Placenta histopathology in SARS-CoV-2 infection: analysis of a consecutive series and comparison with control cohorts.
COVID-19
Histopathology
Inflammation
Obstetrics
SARS-CoV-2
Thrombosis
Journal
Virchows Archiv : an international journal of pathology
ISSN: 1432-2307
Titre abrégé: Virchows Arch
Pays: Germany
ID NLM: 9423843
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
28
10
2020
accepted:
30
03
2021
revised:
14
03
2021
pubmed:
3
5
2021
medline:
6
2
2022
entrez:
2
5
2021
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 33934229
doi: 10.1007/s00428-021-03097-3
pii: 10.1007/s00428-021-03097-3
pmc: PMC8088311
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
715-728Informations de copyright
© 2021. The Author(s).
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