Observational studyAmerican journal of obstetrics & gynecology MFM2023
Confirmation of preeclampsia-like syndrome induced by severe COVID-19: an observational study.
Observational study in American journal of obstetrics & gynecology MFM, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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The trial behind it
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Who cites it
18 citing papers in PubMed, 30 citations in OpenAlex.
- Implementation of First-Trimester Screening and Prevention of Preeclampsia: A Stepped Wedge Cluster-Randomized Trial in Asia.Circulation · 2024Trial
- Persistence of SARS-CoV-2 RNA Residues in Placenta Tissue Following Maternal COVID-19 Infection During Pregnancy.American journal of reproductive immunology (New York, N.Y. : 1989) · 2026Article
- COVID-19 vaccination status during pregnancy and preeclampsia risk: the pandemic-era cohort of the INTERCOVID consortium.EClinicalMedicine · 2026Article
- Mechanistic insights into the impact of prenatal viral infections on maternal and offspring immunity.Npj viruses · 2026Review
- Double Jeopardy: The Intersection of COVID-19 and Pregnancy in an Educational Hospital, Northern Iran, Gorgan.Archives of Razi Institute · 2025Article
- A Disintegrin and Metalloprotease with Thrombospondin Motif, Member 13, and Von Willebrand Factor in Relation to the Duality of Preeclampsia and HIV Infection.International journal of molecular sciences · 2025Review
- Single-nucleus transcriptional profiling of the placenta reveals the syncytiotrophoblast stress response to COVID-19.American journal of obstetrics and gynecology · 2025Article
- Autoantibody production in pregnancy: relationship with mRNA BNT162b2 immunization, active COVID-19, and pre-eclampsia.Frontiers in immunology · 2025Article
- PD-L1 expression and characterization of its carrier macrophages in placentas with acute and specifically post-SARS-CoV-2 infection.Histochemistry and cell biology · 2024Article
- Preeclampsia in the Context of COVID-19: Mechanisms, Pathophysiology, and Clinical Outcomes.American journal of reproductive immunology (New York, N.Y. : 1989) · 2024Review
- The Number of Syncytial Knots and the Intensity of VEGF Expression in the Villi of the Monochorionic Diamniotic Placenta in Selective Fetal Growth Restriction.Bulletin of experimental biology and medicine · 2024Article
- Whole transcriptome profiling of placental pathobiology in SARS-CoV-2 pregnancies identifies placental dysfunction signatures.Clinical & translational immunology · 2024Article
- Mendelian randomization supports genetic liability to hospitalization for COVID-19 as a risk factor of pre-eclampsia.Frontiers in cardiovascular medicine · 2024Article
- SARS-CoV-2 Infection in Late Pregnancy and Childbirth from the Perspective of Perinatal Pathology.Journal of developmental biology · 2023Review
- Risk Factors for Severe-Critical COVID-19 in Pregnant Women.Journal of clinical medicine · 2023Article
- SARS-CoV-2 Infection and Preeclampsia-How an Infection Can Help Us to Know More about an Obstetric Condition.Viruses · 2023Review
- Risk Factors of Adverse Maternal Outcome among SARS-CoV-2 Infected Critically Ill Pregnant Women in Serbia.Journal of clinical medicine · 2023Article
- Role of biomarkers (sFlt-1/PlGF) in cases of COVID-19 for distinguishing preeclampsia and guiding clinical management.Pregnancy hypertension · 2023Article
Corrections and comments
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Authors and funding
14 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSince the outbreak of the COVID-19 pandemic, some studies have reported an increased preeclampsia incidence in pregnant women with SARS-CoV-2 infection. Several explanations for this association have been proposed, including a preeclampsia-like syndrome induced by severe COVID-19. This syndrome was described in a small case series and has not been confirmed in larger studies, and its effect on perinatal outcomes has not been studied.
objectiveThis study aimed to confirm the preeclampsia-like syndrome because of COVID-19 and to investigate its implications on pregnancy outcomes and prognosis. STUDY
designThis was a prospective, observational study conducted in a tertiary referral hospital. The inclusion criteria were pregnant women admitted to the intensive care unit for severe pneumonia because of COVID-19. They were classified into 3 groups based on clinical and laboratory findings: preeclampsia, preeclampsia-like syndrome, and women without preeclampsia features. The 3 cohorts were analyzed and compared at 3 different times: before, during, and after severe pneumonia. The main outcomes were incidence of adverse perinatal outcomes and signs and symptoms of PE, such as hypertension, proteinuria, thrombocytopenia, elevated liver enzymes, and increased angiogenic factors (soluble fms-like tyrosine kinase 1-to-placental growth factor ratio).
resultsA total of 106 women were admitted to the intensive care unit because of severe pneumonia, and 68 women were included in the study. Of those, 53 (50.0%) did not meet the diagnostic criteria for preeclampsia and remained pregnant after pneumonia (non-preeclampsia); 7 (6.6%) met the diagnostic criteria for preeclampsia, had abnormal (>38) soluble fms-like tyrosine kinase 1-to-placental growth factor ratio (preeclampsia), and delivered during severe pneumonia, and 8 (7.5%) met the diagnostic criteria for preeclampsia, had normal (≤38) soluble fms-like tyrosine kinase 1-to-placental growth factor ratio (preeclampsia like), and did not deliver during pneumonia. Despite not having delivered, most preeclampsia-related features improved after severe pneumonia in women with preeclampsia-like syndrome. Women with preeclampsia had significantly poorer outcomes than women with preeclampsia-like syndrome or without preeclampsia.
conclusionMore than 50% of women with severe COVID-19 and diagnostic criteria for preeclampsia may not be preeclampsia but a preeclampsia-like syndrome, which may affect up to 7.5% of women with severe COVID-19. Preeclampsia-like syndrome might have similar perinatal outcomes to those of normotensive women with severe pneumonia because of COVID-19. For these reasons, preeclampsia-like syndrome should be excluded by using soluble fms-like tyrosine kinase 1-to-placental growth factor ratio in future research and before making clinical decisions.
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