We read with the great interest the article by Huang et al titled “The role of aspirin dose and initiation time in the prevention of preeclampsia and corresponding complications: a meta-analysis of RCTs” (Citation1). The authors deciphered the potential prevention value of aspirin in pregnant women at high risk for preeclampsia (PE). But we have noticed that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and PE have common pathophysiological characteristics, as shown in inflammatory changes (Citation2). Recent studies consistently reviewed the signs of SARS-CoV-2 infection was mediated by the angiotensin converting enzyme 2 (ACE2) receptor that caused renin-angiotensin system dysfunction and furtherly promoted vasoconstriction (Citation3), which was similar to the role of ACE2 as regulating arterial pressure in placental tissue among pregnant women (Citation4). Currently, American College of Obstetricians and Gynecologists have reported coronavirus disease (COVID-19) and PE have overlapping clinical characteristics, and pregnant patients with novel COVID-19 also have occurred PE-like syndrome (Citation5). Previous research have demonstrated that the incidence of PE among pregnant women infected with SARSCoV-2 have been shown to increase (Citation6). However some results suggested the levels of specific PE angiogenic and anti-angiogenic markers appeared to not be influenced by inflammation activation of COVID-19, such as sFLT-1 and PlGF (Citation7). In addition it might be distinguished from PE-like syndrome with severe COVID-19 and actual PE by sFlt-1/PlGF assessment and so on (Citation8).
In light of the exciting clues, it became apparent the specific mechanism of aspirin prevention from PE among pregnant women should be elucidated in extended studies for broadening our understanding about it. Although there might be a different mechanism between PE-like syndrome with severe COVID-19 and actual PE, we wondered whether the low-dose aspirin would prevent the pregnant women with COVID-19 from PE-like state, which might shed some light on the clinical value of low-dose aspirin and contribute to improve the prognosis of pregnancies with suspected PE.
Finally, we congratulate that the authors identified low-dose aspirin as the novel protective strategies in PE and look forward to that our interest will stimulate intriguing findings carried out on the clinical use of low-dose aspirin among the pregnant women with COVID-19 .
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References
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- Leavitt AO, Li Q, Chan ED. Re: pre-eclampsia-like syndrome induced by severe COVID-19: a prospective observational study. Bjog. 2021;128(3):3.