Pre-eclampsia-like syndrome induced by severe COVID-19: a prospective observational study.
BJOG
; 127(11): 1374-1380, 2020 10.
Article
in English
| MEDLINE | ID: covidwho-627054
ABSTRACT
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 OUTCOMEMEASURES:
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.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Pre-Eclampsia
/
Pregnancy Complications, Infectious
/
HELLP Syndrome
/
Coronavirus Infections
/
Vascular Endothelial Growth Factor Receptor-1
/
Uterine Artery
/
Placenta Growth Factor
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Topics:
Long Covid
Limits:
Adult
/
Female
/
Humans
/
Pregnancy
Language:
English
Journal:
BJOG
Journal subject:
Gynecology
/
Obstetrics
Year:
2020
Document Type:
Article
Affiliation country:
1471-0528.16339
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