COVID-19 and hemolysis,elevated liver enzymes and thrombocytopenia syndrome in pregnant women-association or causation?  

作　　者：Prashant Nasa Deven Juneja Ravi Jain Ruchi Nasa 

机构地区：[1]Department of Critical Care Medicine,NMC Specialty Hospital,Dubai 7832,United Arab Emirates [2]Department of Internal Medicine,College of Medicine and Health Sciences,Al Ain 17666,Abu Dhabi,United Arab Emirates [3]Institute of Critical Care Medicine,Max Super Specialty Hospital Saket,New Delhi 110017,India [4]Department of Critical Care Medicine,Mahatma Gandhi Medical College and Hospital,Jaipur 302001,India [5]Department of Pathology,Fakeeh University Hospital,Dubai 00000,United Arab Emirates

出　　处：《World Journal of Virology》2022年第5期310-320,共11页世界病毒学杂志

摘　　要：Pregnant women are among the high-risk population for severe coronavirus disease 2019(COVID-19)with unfavorable peripartum outcomes and increased incidence of preterm births.Hemolysis,the elevation of liver enzymes,and low platelet count(HELLP)syndrome and severe preeclampsia are among the leading causes of maternal mortality.Evidence supports a higher odd of pre-eclampsia in women with COVID-19,given overlapping pathophysiology.Involvement of angiotensin-converting enzyme 2 receptors by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)for the entry to the host cells and its downregulation cause dysregulation of the renin-angiotensin-aldosterone system.The overexpression of Angiotensin II mediated via p38 Mitogen-Activated Protein Kinase pathways can cause vasoconstriction and uninhibited platelet aggregation,which may be another common link between COVID-19 and HELLP syndrome.On PubMed search from January 1,2020,to July 30,2022,we found 18 studies on of SARS-COV-2 infection with HELLP Syndrome.Most of these studies are case reports or series,did not perform histopathology analysis of the placenta,or measured biomarkers linked to pre-eclampsia/HELLP syndrome.Hence,the relationship between SARS-CoV-2 infection and HELLP syndrome is inconclusive in these studies.We intend to perform a mini-review of the published literature on HELLP syndrome and COVID-19 to test the hypothesis on association vs causation,and gaps in the current evidence and propose an area of future research.

关 键 词：SARS-CoV-2 PREECLAMPSIA HYPERTENSION Pregnancy-induced Liver dysfunction Pregnancyinduced 

分 类 号：R71[医药卫生—妇产科学]