Coronaviruses in pregnant women in Saudi Arabia: A systematic comparative review of MERS-CoV and SARS-CoV-2

Objective: To compare the effects of coronaviruses, such as Middle East respiratory syndrome coronavirus (MERS-CoV) or coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), on pregnant women in Saudi Arabia, and to understand the disease dynamics of these coronaviruses so as to konw how to provide care and management of infected pregnant women and infants. Methods: We conducted a systematic review of all published papers on MERS-CoV and SARS-CoV-2 infections in pregnant women in Saudi Arabia to identify knowledge gaps. Inclusion and exclusion criteria were based on the PRISMA system. The search included all papers which were published between September 1, 2012 and November 29, 2020 on pregnant women with MERS-CoV and/ or COVID-19 in Saudi Arabia. Of 26 papers screened, five were included in the analysis. Results: A total of 11 pregnant women with MERS-CoV and four with COVID-19 were reported in Saudi Arabia in the medical literature during the review period. The mean ages of the women were 33 and 31 years old for MERS-CoV and COVID-19, respectively. Maternal and fetal mortality in cases of MERS-CoV were 35% and 30%, respectively, while no maternal or fetal mortalities were reported in COVID-19 cases. Conclusions: Very limited data has emerged from Saudi Arabia on pregnant women MERS-CoV and COVID-19. With such high mortality observed with MERS-CoV compared to COVID-19, there is a need for greater reporting of cases to truly grasp the extent of these infections in pregnant women in a country where both coronaviruses are circulating.