SARS–CoV-2 infection of the placenta

• Published in: The Journal of clinical investigation Vol. 130; no. 9; pp. 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., Cruz, Charles Dela, Ring, Aaron M., Grubaugh, Nathan D., Ko, Albert I., Horvath, Tamas L., Iwasaki, Akiko, Reddy, Uma M., Lipkind, Heather S.
• Format: Journal Article
• Language: English
• Published: United States American Society for Clinical Investigation 01.09.2020
• Subjects: Abortion, Therapeutic; Abruptio Placentae - etiology; Abruptio Placentae - pathology; Abruptio Placentae - virology; Adult; Analysis; Betacoronavirus - genetics; Betacoronavirus - isolation & purification; Betacoronavirus - pathogenicity; Clinical Medicine; Coronavirus Infections - complications; Coronavirus Infections - pathology; Coronavirus Infections - virology; Coronaviruses; COVID-19; Female; Health aspects; Humans; Microscopy, Electron, Transmission; Neonatology; Pandemics; Phylogeny; Placenta - pathology; Placenta - virology; Pneumonia, Viral - complications; Pneumonia, Viral - pathology; Pneumonia, Viral - virology; Pre-Eclampsia - etiology; Pre-Eclampsia - pathology; Pre-Eclampsia - virology; Pregnancy; Pregnancy Complications, Infectious - etiology; Pregnancy Complications, Infectious - pathology; Pregnancy Complications, Infectious - virology; Pregnancy Trimester, Second; Pregnant women; RNA, Viral - genetics; RNA, Viral - isolation & purification; SARS-CoV-2; Severe acute respiratory syndrome; Tranexamic acid; Venture capital companies; Viral Load; Connecticut; COVID-19; Molecular pathology; Reproductive Biology
• ISSN: 0021-9738; 1558-8238; 1558-8238
• DOI: 10.1172/JCI139569

BACKGROUNDThe 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.METHODSWe 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.RESULTSSARS-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.CONCLUSIONThis case demonstrates SARS-CoV-2 invasion of the placenta, highlighting the potential for severe morbidity among pregnant women with COVID-19.FUNDINGBeatrice 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.