Investigation of 8-isoprostane and 12-hydroxyeicosatetraenoic acid in peripheral blood for predicting preterm birth in women with COVID-19

Introduction. According to current research, the novel coronavirus infection (COVID-19) has an adverse impact on pregnancy and its outcomes. However, data on the causes of preterm birth in women who had COVID-19 during the current pregnancy remain insufficient. Aim. To determine serum concentrations of 8-isoprostane and 12-hydroxyeicosatetraenoic acid (12-HETE) as predictors of preterm birth in pregnant women with COVID-19. Materials and methods. This prospective comparative study involved three groups of pregnant women. The main group (n = 42) included patients diagnosed with moderately severe COVID-19 (community-acquired pneumonia) and threatened preterm labor. The comparison group (n = 51) comprised patients with moderately severe COVID-19 (community-acquired pneumonia) but with-out threatened preterm labor. The control group (n = 35) consisted of patients without threatened preterm labor and no history of COVID-19, either previously or at the time of examination. Diagnosis was confirmed by detecting SARS-CoV-2 RNA in oropharyngeal and nasopharyngeal swabs by polymerase chain reaction (PCR), as well as current clinical and radiological criteria of viral lung involvement using specialized imaging methods (as indicated). Serum 8-isoprostane was measured by enzyme-linked immunosorbent assay (ELISA) with Cayman Chemical (USA) reagent kits, and 12-HETE was determined using Enzo Life Sciences (USA) reagent kits. Results. In the main group, the median serum 8-isoprostane concentration was 381.85 (375.43–388.30) pg/mL and 12-HETE was 8.73 (8.48–8.81) ng/mL – both higher than in the comparison group (200.00 (185.33–210.99) pg/mL and 2.99 (2.31–3.41) ng/mL) and the control group (178.20 (173.35–184.00) pg/mL, p< 0.001; 2.22 (1.96–2.35) ng/mL, p< 0.001, respectively). Based on discriminant analysis, a mathematical model was developed to calculate a prognostic risk index for preterm birth (PRIPB): PRIPB = -7.607 + 0.022 × 8-isoprostane + 0.309 × 12-HETE. The threshold PRIPB value was 3.244. A PRIPB ≥3.244 indicates a high risk of preterm birth, meaning higher PRIPB values are directly proportional to the risk of preterm birth. A PRIPB < 3.244 suggests no risk of preterm birth. Among 38 women in the main group, the predicted outcome matched the actual result in 90 % of cases. Conclusion. For the first time, an elevated level of 12-HETE was identified alongside an increase in 8-isoprostane in women with COVID-19 during the third trimester of pregnancy. In patients with moderately severe COVID-19, serum concentrations of 8-isoprostane and 12-HETE appear to be markers of preterm birth risk.