ABSTRACT
Background: Some studies have reported that preeclampsia with coronavirus disease 2019 (COVID-19) significantly increases the risk of adverse perinatal outcome until near to three-fold over the normal pregnancy. Preeclampsia pathophysiology in theory, increases the perinatal mortality and morbidity starting from placental injury which is also believed to share the common pathway with COVID-19 infection. Major typical placental injuries for these matters could be apoptotic, necrotic, or pyroptotic. Objective: This study aimed to compare placental damage between those three conditions above in those three typical injuries. Study Design: This was an observational analytic study with cross-sectional setting. Seventy-two pregnant women admitted to hospital consecutively with diagnosis of preeclampsia with COVID-19, Preeclampsia only and COVID-19 only. Diagnosis for preeclampsia was following FIGO criteria with at least one of the severe features. COVID-19 eligible for this study was PCR test confirmative with moderate to severe clinical degree. Placenta were taken after the delivery, and parameters were quantified with immunohistochemistry test for caspase-3, caspase-1, and TNF-alpha representing apoptotic, pyroptotic, and necrotic pathway respectively. Results: Pregnancy with double complications, preeclampsia, and COVID-19, significantly has the highest placental damage on apoptotic, pyroptotic, and necrotic pathway shown from the caspase-3, caspase-1, and TNF-alpha expression in placenta (p <0.05). Moderate to severe degree of COVID-19 resulting higher placental damage compared to preeclampsia in all the three forms (p <0.05). Apoptotic process was the most prominent among other pathways. Conclusion: Preeclampsia with COVID-19 infection showed significant placental damage, with major changes related were apoptosis, inflammation, and necrosis. This data support poor perinatal outcome of pregnancy having preeclampsia and COVID-19 at the same time.
ABSTRACT
The COVID-19 virus has spread throughout the world and has been declared as a global pandemic by WHO. Some population groups are more susceptible to COVID-19 and one of them is pregnant women. Pregnancy increases risks of the COVID-19 especially thrombotic complications. The SARS-CoV-2 infection may vary widely from asymptomatic to severe infection. Some studies have shown that ABO blood group can be a marker of susceptibility to some disease progression. This study aims to investigate relationships between the ABO blood group the COVID-19 infection and its complications in pregnant women at Dr. Moewardi Hospital Surakarta. This study was an observational analytic study with a cross-sectional study design involving 40 pregnant women infected with COVID-19 at Dr. Moewardi Hospital Surakarta. COVID-19 PCR swabs on the women were administered on their oropharynx and nasopharynx and laboratory examination of the ABO blood group in all samples was performed. Comparative data distribution of blood groups in the population and the global population distribution were calculated by Chi Square Goodness of Fit. Comparative data between ABO blood group distributions blood parameters and complications (respiratory thrombotic other infections and death) were calculated by Chi square test and then by One-Way ANOVA. Next correlation tests for the complications of the blood group and the ages applied a multinomial regression. There were significant differences of thrombotic complications on the blood group of pregnant women infected with COVID-19 (p=0.027). Blood type B significantly tended to experience thrombotic complications when compared to other blood groups (p=0.022). The ABO blood group could affect the complication levels in the pregnant women infected with the COVID-19.