Preeclampsia and severe acute respiratory syndrome coronavirus 2 infection: a systematic review

Abstract

Objective:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the coronavirus disease 2019 (COVID-19) disease that has rapidly spread worldwide, causing hundreds of thousand deaths. Normal placentation is characterized by many processes strictly regulated during pregnancy. If placentation is impaired, it can lead to gestational disorders, such as preeclampsia that is a multisystem disorder that occurs in 2–8% of pregnancies worldwide.Methods:We performed a systematic search to understand the potential involvement of SARS-CoV-2 in preeclampsia onset using the databases, PubMed and Web of Science until 31 January 2022.Results:SARS-CoV-2 infection not only causes damage to the respiratory system but also can infect human placenta cells impairing pivotal processes necessary for normal placenta development. The inflammatory response trigged by COVID-19 disease is very similar to that one found in preeclampsia pregnancies suggesting a possible link between SARS-CoV-2 infection and preeclampsia onset during pregnancy.Conclusion:Some studies showed that pregnancies affected by COVID-19 had higher incidence of preeclampsia compared with SARS-CoV-2-negative ones. However, increased blood pressure found in COVID-19 pregnancies does not allow to associate COVID-19 to preeclampsia as hypertension is a common factor to both conditions. At present, no diagnostic tools are available to discriminate real preeclampsia from preeclampsia-like syndrome in patients with SARS-CoV-2 infection. Thus, new specific diagnostic tools are necessary to assure an appropriate diagnosis of preeclampsia in these patients, especially in case of severe COVID-19 disease.

Impact of COVID-19 on the Microbiome and Inflammatory Status of Type 2 Diabetes Patients

“…Last but not least, SARS-CoV-2 infection not only causes damage to the respiratory tract but can affect other organs. Emerging studies have connected COVID-19 with the onset of preeclampsia during pregnancy [47], problems of the reproductive system in men (i.e., deterioration in semen parameters) [48] and neurological complications [49]. Hence, future studies are needed in order to better understand the virus-host-microbiome interplay so that improved therapeutic approaches can be developed.…”

SARS-CoV-2 Infection during Pregnancy and Histological Alterations in the Placenta

“…This should be done to definitively identify if coagulopathic or inflammatory pathologies are increased in this population. The fact that 84% of patients were asymptomatic was another important limitation of our study; a recent systematic review showed that the severity of the infection plays a key role in pregnancy outcome [ 9 ].…”

“…In severe cases, it can cause pneumonia, acute respiratory distress syndrome, sepsis, septic shock and a cytokine storm with multiorgan failure and disseminated coagulopathy, leading to death [ 6 ]. Furthermore, SARS-CoV-2 infection can cause non-respiratory complications—brain haemorrhage, memory loss, altered mental states in both sexes, semen quality worsening in male patients [ 7 , 8 ] and pregnancy complications such as preeclampsia [ 9 ].…”

COVID-19: Has the Liver Been Spared?

“…Vascular complications, myocardial dysfunction, acute kidney injury, gastrointestinal symptoms, neurologic complications, and dermatologic conditions are among the reported extrapulmonary complications [ 2 , 3 ]. Furthermore, recent studies have suggested that COVID-19 could also have a serious impact on the reproductive system, altering male sperm parameters and increasing the rate of female gestational disorders, such as preeclampsia [ 4 , 5 ]. However, whether COVID-19 could also directly affect the liver has been debated, and the literature regarding hepatic involvement in COVID-19 patients is heterogenous, due to variability in the definitions of liver dysfunction and differences in the clinical presentation and disease severity [ 6 ].…”