Obesity as a contributor to immunopathology in pregnant and non‐pregnant adults with COVID‐19

McCartney, Stephen A.; Kachikis, Alisa; Huebner, Emily M.; Walker, Christie L.; Chandrasekaran, Suchi; Waldorf, Kristina M. Adams

doi:10.1111/aji.13320

Cited by 18 publications

(26 citation statements)

References 114 publications

(168 reference statements)

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“…In the present case, like most pregnant women infected with SARS-CoV-2 (16,17), our patient had mild symptoms during COVID-19, and the fetal evaluation was normal at the time of diagnosis. But on the other hand, she had a history of previous bariatric surgery and was still overweight, which placed her in the high-risk group for complications (18). In addition, some studies suggest that when the disease occurs in late pregnancy, it is associated with an increased risk of adverse outcomes, including premature birth (19)(20)(21).…”

Section: Discussionmentioning

confidence: 99%

Case Report: SARS-CoV-2 Mother-to-Child Transmission and Fetal Death Associated With Severe Placental Thromboembolism

et al. 2021

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SARS-CoV-2 infection during pregnancy is not usually associated with significant adverse effects. However, in this study, we report a fetal death associated with mild COVID-19 in a 34-week-pregnant woman. The virus was detected in the placenta and in an unprecedented way in several fetal tissues. Placental abnormalities (MRI and anatomopathological study) were consistent with intense vascular malperfusion, probably the cause of fetal death. Lung histopathology also showed signs of inflammation, which could have been a contributory factor. Monitoring inflammatory response and coagulation in high-risk pregnant women with COVID-19 may prevent unfavorable outcomes, as shown in this case.

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Section: Discussionmentioning

confidence: 99%

Case Report: SARS-CoV-2 Mother-to-Child Transmission and Fetal Death Associated With Severe Placental Thromboembolism

et al. 2021

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“…Only two case reports demonstrated successful tocilizumab therapy in pregnant women with TD2 [ 101 ] or GDM [ 102 ], however one of these observed transaminitis and hyper-triglyceridemia after treatment [ 102 ]. Although pregnancy is not a significant risk factor for severe COVID-19, obesity in pregnant women represents a key co-morbidity and high circulating levels of leptin have been associated with an increased mortality in patients with ARDS [ 103 ]. Moreover, the increased levels of leptin are pro-inflammatory [ 93 ] and could induce macrosomia in the fetus [ 104 ].…”

Section: Diabesity Meta-inflammation and Il-6: The Role In Severmentioning

confidence: 99%

Mediterranean Diet for the Prevention of Gestational Diabetes in the Covid-19 Era: Implications of Il-6 In Diabesity

Fedullo¹,

Schiattarella

Morlando

et al. 2021

IJMS

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The aim of this review is to highlight the influence of the Mediterranean Diet (MedDiet) on Gestational Diabetes Mellitus (GDM) and Gestational Weight Gain (GWG) during the COVID-19 pandemic era and the specific role of interleukin (IL)-6 in diabesity. It is known that diabetes, high body mass index, high glycated hemoglobin and raised serum IL-6 levels are predictive of poor outcomes in coronavirus disease 2019 (COVID-19). The immunopathological mechanisms of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection include rising levels of several cytokines and in particular IL-6. The latter is associated with hyperglycemia and insulin resistance and could be useful for predicting the development of GDM. Rich in omega-3 polyunsaturated fatty acids, vitamins, and minerals, MedDiet improves the immune system and could modulate IL-6, C reactive protein and Nuclear Factor (NF)-κB. Moreover, polyphenols could modulate microbiota composition, inhibit the NF-κB pathway, lower IL-6, and upregulate antioxidant enzymes. Finally, adhering to the MedDiet prior to and during pregnancy could have a protective effect, reducing GWG and the risk of GDM, as well as improving the immune response to viral infections such as COVID-19.

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“…There is growing evidence that epigenetic mechanisms (e.g., DNA methylation, histone modifications, exosome-derived microRNAs) can be responsible for this nutritional programming in utero that affect the infants’ immunocompetence in the early stages of life [ 25 , 26 ] Concerning COVID-19 disease, where malnutrition and trace element deficiency affect the course of infection, obesity is a prognostic risk factor that associates with worse outcomes [ 27 ]. Indeed, maternal obesity has emerged as a key risk factor increasing the susceptibility of pregnant women to severe COVID-19 disease [ 28 ]. Therefore, it is important to highlight the relevance of nutritional status as a critical point in the host’s response to infections, therapies, and vaccines.…”

Section: Maternal Nutrition and Lifestyle For Healthy Pregnanciesmentioning

confidence: 99%

Impact of maternal nutrition in viral infections during pregnancy

Mate

Reyes-Goya

Santana-Garrido

et al. 2021

Biochimica et Biophysica Acta (BBA) - Molecular Basis of Diseas

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Other than being a physiological process, pregnancy is a condition characterized by major adaptations of maternal endocrine and metabolic homeostasis that are necessary to accommodate the fetoplacental unit. Unfortunately, all these systemic, cellular, and molecular changes in maternal physiology also make the mother and the fetus more prone to adverse outcomes, including numerous alterations arising from viral infections. Common infections during pregnancy that have long been recognized as congenitally and perinatally transmissible to newborns include toxoplasmosis, rubella, cytomegalovirus, and herpes simplex viruses (originally coined as ToRCH infections). In addition, enterovirus, parvovirus B19, hepatitis virus, varicella-zoster virus, human immunodeficiency virus, Zika and Dengue virus, and, more recently, coronavirus infections including Middle Eastern respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS) infections (especially the novel SARS-CoV-2 responsible for the ongoing COVID-19 pandemic), constitute relevant targets for current research on maternal-fetal interactions in viral infections during pregnancy. Appropriate maternal education from preconception to the early postnatal period is crucial to promote healthy pregnancies in general and to prevent and/or reduce the impact of viral infections in particular. Specifically, an adequate lifestyle based on proper nutrition plans and feeding interventions, whenever possible, might be crucial to reduce the risk of virus-related gestational diseases and accompanying complications in later life. Here we aim to provide an overview of the emerging literature addressing the impact of nutrition in the context of potentially harmful viral infections during pregnancy.

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Obesity as a contributor to immunopathology in pregnant and non‐pregnant adults with COVID‐19

Cited by 18 publications

References 114 publications

Case Report: SARS-CoV-2 Mother-to-Child Transmission and Fetal Death Associated With Severe Placental Thromboembolism

Case Report: SARS-CoV-2 Mother-to-Child Transmission and Fetal Death Associated With Severe Placental Thromboembolism

Mediterranean Diet for the Prevention of Gestational Diabetes in the Covid-19 Era: Implications of Il-6 In Diabesity

Impact of maternal nutrition in viral infections during pregnancy

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