COVID-19 During Development: A Matter of Concern

Abstract

A new infectious disease, COVID-19, has spread around the world. The most common symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are cough and fever, but severe cases can develop acute respiratory distress syndrome. The main receptor for SARS-CoV-2 in human tissue is angiotensin-converting enzyme 2, and the lungs, heart, and kidneys are the most affected organs. Besides the inflammatory process and tissue damage, the presence of a cytokine "storm" has been related to a higher mortality rate. Other infectious viral diseases, such as Zika, chikungunya, and influenza, were associated with complications in pregnant women, such as growth restriction, malformation, preterm birth, low birth weight, miscarriage, and death, although they can also cause developmental disorders in infants and adolescents. Evidence points out that stressors during pregnancy and infancy may lead to the development of obesity, diabetes, and cardiovascular disease. Therefore, we hypothesize that COVID-19 infection during the critical phases of development can program the individual to chronic diseases in adulthood. It is important that COVID-19 patients receive proper monitoring as a way to avoid expensive costs to public health in the future.

Keywords: COVID-19; SARS-CoV-2; cardiometabolic disease; development; metabolic programming; public health.

FIGURE 1

Human Important Coronaviruses Timeline. 1960 – HCOV-229E emerged a progenitor virus found in bat and intermediary host camelids; HCOV-OC43 originated in rats and has as intermediary host cows. 2003 – SARS-CoV emerged from bat viruses with civets as intermediary hosts. 2004 – HCOV-NL63 emerged from bats with an unknown intermediary host. 2005 – HCOV-HKU1 emerged from rats with an unknown intermediary host. 2012 – MERS-COV emerged from bats, with camels as intermediary host. 2019 – SARS-CoV-2 emerged from bats with pangolin as the intermediary host. Adapted from Cui et al. (2019) and Mittal et al. (2020).

FIGURE 2

SARS-CoV-2 cell infection and organ damage. The viral Spike Glycoprotein is able to infect human cells by binding to the angiotensin-converting enzyme 2 receptor, thereby diffusing through the cell membrane and infecting the cell. It is also demonstrated pathological findings and complications of different organs affected by the disease.

FIGURE 3

COVID-19 during critical phases of development and future outcomes. Viral infections, including that one caused by COVID-19 during the critical phases of development, may lead to negative outcomes in pregnancy, but also infancy and adolescence, which in turn we hypothesize that can increase the risk to the development of NCD’s during adult life, leading to further public health expenses in the future.