31 Lobo RA. Potential options for preservation of fertility in women. N Engl J Med 2005; 353 (01) 64-73 . Doi: 10.1056/NEJMra043475
    CrossrefPubMedGoogle Scholar
  • 32 Heffner LJ. Advanced maternal age–how old is too old?. N Engl J Med 2004; 351 (19) 1927-1929 . Doi: 10.1056/NEJMp048087
    CrossrefPubMedGoogle Scholar
  • 33 Habbema JD, Eijkemans MJ, Leridon H, te Velde ER. Realizing a desired family size: when should couples start?. Hum Reprod 2015; 30 (09) 2215-2221 . Doi: 10.1093/humrep/dev148
    CrossrefPubMedGoogle Scholar
  • 34 Eijkemans MJC, Kersten FAM, Lintsen AME, Hunault CC, Bouwmans CAM, Hakkaart-van Roijen L. , et al. Cost-effectiveness of ‘immediate IVF’ versus ‘delayed IVF’: a prospective study. Hum Reprod 2017; 32 (05) 999-1008 . Doi: 10.1093/humrep/dex018
    CrossrefPubMedGoogle Scholar
  • 35 Ding Y, He L, Zhang Q, Huang Z, Che X, Hou J. , et al. Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS-CoV) in SARS patients: implications for pathogenesis and virus transmission pathways. J Pathol 2004; 203 (02) 622-630 . Doi: 10.1002/path.1560
    CrossrefPubMedGoogle Scholar
  • 36 Li D, Jin M, Bao P, Zhao W, Zhang S. Clinical characteristics and results of semen tests among men with Coronavirus Disease 2019. JAMA Netw Open 2020; 3 (05) e208292 . Doi: 10.1001/jamanetworkopen.2020.8292
    CrossrefPubMedGoogle Scholar
  • 37 Paoli D, Pallotti F, Colangelo S, Basilico F, Mazzuti L, Turriziani O. , et al. Study of SARS-CoV-2 in semen and urine samples of a volunteer with positive naso-pharyngeal swab. J Endocrinol Invest 2020; 1-4 DOI: 10.1007/s40618-020-01261-1. [ahead of print.]
    CrossrefPubMedGoogle Scholar
  • 38 Pan F, Xiao X, Guo J, Song Y, Li H, Patel DP. , et al. No evidence of severe acute respiratory syndrome-coronavirus 2 in semen of males recovering from coronavirus disease 2019. Fertil Steril 2020; 113 (06) 1135-1139 . Doi: 10.1016/j.fertnstert.2020.04.024
    CrossrefPubMedGoogle Scholar
  • 39 Stanley KE, Thomas E, Leaver M, Wells D. Coronavirus disease (COVID-19) and fertility: viral host entry protein expression in male and female reproductive tissues. Fertil Steril 2020; ••• DOI: 10.1016/j.fertnstert.2020.05.001. [ahead of print]
    CrossrefPubMedGoogle Scholar
  • 40 Jing Y, Run-Qian L, Hao-Ran W, Hao-Ran C, Ya-Bin L, Yang G. , et al. Potential influence of COVID-19/ACE2 on the female reproductive system. Mol Hum Reprod 2020; May 4; gaaa030 . Doi: 10.1093/molehr/gaaa030. [ahead of print].
    PubMedGoogle Scholar
  • 41 Randolph HE, Barreiro LB. Herd Immunity: Understanding COVID-19. Immunity 2020; 52 (05) 737-741 . Doi: 10.1016/j.immuni.2020.04.012
    CrossrefPubMedGoogle Scholar
  • 42 American Society for Reproductive Medicine. Patient management and clinical recommendations during the Coronavirus (COVID-19) pandemic [Internet]. 2020 [cited 2020 May 19]. Available from: https://www.asrm.org/news-and-publications/covid-19/statements/patient-management-and-clinical-recommendations-during-the-coronavirus-covid-19-pandemic/
    PubMedGoogle Scholar