Background: In healthy pregnancies, components of the Renin-Angiotensin system (RAS) are present in the placental villi and contribute to invasion, migration, and angiogenesis. At the same time, soluble fms-like tyrosine kinase 1 (sFlt-1) production is induced after binding of ANG-II to its receptor (AT-1R) in response to hypoxia. As RAS plays an essential role in the pathogenesis of COVID-19, we hypothesized that angiogenic marker (sFlt-1) and RAS components (ANG-II and ACE-2) may be related to adverse outcomes in pregnant women with COVID-19; Methods: Prospective cohort study. Primary outcome was severe pneumonia. Secondary outcomes were ICU admission, intubation, sepsis, and death. Spearman’s Rho test was used to analyze the correlation between sFlt-1 and ANG-II levels. The sFlt-1/ANG-II ratio was determined and the association with each adverse outcome was explored by logistic regression analysis and the prediction was assessed using receiver-operating-curve (ROC); Results: Among 80 pregnant women with COVID-19, the sFlt-1/ANG-II ratio was associated with an increased probability of severe pneumonia (odds ratio [OR]: 1.31; p = 0.003), ICU admission (OR: 1.05; p = 0.007); intubation (OR: 1.09; p = 0.008); sepsis (OR: 1.04; p = 0.008); and death (OR: 1.04; p = 0.018); Conclusion: sFlt-1/ANG-II ratio is a good predictor of adverse events such as pneumonia, ICU admission, intubation, sepsis, and death in pregnant women with COVID-19.
【저자키워드】 COVID-19, Maternal death, sFlt-1, angiotensin-II, 【초록키워드】 Pathogenesis, hypoxia, Pneumonia, intubation, Sepsis, Angiogenesis, outcome, prospective cohort study, RAS, adverse outcomes, cohort study, adverse outcome, renin-angiotensin system, ACE-2, pregnant women, adverse events, Probability, Migration, Prospective, adverse event, ICU admission, death, placental, receptor, severe pneumonia, correlation, binding, association, marker, angiotensin, Odds ratio, Invasion, tyrosine, Logistic regression analysis, Renin, Primary outcome, Secondary outcomes, components, pathogenesis of COVID-19, component, pregnancies, ANG-II, secondary, was used, healthy, was determined, contribute, with COVID-19, 【제목키워드】 novel, illness, Ratio,