Serum phospholipid and selected oxylipin levels in second-trimester pregnant women with COVID-19

Background. The inflammatory response in coronavirus disease 2019 (COVID-19) markedly alters lipid metabolism. However, the phospholipid and oxylipin profile of pregnant women with COVID-19, stratified by disease severity, remains insufficiently studied.
The aim. To assess second-trimester serum levels of phospholipids, arachidonic acid, and the oxylipins 12- and 15-hydroxyeicosatetraenoic acids (12-HETE, 15-HETE) in women with COVID-19 according to clinical severity.
Methods. The study enrolled 88 pregnant women at 14–16 weeks of gestation with confirmed COVID-19. Patients with moderate disease (n = 42) formed subgroup 1; those with mild disease (n = 46), subgroup 2. A control group comprised 40 second-trimester pregnant women without COVID-19. Serum phospholipids were quantified by thin-layer chromatography; 12-HETE and 15-HETE by enzyme-linked immunosorbent assay; and arachidonic acid by gas–liquid chromatography.
Results. Compared with the mild-disease subgroup, women with moderate COVID-19 and control group showed significantly higher serum concentrations of sphingomyelin, lysophosphatidylcholine, arachidonic acid, 12-HETE, and 15-HETE, and lower levels of phosphatidylcholine and phosphatidylethanolamine (p < 0.001 for all comparisons).
Conclusion. The development of COVID-19 in second-trimester pregnant women is associated with severity-dependent alterations in serum phospholipids, arachidonic acid, and oxylipins. These changes may reflect the intensity of pulmonary inflammation and underscore the need to optimise therapeutic approaches in this patient population.

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