Histopathological and clinical analysis of COVID-19-infected placentas

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2024年4月7日

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Aline C. M. Nascimento,
Elyzabeth Avvad-Portari,
Marcelo Meuser-Batista,
Thayana Camara Conde,
Renato Augusto Moreira de Sá,
Natalia Salomao,
Kissila Rabelo,
Erica Stein Ciasca,
Michelle de Oliveira Brendolin,
Zilton Vasconcelos,
Patricia Brasil,
Maria Elisabeth Moreira

摘要

Background

The impact of COVID-19 pandemic in pregnant patients is an important emerging topic. Evidence of transplacental transmission and typical histopathological alterations in the placenta are controversial in the literature.

Methods

This was a prospective observational cohort multicenter study in which we selected 23 placentas of 21 patients that showed detection of SARS-CoV-2 RNA by RT-PCR in the placenta tissue and described both morphological and clinical characteristics. Immunohistochemistry was performed to localize the virus in the specimens.

Results

Most of the patients were asymptomatic (61.9%) and preterm delivery was observed in 8 patients (34.7%). In relation to histopathological features, all the placentas showed evidence of maternal vascular malperfusion, as well as some degree of villitis with a high frequency of high grade placentitis (73.9%) and chronic and/or acute intervillositis (82.6%). We observed immunopositivity for SARS-CoV-2 antibody in 69.5% of the cases, notably in the syncytiotrophoblast.

Conclusions

We reported histopathological features of placentas with viral detection in the tissue, thus providing evidence that SARS-CoV-2 can affect the placenta, although maternal and neonatal clinical outcome is usually mild.