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Obstetric outcomes in pregnant COVID-19 women: the imbalance of von Willebrand factor and ADAMTS13 axis.
Grandone, Elvira; Vimercati, Antonella; Sorrentino, Felice; Colaizzo, Donatella; Ostuni, Angelo; Ceci, Oronzo; Capozza, Manuela; Tiscia, Giovanni; De Laurenzo, Antonio; Mastroianno, Mario; Cappucci, Filomena; Fischetti, Lucia; Margaglione, Maurizio; Cicinelli, Ettore; Nappi, Luigi.
  • Grandone E; Thrombosis and Haemostasis Unit, Fondazione I.R.C.C.S. "Casa Sollievo della Sofferenza", Viale Cappuccini, 71013, Foggia, S. Giovanni Rotondo, Italy. e.grandone@operapadrepio.it.
  • Vimercati A; Ob/Gyn Department of The First I.M. Sechenov Moscow State Medical University, Moscow, Russia. e.grandone@operapadrepio.it.
  • Sorrentino F; Ob/Gyn Institute, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy. e.grandone@operapadrepio.it.
  • Colaizzo D; Ob/Gyn Institute, Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy.
  • Ostuni A; Ob/Gyn Institute, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
  • Ceci O; Thrombosis and Haemostasis Unit, Fondazione I.R.C.C.S. "Casa Sollievo della Sofferenza", Viale Cappuccini, 71013, Foggia, S. Giovanni Rotondo, Italy.
  • Capozza M; Immunohematology and Transfusion Medicine Service, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, University of Bari "Aldo Moro", Bari, Italy.
  • Tiscia G; Struttura Regionale Coordinamento Puglia, Bari, Italy.
  • De Laurenzo A; Ob/Gyn Institute, Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy.
  • Mastroianno M; Neonatal Intensive Care Unit, Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy.
  • Cappucci F; Thrombosis and Haemostasis Unit, Fondazione I.R.C.C.S. "Casa Sollievo della Sofferenza", Viale Cappuccini, 71013, Foggia, S. Giovanni Rotondo, Italy.
  • Fischetti L; Thrombosis and Haemostasis Unit, Fondazione I.R.C.C.S. "Casa Sollievo della Sofferenza", Viale Cappuccini, 71013, Foggia, S. Giovanni Rotondo, Italy.
  • Margaglione M; Scientific Direction, Fondazione I.R.C.C.S. "Casa Sollievo della Sofferenza", Foggia, S. Giovanni Rotondo, Italy.
  • Cicinelli E; Thrombosis and Haemostasis Unit, Fondazione I.R.C.C.S. "Casa Sollievo della Sofferenza", Viale Cappuccini, 71013, Foggia, S. Giovanni Rotondo, Italy.
  • Nappi L; Thrombosis and Haemostasis Unit, Fondazione I.R.C.C.S. "Casa Sollievo della Sofferenza", Viale Cappuccini, 71013, Foggia, S. Giovanni Rotondo, Italy.
BMC Pregnancy Childbirth ; 22(1): 142, 2022 Feb 21.
Article in English | MEDLINE | ID: covidwho-1706234
ABSTRACT

BACKGROUND:

Thrombotic microangiopathy has been invoked as one of the most important mechanisms of damage in COVID-19 patients. Protease ADAMTS13 is a marker of microangiopathy responsible for controlling von Willebrand multimers size. Von Willebrand factor/ADAMTS13 ratio has been found impaired in COVID-19 patients outside pregnancy.

METHODS:

We prospectively investigated 90 pregnant women admitted to two tertiary academic hospitals in Italy with a laboratory-confirmed diagnosis of SARS-CoV-2 infection. Demographic, clinical information and routine laboratory data were collected at the hospital admission and until discharge. We investigated whether vonWillebrand /ADAMTS13 axis imbalance is a predictor of adverse outcomes. Logistic regression analysis, which controlled for potential confounders, was performed to evaluate the association between laboratory parameters and clinical outcomes.

RESULTS:

Most women (55.6%) were parae, with median gestational age at admission of 39 weeks. At hospital admission, 63.3% were asymptomatic for COVID-19 and 24.4% showed more than one sign or symptom of infection. Nulliparae with group O showed Willebrand / ADA MTS-13 ratios significantly lower than non-O, whereas in multiparae this difference was not observed. Logistic regression showed that ratio von Willebrand to ADAMTS13 was significantly and independently associated with preterm delivery (OR 1.9, 95%CI 1.1-3.5).

CONCLUSION:

This study shows an imbalance of vonWillebrand /ADAMTS13 axis in pregnant women with COVID-19, leading to a significantly higher and independent risk of preterm delivery. Monitoring these biomarkers might support decision making process to manage and follow-up pregnancies in this setting.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications / Von Willebrand Factor / Premature Birth / ADAMTS13 Protein / COVID-19 Type of study: Etiology study / Prognostic study Topics: Long Covid Limits: Adolescent / Adult / Female / Humans / Middle aged / Pregnancy / Young adult Country/Region as subject: Europa Language: English Journal: BMC Pregnancy Childbirth Journal subject: Obstetrics Year: 2022 Document Type: Article Affiliation country: S12884-022-04405-8

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pregnancy Complications / Von Willebrand Factor / Premature Birth / ADAMTS13 Protein / COVID-19 Type of study: Etiology study / Prognostic study Topics: Long Covid Limits: Adolescent / Adult / Female / Humans / Middle aged / Pregnancy / Young adult Country/Region as subject: Europa Language: English Journal: BMC Pregnancy Childbirth Journal subject: Obstetrics Year: 2022 Document Type: Article Affiliation country: S12884-022-04405-8