Labor Could Increase Systemic Inflammation and Cause or Deteriorate Cytokine Storm in COVID-19

Pregnant women with coronavirus disease 2019 (COVID-19) have a higher risk of morbidity and mortality compared with the general population. Possible pathways are: I) in patients with COVID-19, cytokine storm defined as the excess release of pro-inflammatory cytokines such as interleukin 1β (IL-1β),...

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Bibliographic Details
Published in:Iranian journal of immunology 2022-09, Vol.19 (3), p.330-336
Main Authors: Amir Hossein Norooznezhad, Shamshirsaz, Alireza A, Hantoushzadeh, Sedigheh
Format: Article
Language:English
Subjects:
Angiogenesis
Cesarean section
Coronaviruses
COVID-19
Cytokine storm
Hemorrhage
Hypoxemia
Hypoxia-inducible factor 1a
Hypoxia-inducible factors
IL-1β
Inflammation
Interleukin 6
labor
Morbidity
Mortality
NF-κB protein
pregnancy
Tumor necrosis factor-TNF
Tumor necrosis factor-α
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Summary:Pregnant women with coronavirus disease 2019 (COVID-19) have a higher risk of morbidity and mortality compared with the general population. Possible pathways are: I) in patients with COVID-19, cytokine storm defined as the excess release of pro-inflammatory cytokines such as interleukin 1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) has been associated with morbidities and an even higher rate of mortality. II) Labor, despite being a term/preterm, has an inflammatory nature, although, inflammation is more prominent in preterm delivery. During labor, different pro-inflammatory cytokines such as IL-1β, IL-6, and TNF-α are involved which as mentioned, all are crucial role players in the cytokine storm. III) Tissue injury, and during labor, (especially cesarean section) is shown to cause inflammation via pro-inflammatory cytokines release including those involved in the cytokine storm through the activation of nuclear factor κB (NFκB). IV) post-partum hemorrhage with a notable amount of blood loss which can cause significant hypoxemia. In this condition, hypoxia-inducible factor 1α which has a cross-talk with NFκB, leads to the expression of IL-1β, IL-6, and TNF-α as both angiogenic and pro-inflammatory factors. Considering all the mentioned issues and pathways, we suggest that clinicians be careful about the escalation of the inflammatory status in their pregnant COVID-19 patients during/following labor.
ISSN:1735-1383
1735-367X
DOI:10.22034/iji.2022.93951.2267