The role of 8-isoprostane and 15-hydroxyeicosatetraenoic acid in the pathogenesis of early pregnancy loss in COVID-19

In recent years, the role of oxidative stress and oxylipins in the pathogenesis of various diseases, including those affecting the female reproductive system and pregnancy complications, has been actively discussed. However, the role of 8-isoprostane and 15-hydroxyeicosatetraenoic acid (15-HETE) in the pathogenesis of pregnancy loss during COVID-19 has not been definitively established. Aim. To analyze the levels of 8-isoprostane and 15-HETE in peripheral blood and assess their prognostic significance in early pregnancy loss during COVID-19. Materials and methods. The study involved the main group of 48 women with a confirmed diagnosis of moderate COVID-19 (community-acquired pneumonia) in the first trimester (6–9 weeks). The control group consisted of 45 pregnant women who had not had COVID-19 previously and at the time of examination. The levels of 8-isoprostane in peripheral venous blood were measured using Cayman Chemical (USA) reagent kits, and 15-HETE was measured using Enzo 15(S)-HETE ELISA kits (USA) through an enzyme-linked immunoassay (ELISA). Results. Patients with moderate COVID-19 exhibited a significant increase in 8-isoprostane levels to 379.27±9.04 pg/mL (p<0.001) and 15-HETE to 3.66±0.12 ng/mL (p<0.001), compared to the control group values of 178.3±1.40 pg/mL and 1.57±0.06 ng/mL, respectively. To analyze the selected evaluation criteria, a discriminant function with a probability of differences of at least 95% was determined by deriving a discriminant equation, which for this study was as follows: PI = -59.765 + 0.261 × 8-isoprostane + 4.798 × 15-HETE, where PI is the prognostic index with a threshold value of 3.027. A PI equal to or greater than 3.027 indicated a risk of pregnancy loss in women with moderate COVID-19, while a PI lower than this threshold predicted a normal course of the first trimester of gestation. Conclusion. These findings suggest that elevated levels of 8-isoprostane and 15-HETE in women with moderate COVID-19 are pathologically significant in the development of early pregnancy loss.