Role of biomarkers (sFlt-1/PlGF) in cases of COVID-19 for distinguishing preeclampsia and guiding clinical management

Guilherme M. Nobrega, Jose P. Guida, Juliana M. Novaes, Larissa M. Solda, Luciana Pietro, Adriana G. Luz, Giuliane J. Lajos, Carolina C. Ribeiro-do-Valle, Renato T. Souza, Jose G. Cecatti, Indira U. Mysorekar, Tabata Z. Dias, Maria Laura Costa

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Objectives: To analyze soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factors (PlGF) concentrations and their ratio in pregnant and postpartum women with suspected COVID-19, and further investigate conditions associated with an increased ratio (sFlt-1/PlGF > 38), including preeclampsia (PE) and severe acute respiratory syndrome (SARS). Study Design: The present study is a secondary analysis of a prospective cohort. Blood samples were collected at time of COVID-19 investigation and the serum measurements of sFlt-1 and PlGF were performed. Clinical background, SARS-CoV-2 infection characteristics, maternal and perinatal outcomes were further analyzed. Main outcome measures: Serum measurements of sFlt-1 and PlGF; obstetrics and clinical outcomes. Results: A total of 97 SARS-CoV-2 unvaccinated women with suspected infection were considered, 76 were COVID-19 positive cases and 21 COVID-19 negative. Among COVID-19 positive cases, 09 presented with SARS and 11 were diagnosed with PE, of which 6 had SARS-CoV-2 infection in first and second trimester (04 with sFlt-1/PlGF ≥ 38) and 05 with PE and COVID-19 diagnosed at the same time, during third trimester (03 with sFlt-1/PlGF ≥ 38). Five presented with PE with severe features. sFlt-1/PlGF ratio was significantly higher in the COVID-19 positive/PE positive group compared to COVID-19 positive/PE negative group (p-value = 0.005), with no increase in cases complicated by SARS. Conclusions: sFlt-1/PlGF ratio could be a useful tool for differential diagnosis and adequate counseling among cases of COVID-19 and PE, especially if severe disease. COVID-19 early in pregnancy could potentially be a risk factor for PE later during gestation.

Original languageEnglish
Pages (from-to)32-37
Number of pages6
JournalPregnancy Hypertension
Volume31
DOIs
StatePublished - Mar 2023

Keywords

  • COVID-19
  • Hypertensive disorders of pregnancy
  • Maternal health
  • Renin-angiotensin system

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