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SARS-CoV-2 Infection Exacerbates Hypertensive Disorders in Pregnancy Through Vascular and Immune Pathways
Marta Fabre1,2, Ana Medel-Martinez1, Pilar Calvo1,2
1Obstetrics Department, Hospital Clínico Universitario Lozano Blesa Zaragoza, 50009 Zaragoza, Spain.
International Journal of Molecular Sciences
|July 15, 2026
Summary
Maternal COVID-19 infection in pregnancy alters endothelial and inflammatory biomarkers, distinct from preeclampsia alone. SARS-CoV-2 and preeclampsia together show a unique biomarker profile, suggesting a specific disease association.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Cardiovascular Biology
Background:
- SARS-CoV-2 infection is linked to increased hypertensive disorders in pregnancy, such as preeclampsia (PE).
- Both conditions share mechanisms involving vascular and endothelial dysfunction.
- This study investigates the interplay between maternal COVID-19 and preeclampsia using biomarker analysis.
Purpose of the Study:
- To examine the relationship between maternal COVID-19 infection and preeclampsia (PE).
- To analyze inflammatory, endothelial, and angiogenic biomarkers in pregnancies with and without these complications.
- To identify distinct biomarker profiles associated with SARS-CoV-2 infection and PE.
Main Methods:
- A case-control study compared four groups: healthy pregnancies, preeclampsia cases, COVID-19 cases without PE, and COVID-19 cases with PE.
- Groups were matched for gestational age at blood sampling.
- Levels of endothelial (sICAM1, vWF, END1, sVCAM1), inflammatory (IL8), and angiogenic (sFlt-1, PLGF, sFlt-1/PLGF) biomarkers were measured.
Main Results:
- Significant differences in endothelial markers (sICAM1, vWF, END1, sVCAM1) and IL8 were observed across groups.
- IL8 was notably elevated in preeclampsia cases (with or without COVID-19) compared to controls.
- While PE associated with COVID-19 showed altered angiogenic markers, SARS-CoV-2 infection alone did not significantly change the sFlt-1/PlGF ratio.
Conclusions:
- Preeclampsia associated with SARS-CoV-2 infection retains the typical angiogenic signature of PE but exhibits additional endothelial and inflammatory biomarker changes.
- Findings suggest a distinct endothelial and inflammatory biomarker profile in PE concurrent with SARS-CoV-2 infection.
- Larger prospective studies are needed to confirm these associations.
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