通过胎儿核磁共振成像评估 SARS-CoV-2 大流行中以微米为主的阶段胎儿产前肺部发育情况。

IF 4.7 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
European Radiology Pub Date : 2025-03-01 Epub Date: 2024-08-30 DOI:10.1007/s00330-024-11031-9
Gloria Biechele, Vanessa Koliogiannis, Philippe Rennollet, Tobias Prester, Enrico Schulz, Thomas Kolben, Magdalena Jegen, Christoph Hübener, Uwe Hasbargen, Andreas Flemmer, Olaf Dietrich, Tanja Burkard, Regina Schinner, Julien Dinkel, Maximilian Muenchhoff, Susan Hintz, Maria Delius, Sven Mahner, Jens Ricke, Anne Hilgendorff, Sophia Stoecklein
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引用次数: 0

摘要

目的:随着 SARS-CoV-2 的不断发展,疾病的严重程度和表现形式也因进入机制和作用部位的变化以及疫苗接种和/或感染获得的免疫力的影响而发生了变化。我们重新评估了在晚期、以欧米茄为主的大流行阶段感染 SARS-CoV-2 的无并发症孕妇的胎儿肺部病理情况,以便为了解疾病和妊娠咨询提供信息:在这项病例对照研究中,通过胎儿核磁共振成像评估了24例在大流行阶段(ogmicron-dominated pandemic phase)受轻度母体SARS-CoV-2感染影响的孕妇的胎儿肺容积,这些孕妇通过接种疫苗和/或之前感染SARS-CoV-2获得了免疫力:24例轻度、无并发症SARS-CoV-2感染的孕妇(GA 33.3 ± 3.8,12例女性胎儿)的胎儿肺活量(归一化为估计胎儿体重)与已公布的参考值(96.3% ± 22.5% 第50百分位数参考值,p = 0.43)或特定地点、非COVID对照组的胎儿肺活量(n = 15,94.2% ± 18.5%,p = 0.76)均无显著差异。胎盘评估显示,血栓性变化或胎盘异质性没有组间差异(P分别>0.05),在调整扫描时的胎龄时,胎儿肺容量与胎盘异质性没有相关性(P>0.05):结论:通过核磁共振成像评估胎儿肺容积发现,在混合免疫盛行的大流行阶段,无并发症的 SARS-CoV-2 感染孕妇的肺部生长未受影响。这一发现与疫苗接种前母体感染阿尔法变异体后观察到的胎儿肺容积减少形成鲜明对比,可能反映了趋向性以及与免疫相关的影响:问题在非典型肺炎大流行期间,母体轻度感染 SARS-CoV-2 是否会影响胎儿肺部发育?24例受影响孕妇的胎儿肺容积与已公布的参考值或15例特定部位、未受COVID影响的对照孕妇的胎儿肺容积没有显著差异:临床相关性:在母体轻度感染 SARS-CoV-2 后,胎儿的肺活量在以Ω为主的阶段保持不变,这与之前的研究结果形成鲜明对比,在以α为主的大流行阶段,未接种疫苗的孕妇的胎儿肺活量减少。这些观察结果可能反映了趋向性以及与免疫相关的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Preserved prenatal lung growth assessed by fetal MRI in the omicron-dominated phase of the SARS-CoV-2 pandemic.

Preserved prenatal lung growth assessed by fetal MRI in the omicron-dominated phase of the SARS-CoV-2 pandemic.

Objectives: With SARS-CoV-2 evolving, disease severity and presentation have changed due to changes in mechanisms of entry and effector site as well as due to effects of vaccination- and/or infection-acquired immunity. We re-assessed fetal lung pathology in pregnancies with uncomplicated SARS-CoV-2 infections during the late, omicron-dominated pandemic phase to inform disease understanding and pregnancy consultation.

Methods: In this case-control study, fetal lung volumes were assessed by fetal MRI in 24 pregnancies affected by mild maternal SARS-CoV-2 infection during the omicron-dominated pandemic phase with prevailing immunity through vaccination and/or prior SARS-CoV-2 infection.

Results: Fetal lung volumes (normalized to estimated fetal weight) in 24 pregnancies (GA 33.3 ± 3.8, 12 female fetuses) following mild, uncomplicated SARS-CoV-2 infection did not differ significantly from both, published reference values (96.3% ± 22.5% of 50th percentile reference values, p = 0.43), or fetal lung volumes of a site-specific, non-COVID control group (n = 15, 94.2% ± 18.5%, p = 0.76). Placental assessment revealed no group differences in thrombotic changes or placental heterogeneity (p > 0.05, respectively), and fetal lung volume did not correlate with placental heterogeneity when adjusting for gestational age at scan (p > 0.05).

Conclusion: Assessment of fetal lung volume by MRI revealed unaffected lung growth in pregnancies affected by uncomplicated SARS-CoV-2 infection in the omicron-dominated pandemic phase in the presence of prevailing hybrid immunity. This finding contrasts sharply with the observed reduction in fetal lung volume following maternal alpha-variant infection in the pre-vaccination era and might reflect tropism- as well as immunity-related effects.

Key points: Question: Is fetal lung development affected by mild maternal SARS-CoV-2 infection during the omicron-dominated phase of the pandemic?

Findings: Fetal lung volume in 24 affected pregnancies did not differ significantly from published reference values or fetal lung volumes in 15 site-specific, non-COVID-affected control pregnancies.

Clinical relevance: Preserved fetal lung volume following mild maternal SARS-CoV-2 infection during the omicron-dominated phase contrasts with previous findings of reduced volume in unvaccinated pregnancies during the alpha-dominated pandemic phase. These observations might reflect tropism- as well as immunity-related effects.

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来源期刊
European Radiology
European Radiology 医学-核医学
CiteScore
11.60
自引率
8.50%
发文量
874
审稿时长
2-4 weeks
期刊介绍: European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.
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