Serum hepatic biomarkers in women with obstetric cholestasis and a concurrent SARS-CoV-2 infection.
SARS-CoV-2 infection
biliar acid
covid-19
obstetric cholestasis
pregnancy
transaminases
Journal
The journal of obstetrics and gynaecology research
ISSN: 1447-0756
Titre abrégé: J Obstet Gynaecol Res
Pays: Australia
ID NLM: 9612761
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
revised:
11
07
2022
received:
19
02
2022
accepted:
21
07
2022
pubmed:
3
8
2022
medline:
4
11
2022
entrez:
2
8
2022
Statut:
ppublish
Résumé
The aim of the study was to evaluate the association between SARS-CoV-2 infection and serum hepatic biomarker levels among women with obstetric cholestasis. In this prospective study, we recruited all pregnant women admitted in our hospital with obstetric cholestasis. Among those with a concurrent SARS-CoV-2 infection, we evaluated the following serum hepatic biomarkers: aspartate aminotransferase (AST), alanine aminotransferase (ALT), and biliar acids (BA). Among the 88 women enrolled in the study, 20 presented with a SARS-CoV-2 infection while 68 were negative. SARS-CoV-2 infected women were younger (mean age 30.5 ± 5.7 vs. 34.3 ± 5.4; p < 0.01) and in a greater percentage of non-Caucasian ethnicity when compared to noninfected women (60.0% vs. 17.6%; p < 0.01). Regarding levels of hepatic biomarkers, they showed higher levels of AST (111.5 ± 134.1 vs. 37.3 ± 43.4 UI/L; p = 0.02), ALT (132.2 ± 115.7 vs. 50.5 ± 73.173.1 UI/L; p < 0.01), and BA (41.4 ± 46.8 vs. 18.4 ± 13.4 μmol/L; p = 0.04) compared to noninfected patients. No significant differences in maternal or fetal outcomes were found between infected and noninfected women. SARS-CoV-2 infection was associated with higher levels of liver enzymes in patients with obstetric cholestasis. This could be the result of a possible hepatic involvement in patients with SARS-CoV-2 infection.
Identifiants
pubmed: 35915565
doi: 10.1111/jog.15383
pmc: PMC9538249
doi:
Substances chimiques
Biomarkers
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2713-2720Informations de copyright
© 2022 Japan Society of Obstetrics and Gynecology.
Références
Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S, et al. Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020;127:1116-21.
Thangaratinam S, Cooray SD, Sukumar N, Huda MSB, Devlieger R, Benhalima K, et al. Endocrinology in time of Covid-19: diagnosis and management of gestational diabetes mellitus. Eur J Endocrinol. 2020;183:G49-56.
Gao YJ, Ye L, Zhang JS, Yin YX, Liu M, Yu HB, et al. Clinical features and outcomes of pregnant women with COVID-19: a systematic review and meta-analysis. BMC Infect Dis. 2020;20:564.
Williamson C, Geenes V. Intrahepatic cholestasis of pregnancy. Obstet Gynecol. 2014;124:120-33.
Shobaili HA, Hamed HO, Al Robaee A, Alzolibani AA, Amin AF, Ahmad SR. Obstetrical and fetal outcomes of a new management strategy in patients with intra-hepatic cholestasis of pregnancy. Arch Gynecol Obstet. 2011;283:1219-25.
Kenyon AP, Piercy CN, Girling J, Williamson C, Tribe RM, Shennan AH. Obstetric cholestasis, outcome with active management: a series of 70 cases. BJOG. 2002;109:282-8.
Geenes V, Chappell LC, Seed PT, Steer PJ, Knight M, Williamson C. Association of severe intrahepatic cholestasis of pregnancy with adverse pregnancy outcomes: a prospective population-based case-control study. Hepatology. 2014;59:1482-91.
Walker IA, Nelson-Piercy C, Williamson C. Role of bile acid measurement in pregnancy. Ann Clin Biochem. 2002;39:105-13.
Laatikainen T, Ikonen E. Serum bile acids in cholestasis of pregnancy. Obstet Gynecol. 1977;50:313-8.
Shaw D, Frohlich J, Wittmann BA, Willms M. A prospective study of 18 patients with cholestasis of pregnancy. Am J Obstet Gynecol. 1982;142:621-5.
Fisk NM, Bye WB, Storey GN. Maternal features of obstetric cholestasis: 20 years experience at King George V Hospital. Aust N Z J Obstet Gynaecol. 1988;28:172-6.
Williamson C, Hems LM, Goulis DG, Walker I, Chambers J, Donaldson O, et al. Clinical outcome in a series of cases of obstetric cholestasis identified via a patient support group. BJOG. 2004;111:676-81.
Chappell LC, Gurung V, Seed PT, Chambers J, Williamson C, Thornton JG, et al. Ursodeoxycholic acid versus placebo, and early term delivery versus expectant management, in women with intrahepatic cholestasis of pregnancy: semifactorial randomised clinical trial. BMJ. 2012;344:e3799.
Michie S, West R, Amlôt R. Slowing down the covid-19 outbreak: changing behaviour by understanding it. BMJ. 2020.
Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395:809-15.
Ministero della Salute. Pandemia di COVID-19 - Aggiornamento delle indicazioni sui test diagnostici e sui criteri da adottare nella determinazione delle priorità. Aggiornamento delle indicazioni relative alla diagnosi di laboratorio (0011715-03/04/2020). Roma: Ministero della Salute; 2020.
Linea guida sulla gravidanza fisiologica. Sistema nazionale per le linee guida (SNLG). 2011
Wastnedge EAN, Reynolds RM, van Boeckel SR, et al. Pregnancy and COVID-19. Physiol Rev. 2021;1:303-18.
Knight M, Bunch K, Vousden N, et al. Characteristics and outcomes of pregnant women hospitalised with confirmed SARS-Cov-2 infection in the UK a national cohort study using the UK obstetric surveillance system (UKOSS). BMJ. 2020;369:m2107.
Zhang C, Shi L, Wang F-S. Liver injury in COVID-19: management and challenges. Lancet Gastroenterol Hepatol. 2020;5:428-30.
Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054-62.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.
Guan W, Ni Z, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of 2019 novel coronavirus infection in China. N Engl J Med. 2020;382:1708-20.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323:1061-9.
Wu J, Song S, Cao H-C, Li LJ. Liver diseases in COVID-19: etiology, treatment and prognosis. World J Gastroenterol. 2020;26:2286-93.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507-13.
Anness A, Siddiqui F. COVID-19 complicated by hepatic dysfunction in a 28-week pregnant woman. BMJ Case Rep. 2020;2:e237007.
Knight M, Bunch K, Vousden N, Morris E, Simpson N, Gale C, et al. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-Cov-2 infection in UK: national population based cohort study. BMJ. 2020;369:m2107.
Baker JM, Buchfellner M, Britt W, Sanchez V, Potter JL, Ingram LA, et al. Acute hepatitis and adenovirus infection among children - Alabama, October 2021-February 2022. MMWR Morb Mortal Wkly Rep. 2022;6:638-40.
Marsh K, Tayler R, Pollock L, et al. Investigation into cases of hepatitis of unknown aetiology among young children, Scotland, 1 January 2022 to 12 April 2022. Euro Surveill. 2022;27:2200318.
Iacobucci G. Acute hepatitis is identified in more children, but cause remains elusive. BMJ. 2022;6:o1156.
Khan YH, Mallhi TH, Alanazi AS, Butt MH, Khan A, Salman M. Outbreak of acute hepatitis of unknown etiology in children: the critical role of healthcare professionals in neutralizing misleading narratives during the COVID-19 pandemic. J Med Virol. 2022;94:4063-4.
Barreiro P. Unexplained hepatitis in children after lifting COVID-19 pandemic restrictions. AIDS Rev. 2022;24:99-101.
Alteri C, Cento V, Piralla A, et al. Genomic epidemiology of SARS-CoV-2 reveals multiple lineages and early spread of SARS-CoV-2 infections in Lombardy, Italy. Nat Commun. 2021;19:434.
Barbero P, Mugüerza L, Herraiz I, García Burguillo A, San Juan R, Forcén L, et al. SARS-CoV-2 in pregnancy: characteristics and outcomes of hospitalized and non-hospitalized women due to COVID-19. J Matern Fetal Neonatal Med. 2022;35:2648-54.
Sentilhes L, De Marcillac F, Jouffrieau C, et al. Coronavirus disease 2019 in pregnancy was associated with maternal morbidity and preterm birth. Am J Obstet Gynecol. 2020;223:914.e1-914.e15.
Hirshberg A, Kern-Goldberger AR, Levine LD, Pierce-Williams R, Short WR, Parry S, et al. Care of critically ill pregnant patients with coronavirus disease 2019: a case series. Am J Obstet Gynecol. 2020;223:286-90.
D'Ambrosi F, Iurlaro E, Tassis B, di Maso M, Erra R, Cetera GE, et al. Sociodemographic characteristics of pregnant women tested positive for COVID-19 admitted to a referral center in northern Italy during lockdown period. J Obstet Gynaecol Res. 2021;47:1751-6.
Rotundo L, Pyrsopoulos N. Liver injury induced by paracetamol and challenges associated with intentional and unintentional use. World J Hepatol. 2020;27:125-36.