Preeclampsia in the Context of COVID‐19: Mechanisms, Pathophysiology, and Clinical Outcomes

American Journal of Reproductive Immunology, Journal Year: 2024, Volume and Issue: 92(2)

Published: Aug. 1, 2024

The emergence of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to global COVID-19 pandemic, significantly impacting health pregnant women. Obstetric populations, already vulnerable, face increased morbidity and mortality related COVID-19, aggravated by preexisting comorbidities. Recent studies have shed light on potential correlation between preeclampsia (PE), a leading cause maternal perinatal worldwide, emphasizing significance exploring relationship these two conditions. Here, we review pathophysiological similarities that PE shares with particular focus cases in PE-like SARS-CoV-2 infection. We highlight cellular molecular mechanistic inter-connectivity conditions, for example, regulation renin-angiotensin system, tight junction barrier integrity, complement system. Finally, discuss how pandemic dynamics, including variants vaccination efforts, shaped clinical scenario influenced severity management both PE. Continued research mechanisms infection during pregnancy risk developing from previous infections is warranted delineate complexities interactions improve

Language: Английский

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An Update on COVID-19-Associated Placental Pathologies

Zeitschrift für Geburtshilfe und Neonatologie, Journal Year: 2024, Volume and Issue: 228(01), P. 42 - 48

Published: Feb. 1, 2024

Abstract COVID-19 pregnancies are associated with increased rates of premature delivery and stillbirths. It is still a matter debate whether there COVID-19-associated pattern placenta pathology. We updated our previously published results on systematic literature review meta-analysis pregnancies. In total, 38 reports 3677 placentas were evaluated regarding histopathological changes. Maternal vascular malperfusion (32%), fetal (19%), acute chronic inflammation (20% 22%) frequent pathologies. non-COVID-19 pregnancies, show similar histologic patterns mainly frequencies manifestation. has to be taken into account that might an observation bias, because some findings diagnosed as “pathology” have been classified minor or unspecific in placentas. placentitis occurs 1–2% cases at the most. conclusion, this indicates infection during pregnancy does not result rate specific pathology rare.

Language: Английский

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Impact of SARS-CoV-2 infection during pregnancy on the placenta and fetus

Seminars in Perinatology, Journal Year: 2024, Volume and Issue: 48(4), P. 151919 - 151919

Published: June 1, 2024

Language: Английский

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SARS-CoV-2 Infection and Its Association with Maternal and Fetal Redox Status and Outcomes: A Prospective Clinical Study

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(5), P. 1555 - 1555

Published: Feb. 26, 2025

Background: The impact of the SARS-CoV-2 viral infection during pregnancy on fetus can be direct—transmitted through placenta—and indirect—creating unfavorable conditions for development because inflammation, micro-thrombosis, and hypercoagulation. Our study aimed to determine types frequency pathohistological changes in placental tissue SARS-CoV-2-positive pregnant women examine possible role oxidative stress prognosis delivery its maternal fetal complications. Methods: This prospective clinical included 50 divided into two groups, positive (COVID-19 group) negative (control group), from who we collected demographic, clinical, obstetric, biochemical pathologic data. Data about newborn characteristics were also collected, which anamnestic, Results: values superoxide anion radical index lipid peroxidation significantly different mothers concerning presence infection, while levels nitric oxide, peroxidation, reduced glutathione, dismutase newborns depending infection. Newborn similar between groups except concentrations IgM antibody. incidence FVM type COVID-19 group was 46%, control group, 18%. Conclusions: confirmed significant parameters stress-mediated dysfunction. Future studies should performed with more participants follow-up neonatal development.

Language: Английский

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The pregnancy outcomes of women with SARS-CoV-2 infection in the first trimester ---a longitudinal cohort study

BMC Pregnancy and Childbirth, Journal Year: 2025, Volume and Issue: 25(1)

Published: March 26, 2025

In recent years, severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection has been prevalent worldwide. Pregnant women belong to a special group, and it is very important for clinicians pay attention the impact of SARS-CoV-2 on pregnancy outcomes. However, there are limited studies outcomes during first trimester. To investigate effect in trimester Clinical information pregnant whose last menstrual period was between October 1, 2022, April 2023, who were registered Obstetrics Gynecology department Peking University International Hospital, analyzed. Among them, 498 with included study group; while total 654 no control group. Mann Whitney U test, χ2 Fisher's exact probability method, multivariate logistic regression used analyze A 30 cases group experienced loss before 28 weeks gestation, 468 delivered. 41 613 The rates two groups 6.02% 6.27%, respectively, statistically significant difference (P > 0.05). There 0.05) baseline data (delivery age, pre-pregnancy body mass index, gestational parity) groups. neonatal malformation, premature birth, rupture membranes, postpartum hemorrhage, cesarean section, small age infants, low birth weight macrosomia, asphyxia compared, incidence hypertension significantly higher than that = 0.012). this single center study, we found may increase risk hypertension, incidences other adverse such as did not compared without

Language: Английский

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Extracellular Vesicles Alter Trophoblast Function in Pregnancies Complicated by COVID‐19

Journal of Extracellular Vesicles, Journal Year: 2025, Volume and Issue: 14(4)

Published: April 1, 2025

ABSTRACT Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection and resulting disease (COVID‐19) cause placental dysfunction, which increases the risk of adverse pregnancy outcomes. While abnormal pathology from COVID‐19 is common, direct placenta rare. This suggests that pathophysiology associated with maternal COVID‐19, rather than infection, responsible for dysfunction. We hypothesized circulating extracellular vesicles (EVs), altered by during pregnancy, contribute to To examine this hypothesis, we characterized EVs pregnancies complicated tested their effects on trophoblast cell physiology in vitro. Trophoblast exposure isolated patients an active (AI), but not controls, key functions including hormone production invasion. Thus, participants AI, both symptomatic asymptomatic cases, can disrupt vital functions. EV cargo differed between depending gestational timing Controls, may disruption transcriptome morphology. Our findings show have throughout EVs, are likely participate dysfunction induced COVID‐19.

Language: Английский

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Single-nucleus transcriptional profiling of the placenta reveals the syncytiotrophoblast stress response to COVID-19

American Journal of Obstetrics and Gynecology, Journal Year: 2025, Volume and Issue: 232(4), P. S160 - S175.e7

Published: April 1, 2025

COVID-19 in pregnancy is associated with placental immune activation, inflammation, and vascular malperfusion, but its impact on syncytiotrophoblast biology function unclear. This study aimed to determine the effects of maternal syncytiotrophoblasts using single-nucleus transcriptional profiling compare stress responses preeclampsia. For characterization syncytiotrophoblasts, we used RNA sequencing platform, single-cell combinatorial indexing (sci-RNA-seq3), profile villi fetal membranes from unvaccinated patients symptomatic at birth (n = 4), gestational age-matched controls a case critical second trimester delivery term 1). Clustering nuclei differential gene expression analysis was performed Seurat. Gene ontology conducted Enrichr. High-confidence target identify key transcription factor nodes governing response SARS-CoV-2 infection. Bioinformatic approaches were further dataset published preeclampsia signatures. Tissue analysis, including immunofluorescence, validate data histology for an expanded cohort placentas: 6), asymptomatic 3), 5), severe features 7). The analyzed comprised 15 cell clusters 47,889 nuclei. We identified 3 representing fusing mature overlapping distinct COVID-19. analyses indicated that following alterations syncytiotrophoblasts: (1) endoplasmic reticulum activation signaling pathways, unfolded protein integrated response; (2) regulation by CCAAT/enhancer-binding beta (CEBPB), master lineage; (3) upregulation preeclampsia-associated genes. Using complementary methods, confirmed increased levels proteins (eg, BiP, G3BP1) (spliced XBP1 mRNA), CEBPB (phosphorylation) Increased cytotrophoblast proliferation (Ki-67) also detected COVID-19, consistent trophoblast injury. Markers demonstrated similarities phenotype Maternal lineage factor, CEBPB. Similarities between provide insights into their clinical association.

Language: Английский

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SARS-CoV-2, the human placenta, and adverse perinatal outcomes

American Journal Of Pathology, Journal Year: 2025, Volume and Issue: unknown

Published: April 1, 2025

Language: Английский

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Placental Privilege: Evidence of Organ Resilience in Severe COVID-19 in Pregnancy

Placenta, Journal Year: 2025, Volume and Issue: unknown

Published: May 1, 2025

Language: Английский

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Differences in Placental Pathologic Features by Trimester of Infection with SARS-CoV-2

Pediatric and Developmental Pathology, Journal Year: 2025, Volume and Issue: unknown

Published: May 16, 2025

We describe placental findings associated with SARS-CoV-2 infection in pregnancy and any differences between trimester of infection. included 314 pregnant patients who tested positive for during had their placenta submitted pathology examination. Trimester was based on the gestational age at time Placental categorized into acute inflammation (AI), chronic (CI), maternal vascular malperfusion (MVM), fetal (FVM), divided none, low-grade, high-grade. RT-PCR performed tissue 238/314 (75%) cases. The prevalence AI, CI, FVM, MVM did not differ by However, high-grade inflammatory and/or were more prevalent earlier (1st (27/40, 67.5%), 2nd (37/67, 55.2%), 3rd (82/207, 39.6%, P < .01). Third ≤10 days before delivery a higher FVM compared to remote from (46/134, 34.3% vs 14/73, 19.2%; .02). detected RNA placenta, 8/238 (3.4%) High-grade are pregnancy.

Language: Английский

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