Increased levels of soluble fms-like tyrosine kinase-1 are associated with adverse outcome in pregnant women with COVID-19
| Autor: | Y Alfonso-Guillen, A Espejel-Nuñez, G Estrada-Gutierrez, J M Solis-Paredes, L. C. Poon, L Aguilar-Andrade, Raigam Jafet Martinez-Portilla, S. Espino‐y‐Sosa, A Juarez-Reyes, J A Hernández-Pacheco, A Etchegaray-Solana, J. Torres-Torres, José Rafael Villafán-Bernal |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Placenta Pneumonia Viral Gestational Age Severity of Illness Index law.invention Cohort Studies law Pregnancy Internal medicine Medicine Humans Radiology Nuclear Medicine and imaging Mortality Pregnancy Complications Infectious Adverse effect Prospective cohort study Mexico Placenta Growth Factor Original Paper Vascular Endothelial Growth Factor Receptor-1 Radiological and Ultrasound Technology business.industry SARS-CoV-2 Obstetrics and Gynecology COVID-19 General Medicine Odds ratio medicine.disease Intensive care unit Original Papers Pneumonia Intensive Care Units Reproductive Medicine Maternal death Female Endothelium Vascular business Soluble fms-like tyrosine kinase-1 |
| Zdroj: | Ultrasound in Obstetrics & Gynecology |
| ISSN: | 1469-0705 |
| Popis: | In addition to the lungs, the placenta and the endothelium can be affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) are markers of endothelial dysfunction and could potentially serve as predictors of severe coronavirus disease 2019 (COVID-19). We aimed to investigate the association of serum concentrations of sFlt-1 and PlGF with the severity of COVID-19 in pregnancy.This was a prospective cohort study carried out in a tertiary care hospital in Mexico City, Mexico. Symptomatic pregnant women with a positive reverse-transcription quantitative polymerase chain reaction test for SARS-CoV-2 infection who fulfilled the criteria for hospitalization were included. The primary outcome was severe pneumonia due to COVID-19. Secondary outcomes were intensive care unit (ICU) admission, viral sepsis and maternal death. sFlt-1 levels were expressed as multiples of the median (MoM). The association between sFlt-1 and each adverse outcome was explored by logistic regression analysis, adjusted for gestational age for outcomes occurring in more than five patients, and the predictive performance was assessed by receiver-operating-characteristics-curve analysis.Among 113 pregnant women with COVID-19, higher sFlt-1 MoM was associated with an increased probability of severe pneumonia (adjusted odds ratio (aOR), 1.817 (95% CI, 1.365-2.418)), ICU admission (aOR, 2.195 (95% CI, 1.582-3.047)), viral sepsis (aOR, 2.318 (95% CI, 1.407-3.820)) and maternal death (unadjusted OR, 5.504 (95% CI, 1.079-28.076)). At a 10% false-positive rate, sFlt-1 MoM had detection rates of 45.2%, 66.7%, 83.3% and 100% for severe COVID-19 pneumonia, ICU admission, viral sepsis and maternal death, respectively. PlGF values were similar between women with severe and those with non-severe COVID-19 pneumonia.sFlt-1 MoM is higher in pregnant women with severe COVID-19 and has the capability to predict serious adverse pregnancy events, such as severe pneumonia, ICU admission, viral sepsis and maternal death. © 2021 International Society of Ultrasound in Obstetrics and Gynecology. |
| Databáze: | OpenAIRE |
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