TY - JOUR
T1 - Role of biomarkers (sFlt-1/PlGF) in cases of COVID-19 for distinguishing preeclampsia and guiding clinical management
AU - Nobrega, Guilherme M.
AU - Guida, Jose P.
AU - Novaes, Juliana M.
AU - Solda, Larissa M.
AU - Pietro, Luciana
AU - Luz, Adriana G.
AU - Lajos, Giuliane J.
AU - Ribeiro-do-Valle, Carolina C.
AU - Souza, Renato T.
AU - Cecatti, Jose G.
AU - Mysorekar, Indira U.
AU - Dias, Tabata Z.
AU - Laura Costa, Maria
N1 - Funding Information:
This study was supported by Fundo de Apoio ao Ensino, à Pesquisa e à Extensão (FAEPEX-Unicamp) [Grant No 2300/20] and by the Washington University at Saint Louis, USA, McDonnell Academy seed grant for research on infectious diseases and the impact of COVID-19 (to IUM and MLC). MLC was also supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) [grant number 2021/09937-1] and by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) [grant number 408407/2021-2]. GMN was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) [grant number 88882.329828/2019]. Roche Diagnostics (ROCHE®) supported the measurements of angiogenesis-related factors sFlt-1 and PlGF, providing automated Elecsys® sFlt-1/PlGF kits.
Publisher Copyright:
© 2022 International Society for the Study of Hypertension in Pregnancy
PY - 2023/3
Y1 - 2023/3
N2 - 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.
AB - 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.
KW - COVID-19
KW - Hypertensive disorders of pregnancy
KW - Maternal health
KW - Renin-angiotensin system
UR - http://www.scopus.com/inward/record.url?scp=85144082302&partnerID=8YFLogxK
U2 - 10.1016/j.preghy.2022.11.008
DO - 10.1016/j.preghy.2022.11.008
M3 - Article
C2 - 36525933
AN - SCOPUS:85144082302
SN - 2210-7789
VL - 31
SP - 32
EP - 37
JO - Pregnancy Hypertension
JF - Pregnancy Hypertension
ER -