Background: Preeclampsia (PE) and COVID-19 share a common vascular-endothelial physiopathological pathway that may aggravate or worsen women's outcomes when both coexist. This study aims to evaluate the association of sFlt-1 levels and adverse maternal outcomes among positive SARS-CoV-2 pregnant women with and without hypertensive disorders of pregnancy (HDP).
Methods: We performed a multicenter retrospective cohort study of pregnant women with confirmed SARS-CoV-2 infection that required hospital admission. The exposed cohort comprised women with a diagnosis of an HDP. The primary outcome was a composite definition of adverse maternal outcome. The association between predictors and the main and secondary outcomes was assessed using an elastic-net regression which comprised a Lasso and Ridge regression method for automatic variable selection and penalization of non-statistically significant coefficients using a 10-fold cross-validation where the best model if automatically chosen by the lowest Akaike information criterion (AIC) and Bayesian information criteria (BIC).
Results: Among 148 pregnant women with COVID-19, the best predictive model comprised sFlt-1 MoMs [odds ratio (OR): 5.13; 95% CI: 2.19-12.05], and HDP (OR: 32.76; 95% CI: 5.24-205). sFlt-1 MoMs were independently associated with an increased probability of an adverse maternal outcome despite adjusting for HDP.
Conclusions: Our study shows that sFlt-1 is an independent predictor of adverse outcomes in women with SARS-CoV-2 despite hypertension status.
Keywords: COVID-19; SARS-CoV-2; endothelial dysfunction; placental growth factor; preeclampsia; soluble fms-like tyrosine kinase-1.
Copyright © 2022 Hernandez-Pacheco, Torres-Torres, Martinez-Portilla, Solis-Paredes, Estrada-Gutierrez, Mateu-Rogell, Nares-Torices, Lopez-Marenco, Escobedo-Segura, Posadas-Nava, Villafan-Bernal, Rojas-Zepeda, Becerra-Navarro, Casillas-Barrera, Pichardo-Cuevas, Muñoz-Manrique, Cortes-Ramirez and Espino-y-Sosa.