SARS-CoV-2 infection of the placenta

  1. Hillary Hosier
  2. Shelli Farhadian
  3. Raffaella A. Morotti
  4. Uma Deshmukh
  5. Alice Lu-Culligan
  6. Katherine H. Campbell
  7. Yuki Yasumoto
  8. Chantal B.F. Vogels
  9. Arnau Casanovas-Massana
  10. Pavithra Vijayakumar
  11. Bertie Geng
  12. Camila D. Odio
  13. John Fournier
  14. Anderson F. Brito
  15. Joseph R. Fauver
  16. Feimei Liu
  17. Tara Alpert
  18. Reshef Tal
  19. Klara Szigeti-Buck
  20. Sudhir Perincheri
  21. Christopher Larsen
  22. Aileen M. Gariepy
  23. Gabriela Aguilar
  24. Kristen L. Fardelmann
  25. Malini Harigopal
  26. Hugh S. Taylor
  27. Christian M. Pettker
  28. Anne L. Wyllie
  29. Charles Dela Cruz
  30. Aaron M. Ring
  31. Nathan D. Grubaugh
  32. Albert I. Ko
  33. Tamas L. Horvath
  34. Akiko Iwasaki
  35. Uma M. Reddy
  36. Heather S. Lipkind
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Abstract

Background

The effects of 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.

Methods

We analyzed placenta for the presence of SARS-CoV-2 through molecular and immunohistochemical assays and by and electron microscopy, and we measured the maternal antibody response in blood to this infection.

Results

SARS-CoV-2 localized predominantly to syncytiotrophoblast cells at the maternal-fetal interface of the placenta. Histological examination of the placenta revealed a dense macrophage infiltrate, but no evidence for vasculopathy typically associated with preeclampsia.

Conclusion

This case demonstrates, for the first time, SARS-CoV-2 invasion of the placenta, highlighting the potential for severe morbidity among pregnant women with Covid-19.

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