VP31.03: Endotheliopathy biomarkers and angiogenic factors in distinguishing pre‐eclampsia from COVID‐19 in pregnancy

Objectives

To explore the performance of endotheliopathy biomarkers and angiogenic factors in distinguishing pre‐eclampsia (PE) from COVID‐19 in pregnancy.

Methods

Plasma and sera samples were obtained from pregnant women with COVID‐19 infection (n = 18) and patients with PE (n = 13). Biomarker assessment included circulating VCAM‐1, TNF‐receptor I (TNFRI), angiotensin II (ANGII), heparan sulfate (HS), thrombomodulin (TM), C5b9, PAI‐1, ADAMTS‐13 activity, fms‐like tyrosine kinase‐1 (sFlt1) and placental growth factor (PlGF). The area under the ROC curve was calculated for each of the biomarkers and for the sFlt1/PlGF ratio.

Results

VCAM‐1, TNFRI, ANGII, C5b9, sFlt1 and sFlt1/PlGF ratio were significantly higher (p < 0.05) in PE whereas HS and PlGF were significantly lower (p < 0.05) compared to patients with COVID‐19. No differences were observed in TM, PAI‐1, ADAMTS‐13 activity between the study groups. sFlt1/PlGF ratio showed the highest area under the curve (0.96) with a detection rate of 90% for 10% false positive rate (figure 1). PlGF has the lowest area under the curve (0.70) among the studied biomarkers with a detection rate of 0% for 10% false positive rate.

Conclusions

PE could be distinguished from COVID‐19 by sFlt1/PlGF ratio and other endotheliopathy biomarkers. PlGF should not be used alone in in this context. Instead, the use of sFlt1/PlGF ratio is the best candidate to detect PE and rule out COVID‐19.

Supporting information

Supporting Information