Effect of SARS-CoV-2 Infection in Pregnancy on Maternal and Neonatal Outcomes in Africa: An AFREhealth Call for Evidence through Multicountry Research Collaboration
Jean B. Nachega, Nadia A. Sam‐Agudu, Samantha Budhram, Taha E. Taha, Valerie Vannevel, Priya Soma‐Pillay, Daniel Katuashi Ishoso, Michel Tshiasuma Pipo, Christian Bongo-Pasi Nswe, John Ditekemena, Birhanu Ayele, Rhoderick Machekano, Onesmus Gachuno, John Kinuthia, Nancy Mwongeli, Musa Sekikubo, Philippa Musoke, Evans Kofi Agbeno, Lawal Umar, Mukanire Ntakwinja, Denis Mukwege, Emily R. Smith, Eduard J. Mills, John Otokoye Otshudiema, Placide Mbala‐Kingebeni, Jean-Marie Kayembe, Don Jethro Mavungu Landu, Jean‐Jacques Muyembe Tamfum, Alimuddin Zumla, Eduard Langenegger, Lynne Mofenson
Abstract
In the African context, there is a paucity of data on SARS-CoV-2 infection and associated COVID-19 in pregnancy. Given the endemicity of infections such as malaria, HIV, and tuberculosis (TB) in sub-Saharan Africa (SSA), it is important to evaluate coinfections with SARS-CoV-2 and their impact on maternal/infant outcomes. Robust research is critically needed to evaluate the effects of the added burden of COVID-19 in pregnancy, to help develop evidence-based policies toward improving maternal and infant outcomes. In this perspective, we briefly review current knowledge on the clinical features of COVID-19 in pregnancy; the risks of preterm birth and cesarean delivery secondary to comorbid severity; the effects of maternal SARS-CoV-2 infection on the fetus/neonate; and in utero mother-to-child SARS-CoV-2 transmission. We further highlight the need to conduct multicountry surveillance as well as retrospective and prospective cohort studies across SSA. This will enable assessments of SARS-CoV-2 burden among pregnant African women and improve the understanding of the spectrum of COVID-19 manifestations in this population, which may be living with or without HIV, TB, and/or other coinfections/comorbidities. In addition, multicountry studies will allow a better understanding of risk factors and outcomes to be compared across countries and subregions. Such an approach will encourage and strengthen much-needed intra-African, south-to-south multidisciplinary and interprofessional research collaborations. The African Forum for Research and Education in Health's COVID-19 Research Working Group has embarked upon such a collaboration across Western, Central, Eastern and Southern Africa.