Specific dysregulation of inflammatory and anti-inflammatory cytokine responses in pregnant women with COVID-19 infections

Context: Owing to its extensive inflammation, COVID-19 infection may have a specific response in the anti-inflammatory milieu of pregnancy. Aims: To analyze the lacking evidence of systemic inflammatory and anti-inflammatory cytokine responses of pregnant women with COVID-19 infection compared to no...

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Main Authors: Manggala Pasca Wardhana (Author), Erry Gumilar Dachlan (Author), Kuntaman Kuntaman (Author), Budi Utomo (Author), Ifan Ali Wafa (Author), Salsabila Nabilah Rifdah (Author), Dharma Putra Perjuangan Banjarnahor (Author), Ario Danianto (Author)
Format: Book
Published: GarVal Editorial Ltda., 2023-09-01T00:00:00Z.
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Summary:Context: Owing to its extensive inflammation, COVID-19 infection may have a specific response in the anti-inflammatory milieu of pregnancy. Aims: To analyze the lacking evidence of systemic inflammatory and anti-inflammatory cytokine responses of pregnant women with COVID-19 infection compared to normal pregnancies. Methods: This case-control study was performed on third-trimester symptomatic COVID-19 pregnant women compared with normal pregnancies without other significant inflammation risks. A between-group analysis was conducted to assess the inflammatory, and anti-inflammatory cytokines and chemokines. Through a comparison and correlation analysis, we detected differences between cytokines in the COVID-19 group based on the severity of the infection. Results: Pregnant women with COVID-19 had higher procalcitonin levels (p<0.01), IL-6 (p=0.05), TNF-a, IFN-γ/IL-4 ratio (p<0.01), and lower IL-4 (p<0.05), implying a higher proinflammatory cytokine imbalance in this group compared with normal pregnancies. White blood cells (p<0.05; r=0.345), and IL-17 (p<0.05; r=0.328) had weak positive correlation, while CRP (p<0.01; r=0.484), and IL-6 (p<0.01; r=0.41), had moderate positive correlation with COVID-19 severity during pregnancy. Conclusions: COVID-19 infections provide a unique non-dominance of the anti-inflammatory response in pregnant women, as indicated by a lower response of Th2, which may counteract the Th1 response. These cytokine dysregulations may disturb the viral defense mechanism, leading to a proinflammatory condition as shown by higher TNF-a, IL-6, and IFN-g/IL-4 ratios. Some inflammatory markers have a positive correlation with COVID-19 severity (WBC, CRP, IL-6, and IL-17), suggesting their potential roles as severity markers during pregnancy.
Item Description:10.56499/jppres23.1583_11.5.723
0719-4250