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- W4200425381 abstract "Pregnancies complicated by Coronavirus Disease 2019 (COVID-19) are at an increased risk for severe morbidity due to physiologic changes in immunologic, cardiovascular, and respiratory function. This study aims to investigate the pathophysiology behind various clinical trajectories in pregnant patients with COVID-19 by using multi-omics profiling. This is a prospective cohort study of 31 pregnant patients enrolled in PRIORITY (Pregnancy CoRonavIrus Outcomes RegisTrY) at a single tertiary care center. Participants were categorized by severity of COVID-19 disease (control, asymptomatic, mild/moderate, or severe). Maternal serum samples underwent liquid chromatography-mass spectrometry (LC-MS)-based multiomics anlaysis for profiling of proteins, lipids, electrolytes, and metabolites. Multivariate regression models were used to assess how disease severity related to analyte levels while adjusting for participant age, race, run order, total protein signal, and total compound signal. DAVID functional enrichment analysis was conducted. Of 31 participants, 26 had confirmed diagnosis of COVID-19 (6 asymptomatic, 14 mild/moderate, 6 severe), and 5 participants were controls. Severe COVID-19 was associated with specific proteomic signatures and altered metabolites. There was no observed difference by gestational age of infection. Among the increased proteins there was enrichment of several functional terms that are associated with inflammation and clotting activity: “secreted” (FDR=3e-67), negative regulation of endopeptidase activity (FDR=1e-23), complement activation, classical pathway (FDR=1e-30), coagulation (FDR=7e-10). Asymptomatic and mild/moderate COVID-19 did not have significantly altered plasma protein or compound levels compared to controls. Pregnancies with severe COVID-19 demonstrate greater inflammation and clotting activity with altered complement activation. This altered multiomic expression provides provides information on the pathophysiology of severe COVID-19 in pregnancy and may serve as potential indicators for adverse pregnancy outcomes.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
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- W4200425381 date "2022-01-01" @default.
- W4200425381 modified "2023-09-28" @default.
- W4200425381 title "Severe COVID-19 in pregnancy has a distinct metabolomic profile which defines clinical outcomes" @default.
- W4200425381 doi "https://doi.org/10.1016/j.ajog.2021.11.992" @default.
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