|Title||Histologic and Immunohistochemical Evaluation of 65 Placentas From Women With Polymerase Chain Reaction-Proven Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection.|
|Publication Type||Journal Article|
|Year of Publication||2021|
|Authors||Levitan D, London V, McLaren RA, Mann JDavid, Cheng K, Silver M, Balhotra KSingh, McCalla S, Loukeris K|
|Journal||Arch Pathol Lab Med|
|Date Published||2021 Jun 01|
|Keywords||Adult, Case-Control Studies, COVID-19, COVID-19 Nucleic Acid Testing, Female, Humans, Immunohistochemistry, Infectious Disease Transmission, Vertical, Middle Aged, Placenta, Pregnancy, Pregnancy Complications, Infectious, RNA, Viral, SARS-CoV-2|
CONTEXT.—: Coronavirus disease 2019 (COVID-19) has been shown to have effects outside of the respiratory system. Placental pathology in the setting of maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains a topic of great interest because earlier studies have shown mixed results.
OBJECTIVE.—: To ascertain whether maternal SARS-CoV-2 infection is associated with any specific placental histopathology, and to evaluate the virus's propensity for direct placental involvement.
DESIGN.—: Placentas from 65 women with polymerase chain reaction-proven SARS-CoV-2 infection underwent histologic evaluation using Amsterdam consensus group criteria and terminology. Another 85 placentas from women without SARS-CoV-2 constituted the negative control group. A total of 64 of the placentas from the SARS-CoV-2-positive group underwent immunohistochemical staining for SARS-CoV-2 nucleocapsid protein.
RESULTS.—: Pathologic findings were divided into maternal vascular malperfusion, fetal vascular malperfusion, chronic inflammatory lesions, amniotic fluid infection sequence, increased perivillous fibrin, intervillous thrombi, increased subchorionic fibrin, meconium-laden macrophages (M-LMs) within fetal membranes, and chorangiosis. There was no statistically significant difference in prevalence of any specific placental histopathology between the SARS-CoV-2-positive and SARS-CoV-2-negative groups. There was no immunohistochemical evidence of SARS-CoV-2 virus in any of the 64 placentas that underwent staining for viral nucleocapsid protein.
CONCLUSIONS.—: Our study results and a literature review suggest that there is no characteristic histopathology in most placentas from women with SARS-CoV-2 infection. Likewise, direct placental involvement by SARS-CoV-2 is a rare event.
|Alternate Journal||Arch Pathol Lab Med|
Daniel Levitan, M.D.