COVID-19: A Cause of HELLP Syndrome? A Case Report

Arslan, Ebubekir

doi:10.2147/ijwh.s362877

Cited by 7 publications

(12 citation statements)

References 33 publications

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“…To that end, recent reports in pregnant patients with COVID-19 show evidence of maternal vascular malperfusion (MVM), vascular injury and thrombi [ 6 – 8 ] . Similar pathophysiological mechanisms including platelet activation and endothelial dysfunction have also been reported in HELLP syndrome and preeclampsia [ 5 ] . It is unclear how these pathophysiological mechanisms interact or if there is synergism between the two aetiologies.…”

Section: Introductionsupporting

confidence: 62%

“…Due to the similarities between the two aetiologies, it is essential for clinicians to focus on several clinical features that may aid in differentiating between HELLP and COVID-19. Elevated blood pressures and proteinuria are more suggestive of HELLP syndrome [ 5 ] as 4–12% of women diagnosed with preeclampsia will develop this triad [ 9 ] . However, due to atypical normotensive presentations of HELLP, the absence of elevated blood pressures and proteinuria does not preclude the diagnosis [ 5 ] .…”

Section: Discussionmentioning

confidence: 99%

“…The COVID-19 pandemic has introduced additional challenges in diagnosing HELLP as COVID-19 infection can cause other systemic complications including elevated blood pressure, haemolysis, thrombocytopenia, kidney injury and transaminitis [2][3][4] mimicking preeclampsia and HELLP features. While the pathology of COVID-19 appears to be multifactorial, it is postulated that angiotensin-converting enzyme 2 (ACE2) mediates the action of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the regulation of the renin-angiotensin system, platelet activation and thrombosis, endothelial dysfunction and arterial pressure [3,5] . ACE2 is highly expressed in placental tissue including syncytiotrophoblasts, endothelium, cytotrophoblast and vascular smooth muscle of the villi [3] .…”

Section: Introductionmentioning

confidence: 99%

“…ACE2 is highly expressed in placental tissue including syncytiotrophoblasts, endothelium, cytotrophoblast and vascular smooth muscle of the villi [3] . To that end, recent reports in pregnant patients with COVID-19 show evidence of maternal vascular malperfusion (MVM), vascular injury and thrombi [6][7][8] platelet activation and endothelial dysfunction have also been reported in HELLP syndrome and preeclampsia [5] . It is unclear how these pathophysiological mechanisms interact or if there is synergism between the two aetiologies.…”

Section: Introductionmentioning

confidence: 99%

“…While the pathology of COVID-19 appears to be multifactorial, it is postulated that angiotensin-converting enzyme 2 (ACE2) mediates the action of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the regulation of the renin-angiotensin system, platelet activation and thrombosis, endothelial dysfunction and arterial pressure [ 3 , 5 ] . ACE2 is highly expressed in placental tissue including syncytiotrophoblasts, endothelium, cytotrophoblast and vascular smooth muscle of the villi [ 3 ] .…”

Section: Introductionmentioning

confidence: 99%

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Overlapping Presentations of HELLP Syndrome and COVID-19: A Case Report

Tou

Wang

Siddiqui

et al. 2022

European Journal of Case Reports in Internal Medicine

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Introduction: Hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome is a leading cause of maternal mortality. The emergence of Coronavirus disease 2019 (COVID-19) has led to challenges in diagnosing HELLP syndrome due to overlapping clinical and laboratory presentations. We report a case of HELLP syndrome complicated by COVID-19 infection. Case Description: An otherwise healthy pregnant 31-year-old female presented with fever, myalgia, and headache. She was found to be COVID-positive with laboratory signs of HELLP syndrome. Symptoms and laboratory findings trended toward normal post-partum confirming the diagnosis of HELLP syndrome. Discussion: A prompt diagnosis of HELLP syndrome is essential to avoid maternal and fetal complications. Clinicians should be aware of the similarities in presentation between HELLP syndrome and COVID-19 for timely diagnosis and treatment.

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Section: Introductionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Overlapping Presentations of HELLP Syndrome and COVID-19: A Case Report

Tou

Wang

Siddiqui

et al. 2022

European Journal of Case Reports in Internal Medicine

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Multiple drugs

2022

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COVID-19 related liver injuries in pregnancy

Sekulovski¹,

Bogdanova-Petrova²,

Peshevska-Sekulovska³

et al. 2023

World J Clin Cases

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While severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) quickly spread across the globe, our understanding of its pathogenic mechanisms evolved. Importantly, coronavirus disease 2019 (COVID-19) is now considered a syndromic multisystem inflammatory disease involving not only the respiratory system but also the cardiovascular, excretory, nervous, musculoskeletal, and gastrointestinal systems. Moreover, a membrane-bound form of angiotensin-converting enzyme 2, the entry receptor for SARS-CoV-2, is expressed on the surface of cholangiocytes and hepatocytes, suggesting the potential of COVID-19 to involve the liver. With the widespread distribution of SARS-CoV-2 throughout the population, infection during pregnancy is no longer a rare occurrence; however, little is known about the course of hepatic injuries and related outcomes in pregnant SARS-CoV-2-positive women. Thus, the understudied topic of COVID-related liver disease during pregnancy poses a great challenge for the consulting gynecologist and hepatologist. In this review, we aim to describe and summarize potential liver injuries in pregnant women with COVID-19.

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COVID-19: A Cause of HELLP Syndrome? A Case Report

Cited by 7 publications

References 33 publications

Overlapping Presentations of HELLP Syndrome and COVID-19: A Case Report

Overlapping Presentations of HELLP Syndrome and COVID-19: A Case Report

Multiple drugs

COVID-19 related liver injuries in pregnancy

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