Inflammatory-Metal Profile as a Hallmark for COVID-19 Severity During Pregnancy

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Biochemistry

Background:

• Pregnancy increases susceptibility to infections.
• Limited data exists on SARS-CoV-2 effects in pregnant individuals.
• COVID-19 is associated with altered serum metals and inflammation, but their interplay in pregnancy is unclear.

Purpose of the Study:

• To investigate correlations between serum metal ions and inflammatory markers in pregnant women with COVID-19.
• To assess how disease severity impacts these concentrations and relationships.

Main Methods:

• Analysis of serum metal ion concentrations (magnesium, copper, calcium, iron, zinc, sodium, potassium) in third-trimester pregnant women.
• Measurement of pro-inflammatory (IL-6, TNF-α, IL-8, IL-1α) and anti-inflammatory (IL-4) cytokines, and IP-10 chemokine.
• Correlation analysis between metal ions and cytokines based on COVID-19 severity.

Main Results:

• Severe COVID-19 in pregnancy showed increased magnesium, copper, calcium, and decreased iron, zinc, sodium. Potassium levels were unchanged.
• Elevated pro-inflammatory cytokines (IL-6, TNF-α, IL-8, IL-1α), IL-4, and IP-10 were observed in severe cases.
• Significant negative correlations found between iron/magnesium and zinc/IL-6; positive correlation between copper/IP-10 in severe disease.

Conclusions:

• SARS-CoV-2 infection during pregnancy leads to coordinated alterations in serum metal ions and inflammatory markers.
• These changes suggest underlying pathophysiological interactions specific to COVID-19 in pregnancy.