A group of researchers conducted a study to examine the role of Vitamin D in covid-19 induced pregnancy complications.
The pregnancy is considered a physiological condition, that is accompanied by hypervolemia, increased cardiac output, and a diminished total peripheral resistance, still, the pregnants are normotensive, and blood pressure even tends to decrease in the second trimester. Estrogen and progesterone raise angiotensinogen and renin levels, which in turn leads to increased angiotensin II levels, the increased concentration of angiotensinogen, angiotensin II, indicate the increased activity of RAAS, but instead, there is a decrease in systemic vascular resistance characterizes the hemodynamics of the normal pregnancy
SARS-CoV-2 enters target cells via the ACE2 receptor and downregulates them. ACE2 exhibits high catalytic activity to produce Angiotensin 1–7 (Ang-1–7), which has a vasodilator effect and also inactivates the vasoconstrictor Angiotensin II. In normal pregnancy, ACE2 expression is raised in the uterus and placenta. Ang-1–7 levels in plasma are significantly higher in third-trimester pregnant women when compared to non-pregnant women.
This may be contributing to systemic vasodilation and reduced blood pressure and modulating hemodynamics during pregnancy. Interestingly, Ang-1–7 plasma levels are lower in pregnancies complicated by pre-eclampsia than in normal pregnancies. COVID-19 infection increased the inflammatory cytokines and reduced ACE2 levels.
This may lead to pre-eclampsia or hypertensive pregnancies, then increasing the perinatal and maternal mortality and morbidity. Vitamin D increased ACE2 expression and Ang-1–7 plasma levels and also decreased Ang II levels in plasma.
Moreover, Vitamin D reduced the inflammatory cytokine storm. So, the researchers concluded that Vitamin D supplementation can prevent the risk of preeclampsia or hypertension in pregnant women with COVID-19.
Reference:
Vitamin D may prevent COVID-19 induced pregnancy complications by AliAl-Kaleel et al. published in the Medical Hypotheses.
https://doi.org/10.1016/j.mehy.2021.110733
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