TY - JOUR
T1 - Severe SARS-CoV-2 placenta infection can impact neonatal outcome in the absence of vertical transmission
AU - Cribiù, Fulvia Milena
AU - Erra, Roberta
AU - Pugni, Lorenza
AU - Rubio-Perez, Carlota
AU - Alonso, Lidia
AU - Simonetti, Sara
AU - Croci, Giorgio Alberto
AU - Serna, Garazi
AU - Ronchi, Andrea
AU - Pietrasanta, Carlo
AU - Lunghi, Giovanna
AU - Fagnani, Anna Maria
AU - Piñana, Maria
AU - Matter, Matthias
AU - Tzankov, Alexandar
AU - Terracciano, Luigi
AU - Anton, Andres
AU - Ferrazzi, Enrico
AU - Ferrero, Stefano
AU - Iurlaro, Enrico
AU - Seoane, Joan
AU - Nuciforo, Paolo
N1 - Publisher Copyright:
© 2021 American Society for Clinical Investigation. All rights reserved.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/3/15
Y1 - 2021/3/15
N2 - The effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the pathophysiology of the placenta and its impact on pregnancy outcome has not yet been fully elucidated. Here, we present a comprehensive clinical, morphological, and molecular analysis of placental tissues from pregnant women with and without SARSCoV- 2 infection. SARS-CoV-2 could be detected in half of placental tissues from SARS-CoV-2-positive women. The presence of the virus was not associated with any distinctive pathological, maternal, or neonatal outcome features. SARS-CoV-2 tissue load was low in all but one patient who exhibited severe placental damage leading to neonatal neurological manifestations. The placental transcriptional response induced by high viral load of SARS-CoV-2 showed an immunopathology phenotype similar to autopsy lung tissues from patients with severe coronavirus disease 2019. This finding contrasted with the lack of inflammatory response in placental tissues from SARS-CoV-2-positive women with low viral tissue load and from SARS-CoV-2-negative women. Importantly, no evidence of vertical transmission of SARSCoV- 2 was found in any newborns, suggesting that the placenta may be an effective maternal-neonatal barrier against the virus even in the presence of severe infection. Our observations suggest that severe placental damage induced by the virus may be detrimental for the neonate independently of vertical transmission.
AB - The effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the pathophysiology of the placenta and its impact on pregnancy outcome has not yet been fully elucidated. Here, we present a comprehensive clinical, morphological, and molecular analysis of placental tissues from pregnant women with and without SARSCoV- 2 infection. SARS-CoV-2 could be detected in half of placental tissues from SARS-CoV-2-positive women. The presence of the virus was not associated with any distinctive pathological, maternal, or neonatal outcome features. SARS-CoV-2 tissue load was low in all but one patient who exhibited severe placental damage leading to neonatal neurological manifestations. The placental transcriptional response induced by high viral load of SARS-CoV-2 showed an immunopathology phenotype similar to autopsy lung tissues from patients with severe coronavirus disease 2019. This finding contrasted with the lack of inflammatory response in placental tissues from SARS-CoV-2-positive women with low viral tissue load and from SARS-CoV-2-negative women. Importantly, no evidence of vertical transmission of SARSCoV- 2 was found in any newborns, suggesting that the placenta may be an effective maternal-neonatal barrier against the virus even in the presence of severe infection. Our observations suggest that severe placental damage induced by the virus may be detrimental for the neonate independently of vertical transmission.
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U2 - 10.1172/JCI145427
DO - 10.1172/JCI145427
M3 - Article
C2 - 33497369
AN - SCOPUS:85102682237
VL - 131
JO - Journal of Clinical Investigation
JF - Journal of Clinical Investigation
SN - 0021-9738
IS - 6
M1 - e145427
ER -