Study Finds Pathophysiological Similarities Between Preeclampsia and COVID-19
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Three years after the most lethal period of the COVID-19 pandemic, a review of the scientific literature published in the American Journal of Reproductive Immunology emphasizes the pathophysiological similarities between preeclampsia and COVID-19.
During the COVID-19 pandemic, above all before vaccines were available, an alarm was sounded regarding a possible correlation between severe cases of COVID-19 in pregnant women and preeclampsia. It can entail dangerous complications for mother and baby. Preeclampsia was more frequent in pregnant women infected by SARS-CoV-2 and was associated with a heightened risk of complications and death.
The protocols for treating the two conditions are different. In the case of preeclampsia, the pregnancy must be interrupted and the baby delivered as soon as possible by cesarean section, whereas in a woman with COVID-19 the pregnancy can proceed, with clinical support until the infection improves.
The study was conducted by researchers at the State University of Campinas in São Paulo state, Brazil, and Baylor College of Medicine in Houston, Texas (USA). The similarities highlighted in the article include shared pathways involving the renin-angiotensin system and angiotensin-converting enzyme 2 (ACE2), the receptor to which SARS-CoV-2 binds to infect human cells.
“The two conditions do indeed have many similarities. Both severe COVID-19 and preeclampsia can involve multiple organ dysfunction and high blood pressure. There are also similarities in the mechanism, as angiotensin-converting enzyme 2 plays a key role in regulating blood pressure. It’s possible therefore that COVID-19 heightens the risk of preeclampsia, as suggested by several studies that point to a higher frequency of preeclampsia in COVID-19 patients,” Maria Laura Costa do Nascimento, last author of the review article and a professor of obstetrics at UNICAMP.
The rise in maternal mortality during the pandemic cannot be blamed on the rise in cases of preeclampsia. “This is due to lack of both epidemiological surveillance findings and a proper diagnosis of the condition,” Nascimento said. “What we can say, based on a multicenter study we conducted during the pandemic with data from 16 maternity hospitals across Brazil, is that the risk of death or severe disease increases when both conditions are present. Moreover, our review of the literature shows that the prevalence of preeclampsia rises among COVID-19 patients.”
Reference: Nobrega, G. M., Jones, B. R., Mysorekar, I. U., & Costa, M. L. (2024). Preeclampsia in the Context of COVID‐19: Mechanisms, Pathophysiology, and Clinical Outcomes. American Journal of Reproductive Immunology, 92(2), e13915.
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