Situs inversus has lately gotten a lot of attention in the Chinese media. When a child is born with this uncommon congenital abnormality, their organs swap places with those of a healthy individual. The increasing occurrence of ultrasonographically diagnosed fetal situs inversus, both totalis (with dextrocardia) and partial (with levocardia), is intriguing.
This surge in diagnoses did not occur until China’s “zero-Covid” limitations were lifted. A team of specialists studied the prevalence of fetal situs inversus from January 2014 to July 2023. They analyzed clinical data from two maternity hospitals in different parts of China. The unexpected discovery was based on normal ultrasound exams conducted between 20 and 24 weeks of pregnancy.
There were more than four times as many cases of situs inversus in the first seven months of 2023 than there were in the same period on average between 2014 and 2022. The highest number of diagnoses occurred in April 2023 and remained constant until June of that year. Between January 2023 and July 2023, researchers discovered 56 cases of situs inversus totalis and four cases of situs inversus partialis.
After China abandoned its “zero-Covid” policy, the number of cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) surged. This spike began in early December 2022, peaked around December 20, 2022, and began to fade in early February 2023, affecting an estimated 82% of the population. Â
The reported rise in situs inversus instances, together with the date of the COVID-19 pandemic, is insufficient to draw clear conclusions about causality. Because of this condition, more research into the possible links between SARS-CoV-2 infection and fetal situs inversus is required. SARS-CoV-2 may have a role in the genesis of situs inversus, a congenital disease linked with incorrect morphogen distribution and cilia malfunction in the early stages of pregnancy, according to some studies.
The study of the relationship between visceral lateralization and fetal infection, especially in the first trimester, is continuing. The idea that SARS-CoV-2-induced inflammatory responses in the mother may alter visceral lateralization via routes involving the left-right organizer is also being investigated.Â
More investigation into the relationship between situs inversus, environmental variables, and primary ciliary dyskinesia-related gene anomalies is needed. Despite an increase in the number of diagnoses of situs inversus over the study period, this illness is still very rare.Â
The rise of fetal situs inversus instances in China, and their possible link to the COVID-19 pandemic, underline the importance of continued medical investigation and care in monitoring congenital illnesses. The findings of this study point to the possibility of a link, which, if confirmed, might have substantial ramifications for mother health and prenatal care. Â
Journal ReferenceÂ
Wang, Y., Guo, Z., Ye, B., Liu, L., Mao, X., Luo, Y., … Bian, S. (2023). New England Journal of Medicine, 389(18), 1722–1724. doi:10.1056/nejmc2309215Â
