A Totally 200 pregnant women were included in this study, the number of pregnants with COVID-19 infection were 100 and the other 100 patients were also healthy pregnant women. Each group was divided into trimesters: Respectively Thirty four, 33 and 33 patients were in the first, second and third trimesters of pregnancy in the COVID-19 group. On the other hand, 33, 32 and 35 patients were in the first, second and third trimesters of pregnancy in the control group, respectively.
In the first trimester, serum zinc level was found significantly lower in pregnants with COVID-19 compared to control (67,19 ± 13,87 vs 55,97 ± 16,57, p: 0,004). However serum copper level was higher in patient group than in control ones (86,56 ± 19,70 vs 100,4 ± 19,73, p:0,006) that cause important difference in Zn/Cu ration between groups (0,811 ± 0,219 vs 0,563 ± 0,144, p<0,0001). Serum Magnesium level was also significanly higher in COVID-19 group compared to control (1,557 ± 0,211 vs 1,848 ±0,335, p<0,0001) (Fig 1).
It was observed that zinc and copper levels were different between patient and control group during second trimester. Serum zinc level was observed lower level in pregnants with COVID-19 than control similar to first trimester (52,84 ± 12,57 vs 46,38 ± 12,66, p:0,05). Although serum copper level was higher in patients in first trimester, it was seen that copper level was decreased in SARS-CoV-2(+) group compared to control (157,2 ± 22,16 vs 132,6 ± 26,66, p:0,0003). Zn/Cu ratio (0,339 ±0,081 vs 0,351 ± 0,077, p: 0,529) and magnesium level (1,759 ± 0,195 vs 1,817 ± 0,387, p: 0,467) wasn’t found different between groups in second trimester.
Third trimester data showed that serum zinc level was lower in COVID-19 group than controls (54,37 ± 13,57 vs 46,82 ± 12,51, p:0,02). Serum copper level was found higher again in COVID-19 group compared to control similar to first trimester results (152,8 ± 45,27 vs 180,5 ± 40,56, p:0,008). Zn/Cu ratio was found significantly lower in pregnants with COVID-19 infection compared to control (0,411 ± 0,129 vs 0,276 ± 0,103, p<0,0001). Serum magnesium level was found significantly higher in COVID-19 group compared to healthy pregnants (1,947 ± 0,657 vs 2,767 ± 0,394, p<0,0001).
In the first trimester, zinc concentration significantly correlated with IL-6 level (p:0.003, r:-0.357)and ESR (p:0.01, r:-0,312). Copper concentration showed correlation with WBC (p:0.03, r:-0.263), procalcitonine (p:0.03, r:0.262), ALT (p:0.02, r:0.277) and AST (p:0.01, r:0.298) levels. There were correlations between Zn/Cu Ratio and IL-6 (p:0.01, r:-0.306), lymphocyte (p:0.01, r:-0.217),ESR (p:0.0009, r:-0.404), procalcitonin (p:0.03, r:-0.270). Magnesium concentration of pregnants was correlated with WBC (p:0,0003, r:-0,435), Neutrophil (p:0,002, r:-0,366), Lymphocyte (0,002, r:-0,378), ESR (p:0,001, r:0,384), hemotocrit (p:0.02, r:-0.276) and creatinine (p:0,04, r:-0,250).
Second trimester data of pregnant women showed that serum zinc level correlated with procalcitonin (p:0.04, r:-0.254) and BUN (p:0.02, r:0.279). Copper level was correlated with IL-6 (p:0.01, r:-0.312), WBC (p:0.02, r:0.295), Neutrophil (p:0.03, r:0.264), Lymphocyte (p:0.01, r:0.308), CRP (p:0.008, r:-0.334), procalcitonin (p:0.01, r:-0.327), ferritin (p:0.008, r:-0.334) , hemoglobin (p:0.008, r:0.335), hematocrit (p: 0.008, r:0.333), BUN (p:0.01, r:0.298), creatinine (p:0.03, r:0.271) .
Third trimester correlation data showed that zinc level correlated with CRP (p:0.004, r:-0.360). Copper level was found to be correlated with Lymphocyte (p:0.01, r:0.355), ALT (p:0.02, r:0.278) . Zn/Cu ratio was correlated with IL-6 (p:0.01, r:-0.308), CRP (p:0.004, r:-0.463) levels. Magnesium concentration correlated with Lymphocyte (p:0.04, r:-0.254), CRP (p:0.03, r:0.271), ferritin (p:0.03, r:-0.272) and creatinine (p:0.01, r:0.306) status.