Researchers analyzed a large set of published data and concluded that the presence of SARS-CoV-2 in the maternal organism can cause alterations in levels of angiotensin-converting enzyme 2 (ACE2).
‘Role of ACE2 deficit in COVID-19 affected pregnant women leading to pre-eclampsia and premature delivery is established.’
ACE2 is the protein to which the virus binds to invade cells, and thereby impair the functioning of systems that depend on it to regulate blood pressure. This finding shows that pregnant women with COVID-19 are more susceptible to pre-eclampsia and premature deliver.
“ACE2 plays a very important adaptive role in the maternal and fetal circulatory system, and in placentation. However, because it’s also a receptor for SARS-CoV-2, it increases risk to the placenta in pregnant patients with COVID-19, because the organ becomes a target for the virus, alongside the lungs, kidneys and heart. Our review showed that the response varies greatly from one patient to another, and manifestations take different forms,” Mariane Bertagnolli, principal investigator for the study, told.
With the global spread of the novel coronavirus, studies have shown evidence about vertically transmitted from mother to fetus.
In addition, 25% of babies born to mothers who had confirmed COVID-19 manifested fever, accelerated breathing, shortness of breath, and vomiting.
Researchers were unable to ascertain whether the symptoms resulted from premature delivery due to maternal COVID-19 or were directly caused by the disease.
Apart from the fact that ACE2, the receptor for SARS-CoV-2, is abundant in the placenta, researchers also found that the incidence of severe COVID-19 among pregnant women could be due to inhibition of the enzyme’s action by the viral infection.
Researchers stressed that further research is needed to determine with greater precision why pregnant women are more susceptible to COVID-19, and the role played by the disease in pre-eclampsia.
Besides pre-eclampsia, they are also interested in the role of infection by the novel coronavirus in placental inflammation and vascularization and so they are collecting samples of placenta from women infected by the virus in order to perform a series of experiments to find out what is really happening.