@article { author = {Norooznezhad, Amir and Shamshirsaz, Alireza and Hantoushzadeh, Sedigheh}, title = {Labor Could Increase Systemic Inflammation and Cause or Deteriorate Cytokine Storm in COVID-19}, journal = {Iranian Journal of Immunology}, volume = {19}, number = {3}, pages = {330-336}, year = {2022}, publisher = {Shiraz Institute for Cancer Research}, issn = {1735-1383}, eissn = {1735-367X}, doi = {10.22034/iji.2022.93951.2267}, abstract = {Pregnant women with coronavirus disease 2019 (COVID-19) have a higher risk of morbidity and mortality compared with the general population. Possible pathways are: I) in patients with COVID-19, cytokine storm defined as the excess release of pro-inflammatory cytokines such as interleukin 1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) has been associated with morbidities and an even higher rate of mortality. II) Labor, despite being a term/preterm, has an inflammatory nature, although, inflammation is more prominent in preterm delivery. During labor, different pro-inflammatory cytokines such as IL-1β, IL-6, and TNF-α are involved which as mentioned, all are crucial role players in the cytokine storm. III) Tissue injury, and during labor, (especially cesarean section) is shown to cause inflammation via pro-inflammatory cytokines release including those involved in the cytokine storm through the activation of nuclear factor κB (NFκB). IV) post-partum hemorrhage with a notable amount of blood loss which can cause significant hypoxemia. In this condition, hypoxia-inducible factor 1α which has a cross-talk with NFκB, leads to the expression of IL-1β, IL-6, and TNF-α as both angiogenic and pro-inflammatory factors. Considering all the mentioned issues and pathways, we suggest that clinicians be careful about the escalation of the inflammatory status in their pregnant COVID-19 patients during/following labor.}, keywords = {COVID-19,Cytokine storm,Inflammation,Labor,Pregnancy}, url = {https://iji.sums.ac.ir/article_48692.html}, eprint = {https://iji.sums.ac.ir/article_48692_a8ef6a790f8b9cece8fa6ffaaf3f0298.pdf} }