COVID-19 infection in pregnancy: placental histopathology and perinatal outcomes. Case series analysis


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Abstract

Background: SARS-CoV-2 enters the cell, by interacting with angiotensin-converting enzyme 2 (ACE-2) receptors, and affects a wide range of tissues and organs. Thus, ACE-2 receptors are found in placental tissues, as conf irmed by the growing number of publications on the detection of virions in cotyledons. To date, the infectious involvement and localization of SARS- CoV-2 in placental tissue are described in a small series of cases and occur with a low frequency of 21 %. The current data show that pregnant women infected with SARS-CoV-2 have a high risk of miscarriage, preeclampsia, preterm birth, and perinatal mortality. In view of the fact that constant efforts are being undertaken to study the placentas of patients who have experienced COVID-19 in order to further predict the effect of SARS-CoV-2 on pregnant women and newborns. Case report: This investigation analyzes data on three clinical cases of the course and outcomes pregnancy in patients after having experienced the novel coronavirus infection in early gestation. It presents in detail the nature of histopathological changes in placental tissue after SARS-CoV-2 infection. Conclusion: Based on the presented clinical cases, by comparing the findings and changes in the fetoplacental complex, there is an idea of its possible damage in pregnant women who have experienced SARS-CoV-2 infection in the early stages of gestation, regardless of the severity of the disease, as demonstrated by these clinical cases.

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About the authors

Irina E. Zazerskaya

V.A. Almazov National Medical Research Center, Ministry of Health of Russia

Email: zazera@mail.ru
Dr. Med. Sci., Head of the Department of Obstetrics and Gynecology

Alina O. Godzoeva

V.A. Almazov National Medical Research Center, Ministry of Health of Russia

Email: odzoevaalina@mail.ru
MD, Post-graduate student, Department of Obstetrics and Gynecology, Institute of Medical education

Tatiana Yu. Roshchina

V.A. Almazov National Medical Research Center, Ministry of Health of Russia

MD, Pathologist of the Pathological Department

Olga A. Belyaeva

V.A. Almazov National Medical Research Center, Ministry of Health of Russia

Resident Physician, Department of Obstetrics and Gynecology

Nikita R. Ryabokon

V.A. Almazov National Medical Research Center, Ministry of Health of Russia

MD, PhD, Assistant, Department of Obstetrics and Gynecology, Institute of Medical Education

Olga A. Li

V.A. Almazov National Medical Research Center, Ministry of Health of Russia

MD, PhD, Associate Professor, Department of Obstetrics and Gynecology, Institute of Medical education, Deputy Chief Physician for Medical Work, Perinatal Center

Natalia A. Osipova

V.A. Almazov National Medical Research Center, Ministry of Health of Russia

MD, PhD, Head of Department of Pregnancy Pathology, Institute of Medical Education

Ksenia A. Rudenko

V.A. Almazov National Medical Research Center, Ministry of Health of Russia

Clinical Resident, Senior Laboratory Assistant, Department of Obstetrics and Gynecology

References

  1. COVID-19 Dashboard by the Center for Systems Science and Engineering COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at John Hopkins University. Availble at: https://coronavirus.jhu.edu/map.html
  2. https://covid19.who.int/
  3. Khan M, Adil S.F, Alkhathlan H.Z., Tahir M.N., Saif S., Khan M., Khan S.T. COVID-19: A global challenge with old history, epidemiology and progress so far. Molecules. 2020; 26(1): 39. https://dx.doi.org/10.3390/molecules26010039.
  4. Vousden N, Knight M. Lessons learned from the A (H1N1) influenza pandemic. Best Pract. Res. Clin. Obstet. Gynaecol. 2021; 76: 41-52. https://dx.doi.org/10.1016/j.bpobgyn.2020.08.006.
  5. Wong S.F, Chow K.M., Leung T.N., Ng W.F., Ng T.K., Shek C.C. et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am. J. Obstet. Gynecol. 2004; 191(1): 292-7. https://dx.doi.org/10.1016/j.ajog.2003.11.019.
  6. Синчихин С.П., Степанян Л.В., Мамиев О.Б. Новая коронавирусная инфекция и другие респираторные вирусные заболевания у беременных: клиническая лекция. Гинекология. 2020; 22(2): 6-16. e.6. [Sinchihin S.P., Stepanyan L.V., Mamiev O.B. New coronoviral infection and other respiratory-viral diseases in pregnant women: clinical lecture. Gynecology. 2020; 22(2): e.6. (in Russian)]. https://dx.doi.org/10.26442/20795696.2020.2.200129.
  7. Беженарь В.Ф., Зазерская И.Е., Беттихер О.А., Нестеров И.М., Баутин А.Е. Спорные вопросы акушерской тактики при ведении беременности и родоразрешении пациенток с новой коронавирусной инфекцией COVID-19. Акушерство и гинекология. 2020; 5: 13-21. [Bezhenar V.F., Zazerskaya I.E, Bettikher O.A., Nesterov I.M., Bautin A.E. Controversial issues in obstetric management of women with novel coronavirus disease covid-19 during pregnancy and childbirth. Obstetrics and Gynecology. 2020; 5: 13-21. (in Russian)]. https://dx.doi.org/10.18565/aig.2020.5.13-21.
  8. Saadaoui M, Kumar M, Al Khodor S. COVID-19 infection during pregnancy: risk of vertical transmission, fetal, and neonatal outcomes. J. Pers. Med. 2021;11(6): 483. https://dx.doi.org/10.3390/jpm11060483.
  9. Mark E.G., McAleese S., Golden W.C., Gilmore M.M., Sick-Samuels A., Curless M.S. et al. Coronavirus disease 2019 in pregnancy and outcomes among pregnant women and neonates: a literature review. Pediatr. Infect. Dis. J. 2021; 40(5): 473-8. https://dx.doi.org/10.1097/INF.0000000000003102.
  10. Koi H, Zhang J., Parry S. The mechanisms of placental viral infection. Ann. N. Y. Acad. Sci. 2001; 943: 148-56. https://dx.doi.org/10.1111/j.1749-6632.2001.tb03798.x.
  11. Algarroba G.N., Rekawek P., Vahanian S.A., Khullar P., Palaia T., Peltier M.R. et al. Visualization of severe acute respiratory syndrome coronavirus 2 invading the human placenta using electron microscopy. Am. J. Obstet. Gynecol. 2020; 223(2): 275-8. https://dx.doi.org/10.1016/j.ajog.2020.05.023.
  12. Tasca C., Rossi R.S., Corti S., Anelli G.M., Savasi V., Brunetti F. et al. Placental pathology in COVID-19 affected pregnant women: A prospective case-control study. Placenta. 2021; 110: 9-15. https://dx.doi.org/10.1016/j.placenta.2021.04.002.
  13. Schwartz D.A. An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes. Arch. Pathol. Lab. Med. 2020; 144(7): 799805. https://dx.doi.org/10.5858/arpa.2020-0901-SA.
  14. Menter T., Mertz K.D., Jiang S., Chen H., Monod C., Tzankov A. et al. Placental pathology findings during and after SARS-CoV-2 infection: features of villitis and malperfusion. Pathobiology. 2021; 88(1): 69-77. https://dx.doi.org/10.1159/000511324.
  15. Припутневич Т.В., Гордеев А.Б., Любасовская Л.А., Шабанова Н.Е. Новый коронавирус SARS-COV-2 и беременность: обзор литературы. Акушерство и гинекология. 2020; 5: 6-12. [Priputnevich T.V., Gordeev A.B., Lyubasovskaya L.A., Shabanova N.E. The novel coronavirus SARS-CoV-2 and pregnancy: literature review. Obstetrics and Gynecology. 2020; 5: 6-12. (in Russian)]. https://dx.doi.org/10.18565/aig.2020.5.6-12.
  16. Resta L., Vimercati A., Cazzato G., Mazzia G., Cicinelli E., Colagrande A. et al. SARS-CoV-2 and placenta: new insights and perspectives. Viruses. 2021; 13(5): 723. https://dx.doi.org/10.3390/v13050723.
  17. Della Gatta A.N., Rizzo R., Pilu G., Simonazzi G. Coronavirus disease 2019 during pregnancy: a systematic review of reported cases. Am. J. Obstet. Gynecol. 2020; 223(1): 36-41. https://dx.doi.org/10.1016/j.ajog.2020.04.013.
  18. Leal C.R.V., Maciel R.A.M., Corrêa Júnior M.D. SARS-CoV-2 infection and placental pathology. infecção por SARS-CoV-2 e patologia placentária. Rev. Bras. Ginecol. Obstet. 2021; 43(6): 474-9. https://dx.doi.org/10.1055/s-0041-1730291.
  19. Chen H., Guo J., Wang C., Luo F., Yu X., Zhang W. et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020; 395(10226): 809-15. https://dx.doi.org/10.1016/S0140-6736(20)30360-3.
  20. Di Mascio D., Khalil A., Saccone G., Rizzo G., Buca D., Liberati M. et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. Am. J. Obstet. Gynecol. MFM. 2020; 2(2): 100107. https://dx.doi.org/10.1016/j.ajogmf.2020.100107.
  21. Белокриницкая Т.Е., Артымук Н.В., Филиппов О.С., Фролова Н.И. Клиническое течение, материнские и перинатальные исходы новой коронавирусной инфекции COVID-19 у беременных Сибири и Дальнего Востока. Акушерство и гинекология. 2021; 2: 48-54. [Belokrinitskaya T.E., Artymuk N.V., Filippov O.S., Frolova N.I. Clinical course, maternal and perinatal outcomes of 2019 novel coronavirus infectious disease (COVID-19) in pregnant women in Siberia and Far East. Obstetrics and Gynecology. 2021; 2: 48-54. (in Russian)]. https://dx.doi.org/10.18565/aig.2021.2.48-54.
  22. Bhatraju P.K., Ghassemieh B.J., Nichols M., Kim R., Jerome K.R., Nalla A.K. et al. Covid-19 in critically Ill patients in the Seattle Region - case series. N. Engl. J. Med. 2020; 382(21): 2012-22. https://dx.doi.org/10.1056/NEJMoa2004500.
  23. Беженарь В.Ф., Зазерская И.Е., Кучерявенко А.Н., Мещанинова С.Г., Мазурок В.А., Ржеутская Р.Е., Годзоева А.О. Случай стремительного течения новой коронавирусной инфекции COVID-19 у беременной. Акушерство и гинекология. 2021; 1: 186-93. [Bezhenar V.F., Zazerskaya I.E., Kucheryavenko A.N., Meshchyaninova S.G., Mazurok V.A., Rzheutskaya R.E., Godzoeva A.O. A case of the rapid course of the novel coronavirus infection (COVID-19) in a pregnant woman. Obstetrics and Gynecology. 2021; 1: 186-93 (in Russian)]. https://dx.doi.org/10.18565/aig.2021.1.186-193.
  24. Baergen R.N., Heller D.S. Placental pathology in covid-19 positive mothers: preliminary findings. Pediatr. Dev. Pathol. 2020; 23(3): 177-80. https://dx.doi.org/10.1177/1093526620925569.
  25. Girolamo R.D., Khalil A., Alameddine S., DAngelo E., Galliani C., Matarrelli B. et al. Placental histopathology after SARS-CoV-2 infection in pregnancy: a systematic review and meta-analysis. Am. J. Obstet. Gynecol. MFM. 2021; 3(6): 100468. https://dx.doi.org/10.1016/j.ajogmf.2021.100468.
  26. Щеголев А.И., Туманова У.Н., Серов В.Н. Поражения плаценты у беременных с SARS-CoV-2-инфекцией. Акушерство и гинекология. 2020; 12: 44-52. [Shchegolev A.I., Tumanova U.N., Serov V.N. Placental lesions in pregnant women with SARS-CoV-2 infection. Obstetrics and Gynecology. 2020; 12: 44-52 (in Russian)]. https://dx.doi.org/10.18565/aig.2020.12.44-52.

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