Fetal and placental infection with SARS-CoV-2 in early pregnancy #MMPMID33764543
Valdespino-Vazquez MY; Helguera-Repetto CA; Leon-Juarez M; Villavicencio-Carrisoza O; Flores-Pliego A; Moreno-Verduzco ER; Diaz-Perez DL; Villegas-Mota I; Carrasco-Ramirez E; Lopez-Martinez IE; Giraldo-Gomez DM; Lira R; Yocupicio-Monroy M; Rodriguez-Bosch M; Sevilla-Reyes EE; Cortes-Bonilla M; Acevedo-Gallegos S; Merchant-Larios H; Cardona-Perez JA; Irles C
J Med Virol 2021[Jul]; 93 (7): 4480-4487 PMID33764543show ga
To date, mother-to-fetus transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the coronavirus disease 2019 (COVID-19) pandemic, remains controversial. Although placental COVID-19 infection has been documented in some cases during the second- and third-trimesters, no reports are available for the first trimester of pregnancy, and no SARS-CoV-2 protein has been found in fetal tissues. We studied the placenta and fetal organs from an early pregnancy miscarriage in a COVID-19 maternal infection by immunohistochemical, reverse transcription quantitative real-time polymerase chain reaction, immunofluorescence, and electron microscopy methods. SARS-CoV-2 nucleocapsid protein, viral RNA, and particles consistent with coronavirus were found in the placenta and fetal tissues, accompanied by RNA replication revealed by double-stranded RNA (dsRNA) positive immunostain. Prominent damage of the placenta and fetal organs were associated with a hyperinflammatory process identified by histological examination and immunohistochemistry. The findings provided in this study document that congenital SARS-CoV-2 infection is possible during the first trimester of pregnancy and that fetal organs, such as lung and kidney, are targets for coronavirus. The infection and multi-organic fetal inflammation produced by SARS-CoV-2 during early pregnancy should alert clinicians in the assessment and management of pregnant women for possible fetal consequences and adverse perinatal outcomes.
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J+Med+Virol 2021 ; 93 (7): 4480-4487
