Prognostic value of TNFR1 and CD68 markers in as- sessing the risk of placental insufficiency in pregnant women with COVID-19

   Introduction. Despite well-documented adverse effects of COVID-19 on gestation and perinatal outcomes, the criteria for placental insufficiency (PI) development in this patient population remain incompletely understood, and existing data are fragmented.

   Aim. To determine the prognostic value of CD68 and tumor necrosis factor receptor 1 (TNFR1) expression on peripheral blood monocytes for predicting placental insufficiency in pregnant women with COVID- 19.

   Materials and methods. A total of 114 pregnant women were enrolled and divided into three groups: the main group (n = 37) – moderate-severe COVID-19 with PI; the comparison group (n = 42) – moderate-severe COVID-19 without PI; and the control group (n = 35) – healthy pregnant women without COVID-19 or PI. CD68 and TNFR1 expression on peripheral blood monocytes was assessed by flow cytometry.

   Results. Pregnant women in the main group demonstrated significantly higher CD68 and TNFR1 expression on monocytes compared to both the comparison and control groups (p < 0.001). Threshold values of CD68 ≥ 25.0 % and TNFR1 ≥ 79.0 % were identified as predictive markers for PI development in the third trimester among patients with COVID-19.

   Conclusion. The strong association between these immunological markers and PI supports their use as additional diagnostic criteria for evaluating the risk of placental dysfunction in pregnant women infected with SARS-CoV-2.

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