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    Role of serum metalloproteinases 2 and 9 to assess the severity of COVID-19 in pregnant women: a prospective cross-sectional study
    (Via Medica, 2023) Can, Esra; Bakirci, Isil Turan; Bulut, Huri; Guler, Filiz Yarsilikal; Cetin, Ali
    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 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 COVID-19 especially in the women with COVID-19 with abnormal CT findings.
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    Serum neutrophil gelatinase-associated lipocalin concentrations are significantly associated with the severity of COVID-19 in pregnant patients
    (Saudimedj, 2022) Can, Esra; Ölmez, Fatma; Bulut, Huri; Oğlak, Süleyman Cemil
    Objectives: To evaluate serum neutrophil gelatinaseassociated lipocalin (NGAL) concentrations of pregnant women complicated with coronavirus disease 2019 (COVID-19) and investigate its diagnostic value for the severity of COVID-19. Methods: Of the 46 pregnant women with COVID-19 included in the study, we further classified these women into 2 subgroups: the non-severe COVID-19 group (n=25) and the severe COVID-19 group (n=21). Results: Neutrophil gelatinase-associated lipocalin plasma concentrations were significantly higher in pregnant women complicated with severe COVID-19 (90 [53.1-207.7] ng/ml) compared to those from Original Article pregnant women with non-severe COVID-19 (51.8 [39.6-70.3] ng/ml) and healthy pregnant women (44.3 [32.2-54.1] ng/ml, p<0.001). Also, at a cutoff value of 72 ng/ml, NGAL predicted severe COVID-19 with a sensitivity rate of 57% and a specificity rate of 84%. Serum NGAL level (adjusted hazard ratio [aHR]=1.020, 95% confidence interval [CI]= [1.006-1.035], p=0.007), and D-dimer level (aHR=2.371, 95% CI= [1.085-5.181], p=0.030) were the variables that were revealed to be significantly associated with the disease severity. Conclusion: We demonstrated that NGAL was highly associated with COVID-19 severity. We consider that NGAL might be a useful biomarker to diagnose the disease severity in patients with COVID-19.