COVID-19 and Preeclampsia: A Systematic Review of Pathophysiological Interactions.
| Autor: | Nascimento MID; Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ, Brazil., Cunha AA; Faculdade de Medicina, Universidade do Estado do Rio de Janeiro, Rio de Janeiro RJ, Brazil., Netto NFR; Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ, Brazil., Santos RAD; Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ, Brazil., Barroso RR; Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ, Brazil., Alves TRC; Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil., Soares WE; Faculdade de Medicina, Universidade Federal Fluminense, Niterói, RJ, Brazil. |
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| Jazyk: | angličtina |
| Zdroj: | Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia [Rev Bras Ginecol Obstet] 2023 Jun; Vol. 45 (6), pp. 347-355. Date of Electronic Publication: 2023 Jul 21. |
| DOI: | 10.1055/s-0043-1770091 |
| Abstrakt: | Objective: To review the literature and synthesize evidence on pathophysiological interactions attributed to the simultaneous occurrence of COVID-19 and preeclampsia. Methods: A systematic review was conducted from November (2021) to January (2022) to retrieve observational studies published on the PubMed, LILACS, SciELO Brazil and Google Scholar databases. The search was based on the descriptors [(eclampsia OR preeclampsia) AND (COVID-19)]. Quantitative studies that pointed to pathophysiological interactions were included. Literature reviews, studies with HIV participants, or with clinical approach only were excluded. The selection of studies was standardized and the evaluation was performed by pairs of researchers. Results: In this review, 155 publications were retrieved; 16 met the inclusion criteria. In summary, the physiological expression of angiotensin-converting enzyme-2 (ACE-2) receptors is physiologically increased in pregnant women, especially at the placental site. Studies suggest that the coronavirus binds to ACE-2 to enter the human cell, causing deregulation of the renin-angiotensin-aldosterone system and in the ratio between angiotensin-II and angiotensin-1-7, inducing manifestations suggestive of preeclampsia. Furthermore, the cytokine storm leads to endothelial dysfunction, vasculopathy and thrombus formation, also present in preeclampsia. Conclusion: The studies retrieved in this review suggest that there is a possible overlap of pathophysiological interactions between COVID-19 and preeclampsia, which mainly involve ACE-2 and endothelial dysfunction. Given that preeclampsia courses with progressive clinical and laboratory alterations, a highly quality prenatal care may be able to detect specific clinical and laboratory parameters to differentiate a true preeclampsia superimposed by covid-19, as well as cases with hypertensive manifestations resulting from viral infection. Competing Interests: The authors have no conflicts of interest to declare. (Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).) |
| Databáze: | MEDLINE |
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