Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Umberto I Hospital.
Clinic of Obstetrics and Gynaecology, Department of Clinical Sciences, Università Politecnica delle Marche, Salesi Hospital, Azienda Ospedaliero Universitaria.
J Hypertens. 2022 Sep 1;40(9):1629-1638. doi: 10.1097/HJH.0000000000003213. Epub 2022 Jul 22.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the coronavirus disease 2019 (COVID-19) disease that has rapidly spread worldwide, causing hundreds of thousand deaths. Normal placentation is characterized by many processes strictly regulated during pregnancy. If placentation is impaired, it can lead to gestational disorders, such as preeclampsia that is a multisystem disorder that occurs in 2-8% of pregnancies worldwide.
We performed a systematic search to understand the potential involvement of SARS-CoV-2 in preeclampsia onset using the databases, PubMed and Web of Science until 31 January 2022.
SARS-CoV-2 infection not only causes damage to the respiratory system but also can infect human placenta cells impairing pivotal processes necessary for normal placenta development. The inflammatory response trigged by COVID-19 disease is very similar to that one found in preeclampsia pregnancies suggesting a possible link between SARS-CoV-2 infection and preeclampsia onset during pregnancy.
Some studies showed that pregnancies affected by COVID-19 had higher incidence of preeclampsia compared with SARS-CoV-2-negative ones. However, increased blood pressure found in COVID-19 pregnancies does not allow to associate COVID-19 to preeclampsia as hypertension is a common factor to both conditions. At present, no diagnostic tools are available to discriminate real preeclampsia from preeclampsia-like syndrome in patients with SARS-CoV-2 infection. Thus, new specific diagnostic tools are necessary to assure an appropriate diagnosis of preeclampsia in these patients, especially in case of severe COVID-19 disease.
严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）是导致 2019 年冠状病毒病（COVID-19）的原因，该疾病已在全球迅速传播，导致数十万人死亡。正常胎盘形成的特征是妊娠期间有许多过程受到严格调节。如果胎盘形成受损，可能会导致妊娠并发症，如子痫前期，这是一种多系统疾病，在全球 2-8%的妊娠中发生。
我们进行了系统搜索，使用 PubMed 和 Web of Science 数据库，了解 SARS-CoV-2 感染在子痫前期发病中的潜在作用，截至 2022 年 1 月 31 日。
SARS-CoV-2 感染不仅会损害呼吸系统，还会感染人胎盘细胞，损害正常胎盘发育所需的关键过程。由 COVID-19 疾病引发的炎症反应与子痫前期妊娠中发现的反应非常相似，表明 SARS-CoV-2 感染与妊娠期间子痫前期发病之间可能存在联系。
一些研究表明，与 SARS-CoV-2 阴性妊娠相比，感染 COVID-19 的妊娠子痫前期发生率更高。然而，COVID-19 妊娠中发现的血压升高并不能将 COVID-19 与子痫前期联系起来，因为高血压是这两种情况的共同因素。目前，尚无诊断工具可将 COVID-19 感染患者中的真正子痫前期与子痫前期样综合征区分开来。因此，需要新的特定诊断工具来确保这些患者子痫前期的适当诊断，特别是在 COVID-19 疾病严重的情况下。
