Skip to main content Skip to main navigation menu Skip to site footer

Impact of preeclampsia on the outcome of COVID-19 infection

  • Jonathan Kevin Djuanda ,
  • M. Aldika Akbar ,
  • Agus Sulistyono ,
  • Rozi Aditya ,
  • Ernawati ,

Abstract

Link of Video Abstract: https://youtu.be/Pp9SqvVDzlw

 

Backgrounds: The COVID-19 outbreaks began at 2020 and spreading fast throughout the world. Infection in pregnancy is associated with increasing number of mortality and morbidity reports as well as increasing reports of preeclampsia (PE) cases complicating the cases. This study aimed to analyze the impact of preeclampsia  on the outcome of COVID-19 patients during pregnancy and determine the effect of these variables on maternal and neonatal morbidity and mortality.

Methods: A retrospective study was performed on 711 COVID-19 patients admitted at Dr. Soetomo Hospital during 2020 - 2021. Demographic, clinical, laboratory, complication, and patient outcomes data were collected. Patients were then classified as COVID-19 with preeclampsia and COVID-19 without preeclampsia. Data were collected from hospital medical records, and statistical analysis was carried out to analyze these variables.

Results: We reported 711 pregnant patients with COVID-19, of which 510 patients (72%) had no preeclampsia and 201 patients (28%) had preeclampsia. There were statistically significant differences in maternal age, referral status, gestational age at admission, comorbidities, complications, and symptoms of COVID-19. COVID-19 with PE had higher comorbidities and severe performance than COVID-19 without PE : > 50% were preterm pregnancy, oxygen saturation < 90% on admission reported on 5.9% cases, 35.8% had symptoms, 20.4 % cases suffered severity/ critical condition, 24.4% need ventilation support. However, there was no significant difference in maternal death cases between COVID-19 with and without PE. Risk analysis shows an increased risk of morbidity in pregnant patients with COVID-19 infection: pulmonary edema, critical condition, ICU admission, and Ventilation needed with OR 18.9, 12.5, 5.1, and 2.7, respectively. 

Conclusion: Preeclampsia increases the risk of morbidity in COVID-19 pregnant patients.

References

  1. Wójtowicz A, Zembala-Szczerba M, Babczyk D, Kołodziejczyk-Pietruszka M, Lewaczyńska O, Huras H. Early-and Late-Onset Preeclampsia: A comprehensive cohort study of laboratory and clinical findings according to the New ISHHP Criteria. Int J Hypertens. 2019;2019.
  2. Villar J, Ariff S, Gunier RB, Thiruvengadam R, Rauch S, Kholin A, et al. Maternal and neonatal morbidity and mortality among pregnant women with and without COVID-19 Infection: The INTERCOVID Multinational Cohort Study. JAMA Pediatr. 2021;175(8):817–826.
  3. Mendoza M, Garcia-Ruiz I, Maiz N, Rodo C, Garcia-Manau P, Serrano B, et al. Pre-eclampsia-like syndrome induced by severe COVID-19: a prospective observational study. BJOG An Int J Obstet Gynaecol. 2020;127(11):1374–1380.
  4. Palomo M, Youssef L, Ramos A, Torramade-Moix S, Moreno-Castaño AB, Martinez-Sanchez J, et al. Differences and similarities in endothelial and angiogenic profiles of preeclampsia and COVID-19 in pregnancy. Am J Obstet Gynecol. 2022;227(2):277.e1-277.e16.
  5. Agostinis C, Mangogna A, Balduit A, Aghamajidi A, Ricci G, Kishore U, et al. COVID-19, pre-eclampsia, and complement system. Front Immunol. 2021;12:1–20.
  6. Sayad B, Afshar ZM, Mansouri F, Salimi M, Miladi R, Rahimi S, et al. Pregnancy, preeclampsia, and covid-19: susceptibility and mechanisms: A Review Study. Int J Fertil Steril. 2022;16(2):64–69.
  7. Khalil A, Samara A, Chowdhury T, O’Brien P. Does COVID-19 cause pre-eclampsia? Ultrasound Obstet Gynecol. 2022;59(2):146–152.
  8. Sathiya R, Rajendran J, Sumathi S. COVID-19 and preeclampsia: overlapping features in pregnancy. Rambam Maimonides Med J. 2022;13(1):1–10.
  9. Papageorghiou AT, Deruelle P, Gunier RB, Rauch S, García-May PK, Mhatre M, et al. Preeclampsia and COVID-19: results from the INTERCOVID prospective longitudinal study. Am J Obstet Gynecol. 2021;225(3):289.e1-289.e17.
  10. Wei SQ, Bilodeau-Bertrand M, Liu S, Auger N. The impact of COVID-19 on pregnancy outcomes: A systematic review and meta-analysis. Cmaj. 2021;193(16):E540–E548.
  11. Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020;20(4):425–434.
  12. Giardini V, Gambacorti-Passerini C, Casati M, Carrer A, Vergani P. Can Similarities between the pathogenesis of preeclampsia and COVID-19 increase the understanding of COVID-19?. Int J Transl Med. 2022;2(2):186–197.
  13. Sokolowska M, Lukasik ZM, Agache I, Akdis CA, Akdis D, Akdis M, et al. Immunology of COVID-19: mechanisms, clinical outcome, diagnostics, and perspectives—a report of the European Academy of Allergy and Clinical Immunology (EAACI). Allergy Eur J Allergy Clin Immunol. 2020;75(10):2445–2476.
  14. Robillard PY, Dekker G, Scioscia M, Saito S. Progress in the understanding of the pathophysiology of immunologic maladaptation related to early-onset preeclampsia and metabolic syndrome related to late-onset preeclampsia. Am J Obstet Gynecol [Internet]. 2022;226(2):S867–S875.
  15. Vimercati A, De Nola R, Trerotoli P, Metta ME, Cazzato G, Resta L, et al. COVID-19 infection in pregnancy: obstetrical risk factors and neonatal outcomes—a monocentric, single-cohort study. Vaccines. 2022;10(2):1–11.
  16. Papapanou M, Papaioannou M, Petta A, Routsi E, Farmaki M, Vlahos N, et al. Maternal and neonatal characteristics and outcomes of COVID-19 in pregnancy: An overview of systematic reviews. Int J Environ Res Public Health. 2021;18(2):1–20.
  17. Qeadan F, Mensah NA, Tingey B, Stanford JB. The risk of clinical complications and death among pregnant women with COVID-19 in the Cerner COVID-19 cohort: a retrospective analysis. BMC Pregnancy Childbirth. 2021;21(1):1–14.
  18. Sufriyana H, Salim HM, Muhammad AR, Wu YW, Su ECY. Blood biomarkers representing maternal-fetal interface tissues used to predict early-and late-onset preeclampsia but not COVID-19 infection. Comput Struct Biotechnol J. 2022;20:4206–4224.
  19. Serrano B, Bonacina E, Garcia-Ruiz I, Mendoza M, Garcia-Manau P, Garcia-Aguilar P, et al. Confirmation of preeclampsia-like syndrome induced by severe COVID-19: an observational study. Am J Obstet Gynecol MFM. 2023;5(1):100760.
  20. Wiyati PS, Adawiyah R, Dewantiningrum J, Pramono BA. Maternal and perinatal outcomes with covid-19: lesson learned from the tertiary hospital. Bali Med J. 2021;10(1):442-447.
  21. Mega Putra IG, Surya IGP, Pratiwi ASIM. High level of soluble FMS-like tyrosine kinase-1 (sFlt-1) serum in pregnancy as a risk factor of preeclampsia. Bali Med J.;5(2):322-325.
  22. Wantania JJ, Homenta C, Kepel BJ. Relationship of heme oxygenase-1 (HO-1) level with onset and severity in normotensive pregnancy and severe preeclampsia. Bali Med J.;5(1):105-109.

How to Cite

Djuanda, J. K., Akbar, M. A. ., Sulistyono, A., Aditya, R. ., & Ernawati. (2023). Impact of preeclampsia on the outcome of COVID-19 infection. Bali Medical Journal, 12(2), 1342–1346. https://doi.org/10.15562/bmj.v12i2.4341

HTML
25

Total
17

Share

Search Panel