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Cell Rep Med ; 3(1): 100490, 2022 01 18.
Article in English | MEDLINE | ID: covidwho-1665525


Neurofilament light (NFL) is a promising circulating biomarker in preeclampsia and COVID-19, even without evident neurological complications. Several pathways might contribute to the elevated serum NFL levels seen in both pathologies. Future studies will determine whether NFL is a long COVID marker and delineate NFL's role in COVID-19-associated preeclampsia.

COVID-19/blood , COVID-19/epidemiology , Neurofilament Proteins/blood , Pre-Eclampsia/blood , Pre-Eclampsia/epidemiology , SARS-CoV-2 , Biomarkers/blood , COVID-19/virology , Comorbidity , Female , Humans , Incidence , Pregnancy
Obstet Gynecol ; 137(1): 72-81, 2021 01 01.
Article in English | MEDLINE | ID: covidwho-1455365


OBJECTIVE: To systematically review the performance of soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and the sFlt-1/PlGF ratio in predicting adverse outcomes in women with preeclampsia. DATA SOURCES: We performed a systematic search of MEDLINE, EMBASE, CINAHL, Cochrane, Scopus,, and Emcare databases from 1989 to March 2019 to identify studies correlating sFlt-1, PlGF, and the sFlt-1/PlGF ratio with the occurrence of adverse outcomes in women with preeclampsia. METHODS OF STUDY SELECTION: Two independent reviewers screened 3,194 studies using Covidence. Studies were included if they examined the performance of sFLT-1, PlGF, or the sFLT-1/PlGF ratio in predicting adverse outcomes in women with suspected or confirmed preeclampsia. TABULATION, INTEGRATION, AND RESULTS: We extracted contingency tables with true-positive, false-positive, true-negative, and false-negative results. We calculated sensitivity, specificity, diagnostic odds ratios, and area under the summary receiver operating characteristic curve (area sROC) through a bivariate mixed-effects meta-analysis. Our literature search identified 3,194 articles, of which 33 (n=9,426 patients) were included. There was significant variation in the included studies with regard to the biomarkers and outcomes assessed. As such, few studies (n=4-8) were included in the meta-analysis component with significant heterogeneity between studies (I2=33-99). Nonetheless, both PlGF and the sFlt-1/PlGF ratio demonstrated area sROC values between 0.68 and 0.87 for the prediction of composite adverse maternal and perinatal outcomes, preterm birth and fetal growth restriction. CONCLUSION: Placental growth factor and the sFlt-1/PlGF ratio show prognostic promise for adverse outcomes in preeclampsia, but study heterogeneity limits their clinical utility. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42019136207.

Placenta Growth Factor/blood , Pre-Eclampsia/blood , Vascular Endothelial Growth Factor Receptor-1/blood , Biomarkers/blood , Female , Humans , Pre-Eclampsia/epidemiology , Pregnancy
BMJ Case Rep ; 13(8)2020 Aug 11.
Article in English | MEDLINE | ID: covidwho-712861


The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has presented many diagnostic challenges and uncertainties. Little is known about common pathologies complicating pregnancy and how their behaviour is modified by the presence of SARS-CoV-2. Pregnancy itself can alter the body's response to viral infection, which can cause more severe symptoms. We report the first case of a patient affected with sudden-onset severe pre-eclampsia complicated by acute fatty liver disease of pregnancy, HELLP (haemolysis, elevated liver enzymes and low platelet) syndrome and acute kidney injury following SARS-CoV-2 infection. Although an initial diagnostic dilemma, a multidisciplinary team approach was required to ensure a favourable outcome for both the mother and the baby. Our case report highlights the need for health professionals caring for pregnant women to be aware of the complex interplay between SARS-CoV-2 infection and hypertensive disorders of pregnancy.

Acute Kidney Injury/complications , Betacoronavirus , Coronavirus Infections/complications , Fatty Liver/complications , HELLP Syndrome/diagnosis , Pneumonia, Viral/complications , Pre-Eclampsia/diagnosis , Pregnancy Complications, Infectious/diagnosis , Acute Kidney Injury/blood , Acute Kidney Injury/diagnosis , Adult , COVID-19 , Coronavirus Infections/blood , Fatty Liver/blood , Fatty Liver/diagnosis , Female , HELLP Syndrome/blood , Humans , Kidney Function Tests , Pandemics , Pneumonia, Viral/blood , Pre-Eclampsia/blood , Pregnancy , Pregnancy Complications/blood , Pregnancy Complications/diagnosis , Pregnancy Complications, Infectious/blood , SARS-CoV-2