OC15.07: Distinctive endothelial and angiogenic signature of pre‐eclampsia versus COVID‐19 in pregnancy

Abstract

To study endothelial damage, microvascular thrombosis, immune response and angiogenic imbalance in pre-eclampsia (PE) and COVID-19 in pregnancy. Plasma and sera samples were obtained from pregnant women with COVID-19 infection classified into mild (n=10) or severe (n=9) in addition to normotensive pregnancies as controls (n=10) and patients with PE (n=13). Biomarker assessment included circulating VCAM-1, TNF-receptor I (TNFRI), angiotensin II (ANGII), heparan sulfate (HS), thrombomodulin (TM), VWF antigen, activity and multimeric pattern, α2-antiplasmin (α2AP), dsDNA for neutrophil extracellular traps (NETs), C5b9, PAI-1, ADAMTS-13 activity, fms-like tyrosine kinase-1 (sFlt1) and placental growth factor (PlGF). Statistical analysis included univariate and multivariate methods. Both COVID-19 and PE showed abnormal results in most endotheliopathy and immune response markers, with distinctive profiles among them: severe COVID-19 with predominant alterations in HS, NETS and PlGF, versus PE with most significant alterations in VCAM-1, TNFRI, ANGII, VWF, PAI, c5b9 and sFlt1. The principal component analysis (figure 1) demonstrated a clear separation between PE and the rest of groups (first and second components explained 42.2% and 13.5% of the variance), mainly differentiated by variables related to VWF that were markedly reduced in PE. COVID-19 and PE exhibit distinctive profiles of endothelial damage, immune dysregulation and angiogenic imbalance, which could help in the differential diagnosis and development of new therapeutic strategies. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.