The sFlt-1/PlGF Ratio in Pregnant Patients Affected by COVID-19

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Cardiovascular Biology

Background:

• COVID-19 in pregnant women poses risks for adverse pregnancy outcomes, including preeclampsia.
• The sFlt-1/PlGF ratio is a biomarker associated with placental function and preeclampsia.
• Understanding the impact of SARS-CoV-2 on this ratio is crucial for managing pregnancy complications.

Purpose of the Study:

• To conduct a systematic review and meta-analysis examining the effect of SARS-CoV-2 infection on the sFlt-1/PlGF ratio in pregnant women.
• To compare the sFlt-1/PlGF ratio between pregnant women with and without COVID-19.
• To investigate the association between COVID-19 severity, symptoms, and hypertensive disorders with the sFlt-1/PlGF ratio.

Main Methods:

• Systematic review and meta-analysis of studies reporting sFlt-1/PlGF ratios in pregnant women with COVID-19.
• Searches conducted in PubMed, Web of Science, Embase, and Cochrane Library.
• Meta-analysis performed using the Mantel-Haenszel method to compare ratios.

Main Results:

• Seven studies were included. Pregnant women with COVID-19 showed a higher sFlt-1/PlGF ratio compared to those without (SMD = 1.76, p=0.01).
• No significant difference in sFlt-1/PlGF ratio was found between asymptomatic and symptomatic COVID-19 patients (SMD = 0.30, p=0.36).
• Severe COVID-19 cases had a higher sFlt-1/PlGF ratio than non-severe cases (SMD = -1.88, p=0.05).
• COVID-19 patients with hypertensive disorders had a significantly higher sFlt-1/PlGF ratio than those without (SMD = 2.46, p=0.001).

Conclusions:

• Pregnant women with COVID-19 exhibit an elevated sFlt-1/PlGF ratio compared to uninfected individuals.
• Severe COVID-19 and co-existing hypertensive disorders in pregnancy are associated with significantly higher sFlt-1/PlGF ratios.
• The findings highlight the potential utility of the sFlt-1/PlGF ratio as a biomarker in pregnant women with COVID-19, particularly in assessing disease severity and hypertensive complications.