Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar:31:32-37.
doi: 10.1016/j.preghy.2022.11.008. Epub 2022 Dec 5.

Role of biomarkers (sFlt-1/PlGF) in cases of COVID-19 for distinguishing preeclampsia and guiding clinical management

Guilherme M Nobrega  1 , Jose P Guida  1 , Juliana M Novaes  1 , Larissa M Solda  1 , Luciana Pietro  2 , Adriana G Luz  1 , Giuliane J Lajos  1 , Carolina C Ribeiro-do-Valle  1 , Renato T Souza  1 , Jose G Cecatti  1 , Indira U Mysorekar  3 , Tabata Z Dias  1 , Maria Laura Costa  4
Affiliations

Role of biomarkers (sFlt-1/PlGF) in cases of COVID-19 for distinguishing preeclampsia and guiding clinical management

Guilherme M Nobrega et al. Pregnancy Hypertens. 2023 Mar.

Abstract

Objectives: To analyze soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factors (PlGF) concentrations and their ratio in pregnant and postpartum women with suspected COVID-19, and further investigate conditions associated with an increased ratio (sFlt-1/PlGF > 38), including preeclampsia (PE) and severe acute respiratory syndrome (SARS).

Study design: The present study is a secondary analysis of a prospective cohort. Blood samples were collected at time of COVID-19 investigation and the serum measurements of sFlt-1 and PlGF were performed. Clinical background, SARS-CoV-2 infection characteristics, maternal and perinatal outcomes were further analyzed.

Main outcome measures: Serum measurements of sFlt-1 and PlGF; obstetrics and clinical outcomes.

Results: A total of 97 SARS-CoV-2 unvaccinated women with suspected infection were considered, 76 were COVID-19 positive cases and 21 COVID-19 negative. Among COVID-19 positive cases, 09 presented with SARS and 11 were diagnosed with PE, of which 6 had SARS-CoV-2 infection in first and second trimester (04 with sFlt-1/PlGF ≥ 38) and 05 with PE and COVID-19 diagnosed at the same time, during third trimester (03 with sFlt-1/PlGF ≥ 38). Five presented with PE with severe features. sFlt-1/PlGF ratio was significantly higher in the COVID-19 positive/PE positive group compared to COVID-19 positive/PE negative group (p-value = 0.005), with no increase in cases complicated by SARS.

Conclusions: sFlt-1/PlGF ratio could be a useful tool for differential diagnosis and adequate counseling among cases of COVID-19 and PE, especially if severe disease. COVID-19 early in pregnancy could potentially be a risk factor for PE later during gestation.

Keywords: COVID-19; Hypertensive disorders of pregnancy; Maternal health; Renin-angiotensin system.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flowchart of the study included cases and cases grouping.
Fig. 2
Fig. 2
Boxplots for values of sFlt-1, PlGF and their ratios (sFlt-1/PlGF) according to the presence of preeclampsia (PE) and severe acute respiratory syndrome (SARS). Boxes encompass a range from the 1st to the 3rd quartile, whiskers represent 10–90 percentile and points represent outliers. Mann-Whitney test (test U) was used to compare groups, with p-value ≤ 0.05 as significant.
See this image and copyright information in PMC

References

    1. Abalos E., Cuesta C., Grosso A.L., Chou D., Say L. Global and regional estimates of preeclampsia and eclampsia: a systematic review. Eur. J. Obstet. Gynecol. Reprod. Biol. 2013;170(1):1–7. - PubMed
    1. Say L., Chou D., Gemmill A., Tunçalp Ö., Moller A.-B., Daniels J., et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob. Heal. 2014;2(6):e323–e333. - PubMed
    1. Kumar D., Verma S., Mysorekar I.U. COVID-19 and pregnancy: clinical outcomes; mechanisms, and vaccine efficacy. Transl. Res. 2022 - PMC - PubMed
    1. Takemoto M.L.S., Menezes M.O., Andreucci C.B., Knobel R., Sousa L., Katz L., et al. Clinical characteristics and risk factors for mortality in obstetric patients with severe COVID-19 in Brazil: a surveillance database analysis. BJOG An Int. J. Obstet. Gynaecol. [Internet]. 2020;127(13):1618–1626. https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/1471-0528.16470 Available from: - DOI - PMC - PubMed
    1. Verma S., Carter E.B., Mysorekar I.U. SARS-CoV2 and pregnancy: an invisible enemy? Am. J. Reprod. Immunol. [Internet] 2020:e13308. https://onlinelibrary.wiley.com/doi/abs/10.1111/aji.13308 Available from: - DOI - PMC - PubMed

Substances