COVID-19 en el embarazo y posparto: Síntomas persistentes y concentraciones de biomarcadores de daño neurológico y endotelial.
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Date
2026
Journal Title
Journal ISSN
Volume Title
Publisher
Universidad de Concepción
Abstract
Introducción: Hasta un 45% de las personas infectadas con SARS-CoV-2 podrían desarrollar síndrome post COVID-19, con manifestaciones multiorgánicas y síntomas persistentes. En mujeres infectadas durante la gestación, la evidencia es limitada y heterogénea, sin una asociación clara entre el embarazo y el desarrollo de síndrome post COVID-19.
Objetivo: Caracterizar la manifestación del síndrome post COVID-19 en mujeres que controlaron su embarazo en la Atención Primaria durante el periodo 2020-2021 en Concepción.
Metodología: Estudio transversal, tipo serie de casos, anidado en una cohorte en curso. Los casos son mujeres embarazadas durante el primer periodo de la pandemia y que contrajeron COVID-19, identificando el momento de la infección ( ficha clínica), el perfil sintomatológico (cuestionario de auto reporte) y los niveles de biomarcadores de daño neurológico y endotelial (cadena ligera de neurofilamentos (NfL), proteína ácida fibrilar glial (GFAP) y dimetilarginina asimétrica (ADMA), a través del método ELISA. Se aplicaron pruebas no paramétricas en los softwares SPSS y GraPhPad Prism. El estudio fue aprobado por los comités tres comités de éticas de las instituciones involucradas.
Resultados: Se incluyeron 14 mujeres con antecedente de COVID-19. De las 14 participantes, un 71,4% de la muestra desarrolló al menos un síntoma de síndrome post COVID-19 siendo ansiedad y fatiga los más reportados. Quienes reportan síntomas se infectan principalmente después de la gestación. Los niveles de NfL, ADMA y GFAP presentaron resultados variables en todos los casos. Los casos de infección gestacional presentaron mayores concentraciones de GFAP.
Conclusiones: Los síntomas más reportados son ansiedad y fatiga. Sin embargo, no se pueden atribuir de forma exclusiva al SARS-CoV-2. Las asociaciones observadas entre GFAP y la infección gestacional e IMC requieren estudios con muestra mayores y un grupo de comparación.
Introduction: Up to 45% of individuals infected with SARS-CoV-2 may develop post-COVID-19 syndrome, characterized by multi-organ manifestations and persistent symptoms. Evidence regarding women infected during pregnancy is limited and heterogeneous, with no clear association between pregnancy and the development of post-COVID-19 syndrome. Objective: To characterize the presentation of post-COVID-19 syndrome in women who received prenatal care in primary care settings in Concepción between 2020 and 2021. Methodology: A cross-sectional study (case series design) nested within an ongoing cohort. The study subjects were pregnant women who contracted COVID-19 during the initial phase of the pandemic. Data collected included the timing of infection (from clinical records), symptom profiles (via self-report questionnaires), and levels of biomarkers for neurological and endothelial damage—specifically neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), and asymmetric dimethylarginine (ADMA)—measured using the ELISA method. Non-parametric tests were performed using SPSS and GraphPad Prism software. The study was approved by the ethics committees of the three participating institutions. Results: Fourteen women with a history of COVID-19 were included. Of these participants, 71.4% developed at least one symptom of post-COVID-19 syndrome, with anxiety and fatigue being the most frequently reported. Those reporting symptoms were primarily infected after pregnancy. Levels of NfL, ADMA, and GFAP varied across all cases. Cases involving gestational infection showed higher concentrations of GFAP. Conclusions: Anxiety and fatigue were the most frequently reported symptoms; however, they cannot be attributed exclusively to SARS-CoV-2. The observed associations between GFAP, gestational infection, and BMI warrant further study using larger sample sizes and a comparison group.
Introduction: Up to 45% of individuals infected with SARS-CoV-2 may develop post-COVID-19 syndrome, characterized by multi-organ manifestations and persistent symptoms. Evidence regarding women infected during pregnancy is limited and heterogeneous, with no clear association between pregnancy and the development of post-COVID-19 syndrome. Objective: To characterize the presentation of post-COVID-19 syndrome in women who received prenatal care in primary care settings in Concepción between 2020 and 2021. Methodology: A cross-sectional study (case series design) nested within an ongoing cohort. The study subjects were pregnant women who contracted COVID-19 during the initial phase of the pandemic. Data collected included the timing of infection (from clinical records), symptom profiles (via self-report questionnaires), and levels of biomarkers for neurological and endothelial damage—specifically neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), and asymmetric dimethylarginine (ADMA)—measured using the ELISA method. Non-parametric tests were performed using SPSS and GraphPad Prism software. The study was approved by the ethics committees of the three participating institutions. Results: Fourteen women with a history of COVID-19 were included. Of these participants, 71.4% developed at least one symptom of post-COVID-19 syndrome, with anxiety and fatigue being the most frequently reported. Those reporting symptoms were primarily infected after pregnancy. Levels of NfL, ADMA, and GFAP varied across all cases. Cases involving gestational infection showed higher concentrations of GFAP. Conclusions: Anxiety and fatigue were the most frequently reported symptoms; however, they cannot be attributed exclusively to SARS-CoV-2. The observed associations between GFAP, gestational infection, and BMI warrant further study using larger sample sizes and a comparison group.
Description
Tesis presentada para optar al grado de Magíster en Salud Sexual y Reproductiva.
Keywords
Síndrome Post Agudo de COVID-19, Embarazo, Lesiones Encefálicas, Enfermedades Vasculares, Proteínas de Neurofilamentos