Author:
Grandone Elvira,Vimercati Antonella,Sorrentino Felice,Colaizzo Donatella,Ostuni Angelo,Ceci Oronzo,Capozza Manuela,Tiscia Giovanni,De Laurenzo Antonio,Mastroianno Mario,Cappucci Filomena,Fischetti Lucia,Margaglione Maurizio,Cicinelli Ettore,Nappi Luigi
Abstract
Abstract
Background
Thrombotic microangiopathy has been invoked as one of the most important mechanisms of damage in COVID-19 patients. Protease ADAMTS13 is a marker of microangiopathy responsible for controlling von Willebrand multimers size. Von Willebrand factor/ADAMTS13 ratio has been found impaired in COVID-19 patients outside pregnancy.
Methods
We prospectively investigated 90 pregnant women admitted to two tertiary academic hospitals in Italy with a laboratory-confirmed diagnosis of SARS-CoV-2 infection. Demographic, clinical information and routine laboratory data were collected at the hospital admission and until discharge. We investigated whether vonWillebrand /ADAMTS13 axis imbalance is a predictor of adverse outcomes. Logistic regression analysis, which controlled for potential confounders, was performed to evaluate the association between laboratory parameters and clinical outcomes.
Results
Most women (55.6%) were parae, with median gestational age at admission of 39 weeks. At hospital admission, 63.3% were asymptomatic for COVID-19 and 24.4% showed more than one sign or symptom of infection. Nulliparae with group O showed Willebrand / ADA MTS-13 ratios significantly lower than non-O, whereas in multiparae this difference was not observed. Logistic regression showed that ratio von Willebrand to ADAMTS13 was significantly and independently associated with preterm delivery (OR 1.9, 95%CI 1.1–3.5).
Conclusion
This study shows an imbalance of vonWillebrand /ADAMTS13 axis in pregnant women with COVID-19, leading to a significantly higher and independent risk of preterm delivery. Monitoring these biomarkers might support decision making process to manage and follow-up pregnancies in this setting.
Publisher
Springer Science and Business Media LLC
Subject
Obstetrics and Gynecology
Reference37 articles.
1. Cardona-Pérez JA, Villegas-Mota I, Helguera-Repetto AC, Acevedo-Gallegos S, Rodríguez-Bosch M, Aguinaga-Ríos M, et al. Prevalence, clinical features, and outcomes of SARS-CoV-2 infection in pregnant women with or without mild/moderate symptoms: results from universal screening in a tertiary care center in Mexico City, Mexico. PLoS One. 2021;16(4):1–19.
2. Carrasco I, Muñoz-chapuli M, Vigil-vázquez S, Aguilera-alonso D, Hernández C, Sánchez-sánchez C, et al. SARS-COV-2 infection in pregnant women and newborns in a Spanish cohort ( GESNEO-COVID ) during the first wave. BMC Pregnancy Childbirth. 2021;8:1–10.
3. Flores-Pliego A, Miranda J, Vega-Torreblanca S, Valdespino-Vázquez Y, Helguera-Repetto C, Espejel-Nuñez A, et al. Molecular insights into the thrombotic and microvascular injury in placental endothelium of women with mild or severe COVID-19. Cells. 2021;10:1–22.
4. Tanacan A, Yazihan N, Ahmet S, Taner A. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier connect, the company’s public news and information. Cytokine. 2021;140:155431.
5. Pedersen SF, Ho YC. SARS-CoV-2: a storm is raging. J Clin Invest. 2020;130:2202–5.
Cited by
8 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献