Placenta histopathology in SARS-CoV-2 infection: analysis of a consecutive series and comparison with control cohorts.
Virchows Arch
; 479(4): 715-728, 2021 Oct.
Article
in English
| MEDLINE | ID: covidwho-1209750
ABSTRACT
Infection by SARS-CoV-2 has been shown to involve a wide range of organs and tissues, leading to a kaleidoscope of clinical conditions. Within this spectrum, an involvement of the fetal-maternal unit could be expected, but, so far, the histopathological evaluation of placentas delivered by women with SARS-CoV-2 infection did not show distinct hallmarks. A consecutive series of 11 placentas, delivered by 10 women with COVID-19 admitted to our Obstetrics and Gynecology clinic have been investigated and compared to a control cohort of 58 pre-COVID-19 placentas and 28 placentas delivered by women who had a previous cesarean section. Four out of eleven placentas showed changes consistent with chronic villitis/villitis of unknown etiology (VUE), while in one case, chronic histiocytic intervillositis was diagnosed. Thrombo-hemorrhagic alterations were observed in a subset of cases. Compared to the control cohort, chronic villitis/VUE (p < 0.001), chronic deciduitis (p = 0.023), microvascular thrombosis (p = 0.003), presence of infarction areas (p = 0.047) and of accelerated villous maturation (p = 0.005) showed higher frequencies in placentas delivered by women with COVID-19. Chronic villitis/VUE (p = 0.003) and accelerated villous maturation (p = 0.019) remained statistically significant by restricting the analysis to placentas delivered after a previous cesarean section. The observed differences in terms of pathological findings could be consistent with SARS-CoV-2 pathogenesis, but just a subset of alterations remained statistically significant after adjusting for a previous cesarean section. A careful consideration of potential confounders is warranted in future studies exploring the relationship between COVID-19 and pregnancy.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Placenta
/
COVID-19
Type of study:
Cohort study
/
Etiology study
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Adult
/
Female
/
Humans
/
Pregnancy
Language:
English
Journal:
Virchows Arch
Journal subject:
Molecular Biology
/
Pathology
Year:
2021
Document Type:
Article
Affiliation country:
S00428-021-03097-3
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