The role of pathological hemostasis in formation of perinatal complications of the novel coronavirus infection

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Аннотация

Objective: To investigate relationship between maternal and fetal complications after novel coronavirus (nCoV) infection (COVID-19 infection) in the presence of polymorphism of gene encoding proteins of the hemostasis system.

Materials and methods: A comparative study of 270 cases of pregnancy and delivery was carried out. Among them, 170 women were infected with novel coronavirus, and 100 women had no COVID-19 with a proven absence of antibodies to SARS-CoV-2 in the blood. Real-time PCR was used for detection of gene polymorphism of F2, F5, F7, F13, FGB, ITGA2, ITGB3, SERPINE1 in the peripheral blood samples. The enzyme-linked immunosorbent assay (ELISA) was used to quantify specific proteins – soluble fms-like tyrosine kinase 1; placental growth factor; tissue plasminogen activator (t-PA); plasminogen activator inhibitor-type 1 (PAI-1).

Results: Gene polymorphism of the hemostasis system influences the course of novel coronavirus infection, the concentration of the major regulatory proteins and determines formation of perinatal complications. Maternal carriage of the plasminogen activator inhibitor-type 1 (675 4G/4G) allele during pregnancy is associated with mild course of COVID-19 infection. At the same time, homozygous carriage of PAI-1(675) 4G/4G determines the development of severe preeclampsia. Carriage of F13(103) T allele is associated with increased risk of infection and clinical significance of the disease with circulation of the most aggressive SARS-CoV-2 Beta variant and increased concentration of t-PA and PlGF in the blood. Moreover, the novel coronavirus infection leads additionally to increased concentration of these proteins at delivery. Homozygous carriage of F13(103) T/T increases the risk of premature placental abruption.

Conclusion: The mechanisms of gestational complications after nCoV infection are mediated by accumulation of supraphysiological concentrations of proangiogenic factors and fibrinolysis activators at delivery, and their action is modulated by the presence of genetic risk factors associated with hereditary thrombophilia.

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Авторлар туралы

Ekaterina Matusevich

Siberian State Medical University, Ministry of Health of Russia

Хат алмасуға жауапты Автор.
Email: e.matusevich@bk.ru

Teaching Assistant at the Department of Obstetrics and Gynecology

Ресей, Tomsk

Sergey Yuryev

Siberian State Medical University, Ministry of Health of Russia

Email: e.matusevich@bk.ru

Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology

Ресей, Tomsk

Marina Nikolaeva

Altai State Medical University, Ministry of Health of Russia; Altai Affiliated Institution of the National Medical Research Center of Hematology, Ministry of Health of Russia

Email: e.matusevich@bk.ru

Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology; Senior Researcher

Ресей, Barnaul; Barnaul

Vladimir Frankevich

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: e.matusevich@bk.ru

Dr. Sci. (Physico-mathematical)

Ресей, Moscow

Natalya Frankevich

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: e.matusevich@bk.ru

PhD

Ресей, Moscow

Irina Popova

Siberian State Medical University, Ministry of Health of Russia

Email: e.matusevich@bk.ru

PhD, Researcher at the Central Research Laboratory

Ресей, Tomsk

Tatyana Nemtseva

Siberian State Medical University, Ministry of Health of Russia

Email: e.matusevich@bk.ru

obstetrician-gynecologist, Professor Medical Center

Ресей, Tomsk

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