Cardiovascular complications in pregnant women with COVID-19: An integrative review
DOI:
https://doi.org/10.36489/saudecoletiva.2022v12i81p11654-11665Keywords:
Pregnancy, COVID-19, Pregnancy complications cardiovascular, Cardiology, Cardiovascular diseasesAbstract
Objective: To identify the cardiovascular complications in pregnant women with COVID-19 and their outcomes. Methods: The integrative review was guided by the question about cardiovascular complications of pregnant women with Covid-19. Primary studies were included whose outcomes were cardiovascular complications in pregnant women witch COVID-19, published in English, Portuguese or Spanish in PubMed or BVS sources, between 2016 and 2021. Results: It was observed that the main cardiovascular complications during pregnancy involved the presence of arterial, venous thrombosis, coagulopathies, cardiomyopathies, heart failure and myocardial injury and the main outcome found was the need for cesarean delivery related to fetal distress, fear of vertical transmission of COVID-19 by health professionals and health complications of the pregnant woman. Conclusions: Cardiovascular complications were identified by laboratory, image and electrocardiogram tests that strays out of the classic pattern of alterations present in patients with COVID-19. The results of this study will make it possible to expand the knowledge of health professionals in the face of atypical conditions that pregnant women may experience throughout their hospitalizations as well as the risk of cardiovascular complications for pregnancy.
References
Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential Effects of Coronaviruses on the Cardiovascular System: A Review. JAMA Cardiol. 2020;5(7):831-840. doi:10.1001/jamacardio.2020.1286
Johns Hopkins University. Coronavirus Resource Center 2020 [cited 2020 May 17,2020]. https://coronavirus.jhu.edu/.
Couto, Marcia Thereza, Barbieri, Carolina Luisa Alves e Matos, Camila Carvalho de Souza AmorimConsiderações sobre o impacto da covid-19 na relação indivíduo-sociedade: da hesitação vacinal ao clamor por uma vacina. Saúde e Sociedade [online]. 2021, v. 30, n. 1 [Acessado 22 Outubro 2021] , e200450. Disponível em: <https://doi.org/10.1590/S0104-12902021200450>. Epub 19 Mar 2021. ISSN 1984-0470. https://doi.org/10.1590/S0104-12902021200450.
Rasmussen SA, Kelley CF, Horton JP, Jamieson DJ. Coronavirus Disease 2019 (COVID-19) Vaccines and Pregnancy: What Obstetricians Need to Know [published correction appears in Obstet Gynecol. 2021 May 1;137(5):962]. Obstet Gynecol. 2021;137(3):408-414. doi:10.1097/AOG.0000000000004290
Azinheira Nobrega Cruz N, Stoll D, Casarini DE, Bertagnolli M. Role of ACE2 in pregnancy and potential implications for COVID-19 susceptibility. Clin Sci (Lond). 2021;135(15):1805-1824. doi:10.1042/CS20210284
Zelop CM, Bonney EA. COVID-19 in pregnancy: possible mechanisms not to be discounted. J Matern Fetal Neonatal Med. 2020 Aug 18:1-4. doi: 10.1080/14767058.2020.1807508. Epub ahead of print. PMID: 32811230.
Mendes, Karina Dal Sasso, Silveira, Renata Cristina de Campos Pereira e Galvão, Cristina MariaRevisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & Contexto - Enfermagem [online]. 2008, v. 17, n. 4 [Acessado 21 Outubro 2021] , pp. 758-764. Disponível em: <https://doi.org/10.1590/S0104-07072008000400018>. Epub 12 Jan 2009. ISSN 1980-265X.
Santos C, Pimenta C, Nobre M. The PICO strategy for the research question construction and evidence search. Rev. Latino-Am. Enfermagem. [Internet] 2007 [cited June 29 2016];15(3):508-11.
Servante, J., Swallow, G., Thornton, J.G. et al. Haemostatic and thrombo-embolic complications in pregnant women with COVID-19: a systematic review and critical analysis. BMC Pregnancy Childbirth 21, 108 (2021). https://doi.org/10.1186/s12884-021-03568-0
Flores-Pliego A, Miranda J, Vega-Torreblanca S, Valdespino-Vázquez Y, Helguera-Repetto C, Espejel-Nuñez A, Borboa-Olivares H, Espino Y Sosa S, Mateu-Rogell P, León-Juárez M, Ramírez-Santes V, Cardona-Pérez A, Villegas-Mota I, Torres-Torres J, Juárez-Reyes Á, Rizo-Pica T, González RO, González-Mariscal L, Estrada-Gutierrez G. Molecular Insights into the Thrombotic and Microvascular Injury in Placental Endothelium of Women with Mild or Severe COVID-19. Cells. 2021 Feb 10;10(2):364. doi: 10.3390/cells10020364. PMID: 33578631; PMCID: PMC7916402.
De Vita, S, Ippolito, S, Caracciolo, MM, Barosi, A. Peripartum cardiomyopathy in a COVID-19-infected woman: differential diagnosis with acute myocarditis—A case report from a Hub Institution during the COVID-19 outbreak. Echocardiography. 2020; 37: 1673– 1677. https://doi.org/10.1111/echo.14873
Bhattacharyya PJ, Attri PK, Farooqui W. Takotsubo cardiomyopathy in early term pregnancy: a rare cardiac complication of SARS-CoV-2 infectionBMJ Case Reports CP 2020;13:e239104.
Takemoto M, Menezes MO, Andreucci CB, Knobel R, Sousa L, Katz L, Fonseca EB, Nakamura-Pereira M, Magalhães CG, Diniz C, Melo A, Amorim M; Brazilian Group for Studies of COVID-19 and Pregnancy. Clinical characteristics and risk factors for mortality in obstetric patients with severe COVID-19 in Brazil: a surveillance database analysis. BJOG. 2020 Dec;127(13):1618-1626. doi: 10.1111/1471-0528.16470. Epub 2020 Sep 14. PMID: 32799381; PMCID: PMC7461482.
Ahmed I, Azhar A, Eltaweel N, Tan BK. First COVID-19 maternal mortality in the UK associated with thrombotic complications. Br J Haematol. 2020 Jul;190(1):e37-e38. doi: 10.1111/bjh.16849. Epub 2020 Jun 8. PMID: 32420614; PMCID: PMC7276811.
Ortiz Molina E, Hernandez Pailos R, Pola Guillen M, Pascual Pedreno A, Rodriguez Rodriguez E, Hernandez Martinez A. COVID-19 infection in symptomatic pregnant women at the midpoint of the pandemic in Spain: a retrospective analysis. Ginekol Pol. 2020;91(12):755-763. doi: 10.5603/GP.a2020.0130. PMID: 33447995.
Wastnedge EAN, Reynolds RM, van Boeckel SR, Stock SJ, Denison FC, Maybin JA, Critchley HOD. Pregnancy and COVID-19. Physiol Rev. 2021 Jan 1;101(1):303-318. doi: 10.1152/physrev.00024.2020. Epub 2020 Sep 24. PMID: 32969772; PMCID: PMC7686875.
Di Mascio D, Sen C, Saccone G, Galindo A, Grünebaum A, Yoshimatsu J, Stanojevic M, Kurjak A, Chervenak F, Rodríguez Suárez MJ, Gambacorti-Passerini ZM, Baz MLAA, Aguilar Galán EV et al. Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19. J Perinat Med. 2020 Nov 26;48(9):950-958. doi: 10.1515/jpm-2020-0355. Erratum in: J Perinat Med. 2020 Dec 02;49(1):111-115. PMID: 32975205.
Takayama W, Endo A, Yoshii J, Arai H, Oi K, Nagaoka E, Toyama S, Yamamoto H, Uchida T, Otomo Y. Severe COVID-19 Pneumonia in a 30-Year-Old Woman in the 36th Week of Pregnancy Treated with Postpartum Extracorporeal Membrane Oxygenation. Am J Case Rep. 2020 Oct 28;21:e927521. doi: 10.12659/AJCR.927521. PMID: 33110055; PMCID: PMC7603798.
Karabulut Keklik ES, Dal H, Bozok Ş. Cytokine Hemoadsorption in the Management of a Pregnant Woman with COVID-19 Pneumonia: Case Report. SN Compr Clin Med. 2020 Sep 16:1-5. doi: 10.1007/s42399-020-00508-5. Epub ahead of print. PMID: 32954212; PMCID: PMC7492132.
Goudarzi, S, Firouzabadi, FD, Mahmoudzadeh, F, Aminimoghaddam, S. Pulmonary embolism in pregnancy with COVID-19 infection: A case report. Clin Case Rep. 2021; 9: 1882– 1886.
Mercedes BR, Serwat A, Naffaa L, et al. New-onset myocardial injury in pregnant patients with coronavirus disease 2019: a case series of 15 patients. Am J Obstet Gynecol. 2021;224(4):387.e1-387.e9. doi:10.1016/j.ajog.2020.10.03
Di Mascio D, Khalil A, Saccone G, Rizzo G, Buca D, Liberati M, Vecchiet J, Nappi L, Scambia G, Berghella V, D'Antonio F. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am J Obstet Gynecol MFM. 2020 May;2(2):100107. doi: 10.1016/j.ajogmf.2020.100107. Epub 2020 Mar 25. PMID: 32292902; PMCID: PMC7104131.
Porto, Luiz, et al. “Coagulação Intravascular Disseminada Na Gravidez – Considerações, Diagnóstico E Manejo.” Revista Médica de Minas Gerais, vol. 20, no. 2,supl.1, 2010, pp. S15–S19. LILACS.
Ramos, Roberta Pulcheri e Ota-Arakaki, Jaquelina SonoeThrombosis and anticoagulation in COVID-19. Jornal Brasileiro de Pneumologia [online]. 2020, v. 46, n. 04 [Acessado 13 Março 2022] , e20200317. Disponível em: <https://doi.org/10.36416/1806-3756/e20200317>. Epub 20 Jul 2020. ISSN 1806-3756. https://doi.org/10.36416/1806-3756/e20200317
Nascimento, Jorge Henrique Paiter et al. COVID-19 e Injúria Miocárdica em UTI Brasileira: Alta Incidência e Maior Risco de Mortalidade Intra-Hospitalar. Arquivos Brasileiros de Cardiologia [online]. 2021, v. 116, n. 2 [Acessado 13 Março 2022] , pp. 275-282. Disponível em: <https://doi.org/10.36660/abc.20200671>. Epub 18 Jan 2021. ISSN 1678-4170. https://doi.org/10.36660/abc.20200671.
Barros, Gabriel Martins, et al. “Considerações Sobre a Relação Entre a Hipertensão E O Prognóstico Da COVID-19.” Journal of Health & Biological Sciences, vol. 8, no. 1, 14 May 2020, pp. 1–3, periodicos.unichristus.edu.br/jhbs/article/view/3250, 10.12662/2317-3076jhbs.v8i1.3250.p1-3.2020. Accessed 3 Dec. 2021.
Souza, Alex Sandro Rolland e Amorim, Melania Maria RamosMaternal mortality by COVID-19 in Brazil. Revista Brasileira de Saúde Materno Infantil [online]. 2021, v. 21, n. Suppl 1 [Acessado 13 Março 2022] , pp. 253-256. Disponível em: <https://doi.org/10.1590/1806-9304202100S100014>. Epub 24 Fev 2021. ISSN 1806-9304. https://doi.org/10.1590/1806-9304202100S100014
Crispim, Maria Eduarda Serafim, et al. “INFECÇÃO POR COVID-19 DURANTE a GESTAÇÃO: AVALIAÇÃO DAS MANIFESTAÇÕES CLÍNICAS E DESFECHO GESTACIONAL.” Revista de Ciências Da Saúde Nova Esperança, vol. 18, no. 3, 21 Dec. 2020, pp. 214–222, revista.facene.com.br/index.php/revistane/article/view/660/440, 10.17695/rcsnevol18n3p214-222. Accessed 16 May 2021
Della Gatta, Anna Nunzia et al. “Coronavirus disease 2019 during pregnancy: a systematic review of reported cases.” American journal of obstetrics and gynecology vol. 223,1 (2020): 36-41. doi:10.1016/j.ajog.2020.04.013