Chronic Histiocytic Intervillositis With Trophoblast Necrosis Is a Risk Factor Associated With Placental Infection From Coronavirus Disease 2019 (COVID-19) and Intrauterine Maternal-Fetal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Transmission in Live-Born and Stillborn Infants

被引：123

作者：

Schwartz, David A. ^{[1
]}

Baldewijns, Marcella ^{[2
]}

Benachi, Alexandra ^{[3
]}

Bugatti, Mattia ^{[4
]}

Collins, Rebecca R. J. ^{[5
]}

De Luca, Daniele ^{[6
]}

Facchetti, Fabio ^{[7
]}

Linn, Rebecca L. ^{[8
,9
]}

Marcelis, Lukas ^{[10
]}

Morotti, Denise ^{[11
,12
]}

Morotti, Raffaella ^{[13
]}

Parks, W. Tony ^{[14
,15
]}

Patane, Luisa ^{[16
]}

Prevot, Sophie ^{[17
]}

Pulinx, Bianca ^{[18
]}

Rajaram, Veena ^{[5
]}

Strybol, David ^{[19
]}

Thomas, Kristen ^{[20
,21
]}

Vivanti, Alexandre J. ^{[22
]}

机构：

[1] Med Coll Georgia, Dept Pathol, Augusta, GA 30912 USA

[2] Univ Hosp Leuven, Dept Pathol, Leuven, Belgium

[3] Paris Saclay Univ Hosp, Antoine Beclere Hosp, Div Obstet & Gynecol, Clamart, France

[4] Univ Brescia, Dept Mol & Translat Med, Pathol Unit, Brescia, Italy

[5] Univ Texas Southwestern Med Ctr Dallas, Dept Pathol, Dallas, TX USA

[6] Paris Saclay Univ, Paris Saclay Univ Hosp, AP HP,Div Pediat Transportat & Neonatal Crit Care, Med Ctr A Beclere & Physiopathol & Therapeut Inno, Paris, France

[7] Univ Brescia, Dept Mol & Translat Med, Brescia, Italy

[8] Univ Penn, Dept Pathol, Perelman Sch Med, Philadelphia, PA 19104 USA

[9] Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA

[10] UZ Leuven, Dept Pathol, Leuven, Belgium

[11] ASST Papa Giovanni XXIII, Pathol Unit, Bergamo, Italy

[12] ASST Papa Giovanni XXIII, Med Genet Lab, Bergamo, Italy

[13] Yale Univ, Sch Med, Dept Pathol, New Haven, CT 06510 USA

[14] Univ Toronto, Dept Pathol & Lab Med, Toronto, ON, Canada

[15] Mt Sinai Hosp, Toronto, ON, Canada

[16] Papa Giovanni XXIII Hosp, Dept Obstet & Gynecol, Bergamo, Italy

[17] Paris Saclay Univ Hosp, Bicetre Hosp, AP HP, Div Pathol, Le Kremlin Bicetre, France

[18] Sint Trudo Hosp, Dept Clin Biol, St Truiden, Belgium

[19] Sint Trudo Hosp, Dept Pathol, St Truiden, Belgium

[20] NYU Langone Hlth, Dept Pathol, Main Campus, New York, NY USA

[21] NYU, Sch Med, Bellevue Hosp Ctr, New York, NY USA

[22] Univ Paris Saclay, Antoine Beclere Hosp, AP HP, Dept Obstet & Gynecol, Clamart, France

来源：

ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE | 2021年 / 145卷 / 05期

关键词：

VERTICAL TRANSMISSION; UNKNOWN ETIOLOGY; ZIKA VIRUS;

D O I：

10.5858/arpa.2020-0771-SA

中图分类号：

R446 [实验室诊断]; R-33 [实验医学、医学实验];

学科分类号：

1001 ;

摘要：

Context.-The number of neonates with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is increasing, and in a few there are reports of intrauterine infection. Objective.-To characterize the placental pathology findings in a preselected cohort of neonates infected by transplacental transmission arising from maternal infection with SARS-CoV-2, and to identify pathology risk factors for placental and fetal infection. Design.-Case-based retrospective analysis by a multinational group of 19 perinatal specialists of the placental pathology findings from 2 cohorts of infants delivered to mothers testing positive for SARS-CoV-2: live-born neonates infected via transplacental transmission who tested positive for SARS-CoV-2 after delivery and had SARS-CoV-2 identified in cells of the placental fetal compartment by molecular pathology, and stillborn infants with syncytiotrophoblast positive for SARS-CoV-2. Results.-In placentas from all 6 live-born neonates acquiring SARS-CoV-2 via transplacental transmission, the syncytiotrophoblast was positive for coronavirus using immunohistochemistry, RNA in situ hybridization, or both. All 6 placentas had chronic histiocytic intervillositis and necrosis of the syncytiotrophoblast. The 5 stillborn/terminated infants had placental pathology findings that were similar, including SARS-CoV-2 infection of the syncytiotrophoblast, chronic histiocytic intervillositis, and syncytiotrophoblast necrosis. Conclusions.-Chronic histiocytic intervillositis together with syncytiotrophoblast necrosis accompanies SARS-CoV-2 infection of syncytiotrophoblast in live-born and stillborn infants. The coexistence of these 2 findings in all placentas from live-born infants acquiring their infection prior to delivery indicates that they constitute a pathology risk factor for transplacental fetal infection. Potential mechanisms of infection of the placenta and fetus with SARS-CoV-2, and potential future studies, are discussed.

引用

页码：517 / 528

页数：12

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