Role of serum metalloproteinases 2 and 9 to assess the severity of COVID-19 in pregnant women: a prospective cross-sectional study

Abstract

Objectives: To investigate the relationship between blood matrix metalloproteinases -2 and -9 levels and disease severity in pregnant women with COVID-19 infection. Material and methods: A prospective cohort study was conducted at the Kanuni Sultan Suleyman Education and Research Hospital in Istanbul, Turkey. We measured serum MMPs-2 and-9 levels of the healthy pregnant controls and pregnant women with COVID-19 and sought to assess the status of these MMPs in pregnant women with COVID-19, especially in women with a severe form of COVID-19 as diagnosed by abnormal computed tomography (CT) findings in addition to severe clinical and laboratory findings. Results: Of the healthy pregnant controls and pregnant women with COVID-19, the serum MMP-2 levels were comparable, but the MMP-9 level was lower in the pregnant women with COVID-19. Although the serum MMP2 level was somewhat lower in the women with COVID-19 with abnormal CT findings. The serum MMP-9 level of pregnant women with COVID-19 with abnormal CT was meaningfully lower. Conclusions: In the pregnant women, COVID-19 decreases the serum MMP-9 but does not change the serum MMP-2. COVID-19 with abnormal CT findings causes minimal decrease in the serum MMP-2 but decreases the serum MMP-9 with abnormal CT findings. Considering the study variables of current study, the probability of LMWH-related MMP alterations needs to be a study topic to clarify the possible contribution of LMWH to the status of serum MMPs in pregnant women with COVİD-19 especially in the women with COVID-19 with abnormal CT findings.