The Efficacy and Safety of Various Antiviral Therapy for the Treatment of Pregnant COVID-19 Patients: A Comprehensive Systematic Review

Current available data regarding antiviral treatment for pregnant women with COVID-19 are scarce. Therefore, this systematic review is created to collect and review various available data regarding the use of antivirals for treating pregnant women with COVID-19. Literature search was performed on PubMed and Cochrane databases, selecting studies which evaluated the efficacy and safety of antivirals on pregnant women with COVID-19 from inception to June 27, 2021. The Newcastle-Ottawa scale was used to assess cohort and case series studies. A total of 9 studies were included in this study with 2 being prospective cohort studies and 7 case series, and 3 kinds of antivirals remdesivir, nitazoxanide, and lopinavir-ritonavir. Of all the 9 studies, a total of 98 pregnant women, 19 postpartum women, and 3 immediate puerperium women were included. The use of remdesivir showed promising outcome with 74/79 (93.7%) patients fully recovered and 33/33 (100%) successful delivery and live neonates. Nitazoxanide with a smaller sample size reported 18/20 (90%) patients fully recovered, 12/12 (100%) successful deliveries, and 12/15 (80%) live neonates. Limited data were provided for lopinavir-ritonavir with only 2 patients included and all of them fully recovered. To date, the use of remdesivir seems promising with reassuring clinical, pregnancy, and neonates’ outcome. However, as data are still scarce, larger studies, especially clinical trials, are required as most of the clinical trials exclude pregnant women as subjects.