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Espino-Y-Sosa, Salvador; Martinez-Portilla, Raigam Jafet; Torres-Torres, Johnatan; Solis-Paredes, Juan Mario; Estrada-Gutierrez, Guadalupe; Hernandez-Pacheco, Jose Antonio; Espejel-Nuñez, Aurora; Mateu-Rogell, Paloma; Juarez-Reyes, Angeles; Lopez-Ceh, Francisco Eduardo; Villafan-Bernal, Jose Rafael; Rojas-Zepeda, Lourdes; Guzman-Guzman, Iris Paola; Poon, Liona C
Viruses, 09/2021, Letnik: 13, Številka: 10Journal Article
In healthy pregnancies, components of the Renin-Angiotensin system (RAS) are present in the placental villi and contribute to invasion, migration, and angiogenesis. At the same time, soluble fms-like tyrosine kinase 1 (sFlt-1) production is induced after binding of ANG-II to its receptor (AT-1R) in response to hypoxia. As RAS plays an essential role in the pathogenesis of COVID-19, we hypothesized that angiogenic marker (sFlt-1) and RAS components (ANG-II and ACE-2) may be related to adverse outcomes in pregnant women with COVID-19; Methods: Prospective cohort study. Primary outcome was severe pneumonia. Secondary outcomes were ICU admission, intubation, sepsis, and death. Spearman's Rho test was used to analyze the correlation between sFlt-1 and ANG-II levels. The sFlt-1/ANG-II ratio was determined and the association with each adverse outcome was explored by logistic regression analysis and the prediction was assessed using receiver-operating-curve (ROC); Results: Among 80 pregnant women with COVID-19, the sFlt-1/ANG-II ratio was associated with an increased probability of severe pneumonia (odds ratio OR: 1.31; = 0.003), ICU admission (OR: 1.05; = 0.007); intubation (OR: 1.09; = 0.008); sepsis (OR: 1.04; = 0.008); and death (OR: 1.04; = 0.018); Conclusion: sFlt-1/ANG-II ratio is a good predictor of adverse events such as pneumonia, ICU admission, intubation, sepsis, and death in pregnant women with COVID-19.
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