RESUMEN
The 2019 novel coronavirus disease (COVID-19) pandemic poses unique challenges to the medical community as the optimal treatment has not been determined and is often at the discretion of institutional guidelines. Pregnancy has previously been described as a high-risk state in the context of infectious diseases, given a particular susceptibility to pathogens and adverse outcomes. Although ongoing studies have provided insight on the course of this disease in the adult population, the implications of COVID-19 on pregnancy remains an understudied area. The objective of this study is to review the literature and describe clinical presentations among pregnant women afflicted with COVID-19.
Asunto(s)
COVID-19/fisiopatología , Complicaciones Infecciosas del Embarazo/fisiopatología , Lesión Renal Aguda/fisiopatología , Anosmia/fisiopatología , Infecciones Asintomáticas , Trastornos de la Coagulación Sanguínea/fisiopatología , COVID-19/inmunología , COVID-19/metabolismo , COVID-19/terapia , Prueba de COVID-19 , Cardiomiopatías/fisiopatología , Enfermedades del Sistema Nervioso Central/fisiopatología , Progresión de la Enfermedad , Femenino , Síndrome HELLP/metabolismo , Humanos , Hipercapnia , Hipoxia/diagnóstico , Hipoxia/fisiopatología , Hipoxia/terapia , Hepatopatías/metabolismo , Hepatopatías/fisiopatología , Tamizaje Masivo , Mialgia/fisiopatología , Miocarditis/fisiopatología , Terapia por Inhalación de Oxígeno , Preeclampsia/metabolismo , Embarazo , Complicaciones Infecciosas del Embarazo/inmunología , Complicaciones Infecciosas del Embarazo/metabolismo , Complicaciones Infecciosas del Embarazo/terapia , SARS-CoV-2 , Índice de Severidad de la Enfermedad , Trastornos del Gusto/fisiopatologíaRESUMEN
OBJECTIVES: To investigate the incidence of clinical, ultrasonographic and biochemical findings related to pre-eclampsia (PE) in pregnancies with COVID-19, and to assess their accuracy to differentiate between PE and the PE-like features associated with COVID-19. DESIGN: A prospective, observational study. SETTING: Tertiary referral hospital. PARTICIPANTS: Singleton pregnancies with COVID-19 at >20+0 weeks. METHODS: Forty-two consecutive pregnancies were recruited and classified into two groups: severe and non-severe COVID-19, according to the occurrence of severe pneumonia. Uterine artery pulsatility index (UtAPI) and angiogenic factors (soluble fms-like tyrosine kinase-1/placental growth factor [sFlt-1/PlGF]) were assessed in women with suspected PE. MAIN OUTCOME MEASURES: Incidence of signs and symptoms related to PE, such as hypertension, proteinuria, thrombocytopenia, elevated liver enzymes, abnormal UtAPI and increased sFlt-1/PlGF. RESULTS: Thirty-four cases were classified as non-severe and 8 as severe COVID-19. Five (11.9%) women presented signs and symptoms of PE, all five being among the severe COVID-19 cases (62.5%). However, abnormal sFlt-1/PlGF and UtAPI could only be demonstrated in one case. One case remained pregnant after recovery from severe pneumonia and had a spontaneous resolution of the PE-like syndrome. CONCLUSIONS: Pregnant women with severe COVID-19 can develop a PE-like syndrome that might be distinguished from actual PE by sFlt-1/PlGF, LDH and UtAPI assessment. Healthcare providers should be aware of its existence and monitor pregnancies with suspected pre-eclampsia with caution. TWEETABLE ABSTRACT: This study shows that a pre-eclampsia-like syndrome could be present in some pregnancies with severe COVID-19.