key: cord-0722933-2razjkit
authors: Giorgione, Veronica; Thilaganathan, Basky
title: SARS-COV-2 related myocardial injury might explain the predisposition to preeclampsia with maternal SARS-COV-2 infection
date: 2021-10-05
journal: Am J Obstet Gynecol
DOI: 10.1016/j.ajog.2021.09.043
sha: a02225d2447d396601b379292ef73ae07fc2e3f9
doc_id: 722933
cord_uid: 2razjkit

nan

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Put together, these results suggest that maternal COVID-infection predispose to and trigger 35 the development of preeclampsia. Although the mechanism underlying COVID-19-related 36 multi-organ manifestations are not completely understood, cardiovascular dysfunction is 37 typical, and we believe that the possibility of an association between the latter finding and 38 preeclampsia should be explored further. 39

Maternal cardiovascular dysfunction predisposes to preeclampsia, predominates at 40 presentation of the disorder and persists as a cardiovascular legacy for decades following 41 birth. 2 It is entirely plausible that the complex relationship between COVID-19 infection and 42 acute, severe cardiovascular dysfunction that has been described outside pregnancy may 43 also occur during SARS-CoV-2 infection in pregnancy. 3 Indeed, cardiovascular risk factors, 44 such as hypertension, diabetes mellitus and obesity, are also pre-disposing factors for 45 COVID-19 infection. And COVID-19 infection itself is known to cause acute myocardial infection, myocardial injury and subclinical cardiovascular dysfunction leading to acquired 58 utero-placental malperfusion and ischemia may lead to an angiogenic imbalance and the 59 subsequent development of preeclampsia (Figure 1 ). 2 Further studies on the assessment of 60 maternal cardiovascular system by non-invasive imaging techniques and cardiac 61 biomarkers in pregnancies complicated by SARS-CoV-2 infection could be beneficial to 62

improve, first of all, the prenatal and postnatal care of these women considering the worse 63 prognosis related to the myocardial injury and, also, to prove this hypothesis. 

SARS-COV-2 infection during pregnancy and risk of 70 preeclampsia: a systematic review and meta-analysis

The placenta and preeclampsia: 72 villain or victim?

COVID-19 and cardiovascular 74 disease: from basic mechanisms to clinical perspectives