The systemic inflammatory landscape of COVID-19 in pregnancy: Extensive serum proteomic profiling of mother-infant dyads with in utero SARS-CoV-2
Cell Reports Medicine, 2021
Foo S., Cambou M., Mok T., Fajardo V., Jung K., Fuller T., Chen W., Kerin T., Mei J., Bhattacharya D., Choi Y., Wu X., Xia T., Shin W., Cranston J., Aldrovandi G., Tobin N., Contreras D., Ibarrondo F., Yang O., Yang S., Garner O., Cortado R., Bryson Y., Janzen C., Ghosh S., Devaskar S., Asilnejad B., Moreira M., Vasconcelos Z., Soni P., Gibson L., Brasil P., Comhair S., Arumugaswami V., Erzurum S., Rao R., Jung J., Nielsen-Saines K.
| Disease area | Application area | Sample type | Products |
|---|---|---|---|
Infectious Diseases Obstetrics | Pathophysiology | Plasma |  Olink Explore 3072/384 |
Abstract
While pregnancy increases the risk for severe COVID-19, the clinical and immunological implications of COVID-19 on maternal-fetal health remain unknown. Here, we present the clinical and immunological landscapes of 93 COVID-19 mothers and 45 of their SARS-CoV-2-exposed infants through comprehensive serum proteomics profiling for >1,400 cytokines of their peripheral and cord blood specimens. Prenatal SARS-CoV-2 infection triggers NF-κB-dependent proinflammatory immune activation. Pregnant women with severe COVID-19 show increased inflammation and unique IFN-λ antiviral signaling, with elevated levels of IFNL1 and IFNLR1. Furthermore, SARS-CoV-2 infection re-shapes maternal immunity at delivery, altering the expression of pregnancy complication-associated cytokines, inducing MMP7, MDK, and ESM1 and reducing BGN and CD209. Finally, COVID-19-exposed infants exhibit induction of T cell-associated cytokines (IL33, NFATC3, and CCL21), while some undergo IL-1β/IL-18/CASP1 axis-driven neonatal respiratory distress despite birth at term. Our findings demonstrate COVID-19-induced immune rewiring in both mothers and neonates, warranting long-term clinical follow-up to mitigate potential health risks.