SARS–CoV-2 infection of the placenta

BACKGROUND. The effects of the novel coronavirus disease 2019 (COVID-19) in pregnancy remain relatively unknown. We present a case of second trimester pregnancy with symptomatic COVID-19 complicated by severe preeclampsia and placental abruption. METHODS. We analyzed the placenta for the presence of...

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Bibliographic Details
Published in:The Journal of clinical investigation 2020-09, Vol.130 (9), p.4947-4953
Main Authors: Hosier, Hillary, Farhadian, Shelli F, Morotti, Raffaella A, Deshmukh, Uma, Lu-Culligan, Alice, Campbell, Katherine H, Yasumoto, Yuki, Vogels, Chantal B F, Casanovas-Massana, Arnau, Vijayakumar, Pavithra, Geng, Bertie, Odio, Camila D, Fournier, John, Brito, Anderson F, Fauver, Joseph R, Liu, Feimei, Alpert, Tara, Tal, Reshef, Szigeti-Buck, Klara, Perincheri, Sudhir, Larsen, Christopher, Gariepy, Aileen M, Aguilar, Gabriela, Fardelmann, Kristen L, Harigopal, Malini, Taylor, Hugh S, Pettker, Christian M, Wyllie, Anne L, Dela Cruz, Charles, Ring, Aaron M, Grubaugh, Nathan D, Ko, Albert I, Horvath, Tamas L, Iwasaki, Akiko, Reddy, Uma M, Lipkind, Heather S
Format: Article
Language:English
Subjects:
Antibody response
Biomedical research
Coronaviridae
Coronaviruses
COVID-19
Electron microscopy
Fetuses
Macrophages
Morbidity
Placenta
Pre-eclampsia
Preeclampsia
Pregnancy
Severe acute respiratory syndrome coronavirus 2
Vascular diseases
Viral infections
Womens health
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Summary:BACKGROUND. The effects of the novel coronavirus disease 2019 (COVID-19) in pregnancy remain relatively unknown. We present a case of second trimester pregnancy with symptomatic COVID-19 complicated by severe preeclampsia and placental abruption. METHODS. We analyzed the placenta for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through molecular and immunohistochemical assays and by and electron microscopy and measured the maternal antibody response in the blood to this infection. RESULTS. SARS-CoV-2 localized predominantly to syncytiotrophoblast cells at the materno-fetal interface of the placenta. Histological examination of the placenta revealed a dense macrophage infiltrate, but no evidence for the vasculopathy typically associated with preeclampsia. CONCLUSION. This case demonstrates SARS-CoV-2 invasion of the placenta, highlighting the potential for severe morbidity among pregnant women with COVID-19. FUNDING. Beatrice Kleinberg Neuwirth Fund and Fast Grant Emergent Ventures funding from the Mercatus Center at George Mason University. The funding bodies did not have roles in the design of the study or data collection, analysis, and interpretation and played no role in writing the manuscript.
ISSN:0021-9738
1558-8238
DOI:10.1172/JCn39569