Suppr超能文献

子痫前期与 COVID-19:机制、病理生理学和临床结局。

Preeclampsia in the Context of COVID-19: Mechanisms, Pathophysiology, and Clinical Outcomes.

机构信息

Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.

Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA.

出版信息

Am J Reprod Immunol. 2024 Aug;92(2):e13915. doi: 10.1111/aji.13915.

Abstract

The emergence of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to the global COVID-19 pandemic, significantly impacting the health of pregnant women. Obstetric populations, already vulnerable, face increased morbidity and mortality related to COVID-19, aggravated by preexisting comorbidities. Recent studies have shed light on the potential correlation between COVID-19 and preeclampsia (PE), a leading cause of maternal and perinatal morbidity worldwide, emphasizing the significance of exploring the relationship between these two conditions. Here, we review the pathophysiological similarities that PE shares with COVID-19, with a particular focus on severe COVID-19 cases and in PE-like syndrome cases related with SARS-CoV-2 infection. We highlight cellular and molecular mechanistic inter-connectivity between these two conditions, for example, regulation of renin-angiotensin system, tight junction and barrier integrity, and the complement system. Finally, we discuss how COVID-19 pandemic dynamics, including the emergence of variants and vaccination efforts, has shaped the clinical scenario and influenced the severity and management of both COVID-19 and PE. Continued research on the mechanisms of SARS-CoV-2 infection during pregnancy and the potential risk of developing PE from previous infections is warranted to delineate the complexities of COVID-19 and PE interactions and to improve clinical management of both conditions.

摘要

严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)的出现导致了全球 COVID-19 大流行,这对孕妇的健康产生了重大影响。已经处于弱势的产科人群因 COVID-19 相关的发病率和死亡率增加,加上先前存在的合并症而面临更大的风险。最近的研究揭示了 COVID-19 与子痫前期(PE)之间的潜在关联,PE 是全球孕产妇和围产期发病率的主要原因,这强调了探索这两种情况之间关系的重要性。在这里,我们回顾了 PE 与 COVID-19 之间共享的病理生理相似性,特别关注严重 COVID-19 病例和与 SARS-CoV-2 感染相关的 PE 样综合征病例。我们强调了这两种情况之间细胞和分子机制的相互联系,例如肾素-血管紧张素系统、紧密连接和屏障完整性以及补体系统的调节。最后,我们讨论了 COVID-19 大流行动态,包括变异的出现和疫苗接种工作,如何塑造了临床情况,并影响了 COVID-19 和 PE 的严重程度和管理。需要继续研究 SARS-CoV-2 感染在怀孕期间的机制,以及先前感染引发 PE 的潜在风险,以阐明 COVID-19 和 PE 相互作用的复杂性,并改善这两种情况的临床管理。

相似文献

1
Preeclampsia in the Context of COVID-19: Mechanisms, Pathophysiology, and Clinical Outcomes.
Am J Reprod Immunol. 2024 Aug;92(2):e13915. doi: 10.1111/aji.13915.
3
Antibody tests for identification of current and past infection with SARS-CoV-2.
Cochrane Database Syst Rev. 2022 Nov 17;11(11):CD013652. doi: 10.1002/14651858.CD013652.pub2.
4
COVID-19 is associated with early emergence of preeclampsia: results from a large regional collaborative.
J Matern Fetal Neonatal Med. 2024 Dec;37(1):2345852. doi: 10.1080/14767058.2024.2345852. Epub 2024 May 26.
5
SARS-CoV-2-neutralising monoclonal antibodies for treatment of COVID-19.
Cochrane Database Syst Rev. 2021 Sep 2;9(9):CD013825. doi: 10.1002/14651858.CD013825.pub2.
6
Measures implemented in the school setting to contain the COVID-19 pandemic.
Cochrane Database Syst Rev. 2022 Jan 17;1(1):CD015029. doi: 10.1002/14651858.CD015029.
7
Association between coronavirus 2 infection and preeclampsia among unvaccinated women.
Rev Bras Ginecol Obstet. 2025 Jul 15;47. doi: 10.61622/rbgo/2025rbgo36. eCollection 2025.
8
Physical interventions to interrupt or reduce the spread of respiratory viruses.
Cochrane Database Syst Rev. 2023 Jan 30;1(1):CD006207. doi: 10.1002/14651858.CD006207.pub6.
10
Workplace interventions to reduce the risk of SARS-CoV-2 infection outside of healthcare settings.
Cochrane Database Syst Rev. 2022 May 6;5(5):CD015112. doi: 10.1002/14651858.CD015112.pub2.

引用本文的文献

1
ORF3a is a key driver of maternal SARS-CoV-2 infection-associated placental dysfunction.
Res Sq. 2025 Jul 3:rs.3.rs-6857689. doi: 10.21203/rs.3.rs-6857689/v1.
2
Evaluating the safety and efficacy of nirmatrelvir-ritonavir therapy in pregnant women with COVID-19: a systematic review and meta-analysis.
Eur J Clin Pharmacol. 2025 Apr;81(4):495-506. doi: 10.1007/s00228-025-03808-8. Epub 2025 Feb 13.

本文引用的文献

1
Placental and Renal Pathways Underlying Pre-Eclampsia.
Int J Mol Sci. 2024 Feb 27;25(5):2741. doi: 10.3390/ijms25052741.
2
Whole transcriptome profiling of placental pathobiology in SARS-CoV-2 pregnancies identifies placental dysfunction signatures.
Clin Transl Immunology. 2024 Feb 6;13(2):e1488. doi: 10.1002/cti2.1488. eCollection 2024.
3
A longitudinal study on the effect of obesity upon circulating renin-angiotensin system in normal pregnancy.
Nutr Metab Cardiovasc Dis. 2024 Mar;34(3):771-782. doi: 10.1016/j.numecd.2023.10.030. Epub 2023 Oct 28.
4
COVID-19 and SLE: Infection and autoimmunity at its best.
Lupus. 2023 Dec;32(14):1591-1597. doi: 10.1177/09612033231213914. Epub 2023 Nov 5.
5
Morphological placental findings in women infected with SARS-CoV-2 according to trimester of pregnancy and severity of disease.
Placenta. 2023 Aug;139:190-199. doi: 10.1016/j.placenta.2023.06.015. Epub 2023 Jul 8.
6
Analysis of placental pathology after COVID-19 by timing and severity of infection.
Am J Obstet Gynecol MFM. 2023 Jul;5(7):100981. doi: 10.1016/j.ajogmf.2023.100981. Epub 2023 Apr 23.
7
Pre-eclampsia is associated with complement pathway activation in the maternal and fetal circulation, and placental tissue.
Pregnancy Hypertens. 2023 Jun;32:43-49. doi: 10.1016/j.preghy.2023.04.001. Epub 2023 Apr 21.
8
Tight junction protein occludin is an internalization factor for SARS-CoV-2 infection and mediates virus cell-to-cell transmission.
Proc Natl Acad Sci U S A. 2023 Apr 25;120(17):e2218623120. doi: 10.1073/pnas.2218623120. Epub 2023 Apr 17.
9
Pregnancy and Severe ARDS with COVID-19: Epidemiology, Diagnosis, Outcomes and Treatment.
Semin Fetal Neonatal Med. 2023 Feb;28(1):101426. doi: 10.1016/j.siny.2023.101426. Epub 2023 Mar 7.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验