Endothelial Dysfunction and Pregnant COVID-19 Patients with Thrombophilia: A Narrative Review

Metodija Sekulovski; Niya Mileva; Lyubomir Chervenkov; Monika Peshevska-Sekulovska; Georgi Vasilev Vasilev; Georgi Hristov Vasilev; Dimitrina Miteva; Latchezar Tomov; Snezhina Lazova; Milena Gulinac; Tsvetelina Velikova

doi:10.3390/biomedicines11092458

Endothelial Dysfunction and Pregnant COVID-19 Patients with Thrombophilia: A Narrative Review

Biomedicines. 2023 Sep 4;11(9):2458. doi: 10.3390/biomedicines11092458.

Authors

Metodija Sekulovski^{1

2}, Niya Mileva³, Lyubomir Chervenkov⁴, Monika Peshevska-Sekulovska^{2

5}, Georgi Vasilev Vasilev^{2

6}, Georgi Hristov Vasilev^{2

7}, Dimitrina Miteva^{2

8}, Latchezar Tomov^{2

9}, Snezhina Lazova^{2

10

11}, Milena Gulinac^{2

12}, Tsvetelina Velikova²

Affiliations

¹ Department of Anesthesiology and Intensive Care, University Hospital Lozenetz, 1 Kozyak Str., 1407 Sofia, Bulgaria.
² Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria.
³ Medical Faculty, Medical University of Sofia, 1 Georgi Sofiiski Str., 1431 Sofia, Bulgaria.
⁴ Department of Diagnostic Imaging, Medical University Plovdiv, Bul. Vasil Aprilov 15A, 4000 Plovdiv, Bulgaria.
⁵ Department of Gastroenterology, University Hospital Lozenetz, 1407 Sofia, Bulgaria.
⁶ Clinic of Endocrinology and Metabolic Disorders, UMHAT "Sv. Georgi", 4000 Plovdiv, Bulgaria.
⁷ Laboratory of Hematopathology and Immunology, National Specialized Hospital for Active Treatment of Hematological Diseases, "Plovdivsko Pole" Str., 6, 1756 Sofia, Bulgaria.
⁸ Department of Genetics, Faculty of Biology, Sofia University "St. Kliment Ohridski", 8 Dragan Tzankov Str., 1164 Sofia, Bulgaria.
⁹ Department of Informatics, New Bulgarian University, Montevideo 21 Str., 1618 Sofia, Bulgaria.
¹⁰ Pediatric Clinic, University Hospital "N. I. Pirogov," 21 "General Eduard I. Totleben" Blvd; 1606 Sofia, Bulgaria.
¹¹ Department of Healthcare, Faculty of Public Health "Prof. Tsekomir Vodenicharov, MD, DSc", Medical University of Sofia, Bialo More 8 Str., 1527 Sofia, Bulgaria.
¹² Department of General and Clinical Pathology, Medical University of Plovdiv, Bul. Vasil Aprilov 15A, 4000 Plovdiv, Bulgaria.

Abstract

Pregnancy with SARS-CoV-2 infection can raise the risk of many complications, including severe COVID-19 and maternal-fetal adverse outcomes. Additionally, endothelial damage occurs as a result of direct SARS-CoV-2 infection, as well as immune system, cardiovascular, and thrombo-inflammatory reactions. In this narrative review, we focus on endothelial dysfunction (ED) in pregnancy, associated with obstetric complications, such as preeclampsia, fetal growth retardation, gestational diabetes, etc., and SARS-CoV-2 infection in pregnant women that can cause ED itself and overlap with other pregnancy complications. We also discuss some shared mechanisms of SARS-CoV-2 pathophysiology and ED.

Keywords: COVID-19; SARS-CoV-2 infection; endothelial dysfunction; pregnancy; pregnant women; thrombophilia.

Publication types

Review

Grants and funding

BG-RRP-2.004-0008-C01/by the European Union-NextGenerationEU, through the National Recovery and Resilience Plan of the Republic of Bulgaria