HealthDay News — There is a dose-response relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the risk for preeclampsia, according to a research letter published in the American Journal of Obstetrics & Gynecology.

Jonathan Lai, MD, from King’s College Hospital London, and colleagues examined the association between severity of SARS-CoV-2 infection and preeclampsia among 1223 patients. Overall, 51 (4.2%) had preeclampsia; 21 were diagnosed before SARS-CoV-2 infection.

In a cohort of patients with comparable risk factors to those of the study population, the prior risk for preeclampsia was about 1%. The researchers found that after excluding cases diagnosed before SARS-CoV-2 infection, the observed rate of preeclampsia was higher than expected: 1.9%, 2.2%, 5.7%, and 11.1% among asymptomatic patients, and those with mild, moderate, and severe disease, respectively; this monotonic relationship between COVID-19 severity and preeclampsia risk was statistically significant. Comparing the risk for preeclampsia between asymptomatic patients and patients with COVID-19 symptoms, the risk for preeclampsia was increased in association with severe COVID-19 (adjusted risk ratio, 4.9). Furthermore, compared with those with asymptomatic or mild disease, the risk was increased for those with moderate or severe COVID-19 (adjusted risk ratio, 3.3).

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“We present evidence that the more severe the infection with SARS-CoV-2, the greater the risk of preeclampsia and preterm birth,” the authors write. “SARS-CoV-2 infection can lead to endothelial dysfunction, intravascular inflammation, proteinuria, activation of thrombin, and hypertension, which are all features of preeclampsia. Therefore, a causal relationship must be considered.”

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