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  • Pre-eclampsia-like syndrome induced by severe COVID-19: a prospective observational study #MMPMID32479682
  • Mendoza M; Garcia-Ruiz I; Maiz N; Rodo C; Garcia-Manau P; Serrano B; Lopez-Martinez RM; Balcells J; Fernandez-Hidalgo N; Carreras E; Suy A
  • BJOG 2020[Oct]; 127 (11): 1374-1380 PMID32479682show ga
  • OBJECTIVES: To investigate the incidence of clinical, ultrasonographic and biochemical findings related to pre-eclampsia (PE) in pregnancies with COVID-19, and to assess their accuracy to differentiate between PE and the PE-like features associated with COVID-19. DESIGN: A prospective, observational study. SETTING: Tertiary referral hospital. PARTICIPANTS: Singleton pregnancies with COVID-19 at >20(+0) weeks. METHODS: Forty-two consecutive pregnancies were recruited and classified into two groups: severe and non-severe COVID-19, according to the occurrence of severe pneumonia. Uterine artery pulsatility index (UtAPI) and angiogenic factors (soluble fms-like tyrosine kinase-1/placental growth factor [sFlt-1/PlGF]) were assessed in women with suspected PE. MAIN OUTCOME MEASURES: Incidence of signs and symptoms related to PE, such as hypertension, proteinuria, thrombocytopenia, elevated liver enzymes, abnormal UtAPI and increased sFlt-1/PlGF. RESULTS: Thirty-four cases were classified as non-severe and 8 as severe COVID-19. Five (11.9%) women presented signs and symptoms of PE, all five being among the severe COVID-19 cases (62.5%). However, abnormal sFlt-1/PlGF and UtAPI could only be demonstrated in one case. One case remained pregnant after recovery from severe pneumonia and had a spontaneous resolution of the PE-like syndrome. CONCLUSIONS: Pregnant women with severe COVID-19 can develop a PE-like syndrome that might be distinguished from actual PE by sFlt-1/PlGF, LDH and UtAPI assessment. Healthcare providers should be aware of its existence and monitor pregnancies with suspected pre-eclampsia with caution. TWEETABLE ABSTRACT: This study shows that a pre-eclampsia-like syndrome could be present in some pregnancies with severe COVID-19.
  • |Adult[MESH]
  • |Alanine Transaminase/metabolism[MESH]
  • |Aspartate Aminotransferases/metabolism[MESH]
  • |Betacoronavirus[MESH]
  • |Blood Pressure[MESH]
  • |Coronavirus Infections/complications/metabolism/*physiopathology[MESH]
  • |Female[MESH]
  • |HELLP Syndrome/etiology/metabolism/*physiopathology[MESH]
  • |Humans[MESH]
  • |L-Lactate Dehydrogenase/metabolism[MESH]
  • |Pandemics[MESH]
  • |Placenta Growth Factor/*metabolism[MESH]
  • |Pneumonia, Viral/complications/metabolism/*physiopathology[MESH]
  • |Pre-Eclampsia/etiology/metabolism/*physiopathology[MESH]
  • |Pregnancy[MESH]
  • |Pregnancy Complications, Infectious/metabolism/*physiopathology[MESH]
  • |Proteinuria/etiology/physiopathology[MESH]
  • |Pulsatile Flow[MESH]
  • |Severity of Illness Index[MESH]
  • |Tertiary Care Centers[MESH]
  • |Thrombocytopenia/etiology/physiopathology[MESH]
  • |Uterine Artery/*diagnostic imaging[MESH]
  • |Vascular Endothelial Growth Factor Receptor-1/*metabolism[MESH]

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  • suck abstract from ncbi

    1374 11.127 2020