SARS-CoV-2 variant-related abnormalities detected by prenatal MRI: a prospective case-control study.

COVID-19 COVID-19 during pregnancy Omicron Placenta Prenatal MRI SARS-CoV-2 Variants Vascular

Journal

The Lancet regional health. Europe
ISSN: 2666-7762
Titre abrégé: Lancet Reg Health Eur
Pays: England
ID NLM: 101777707

Informations de publication

Date de publication:
Mar 2023
Historique:
received: 07 11 2022
revised: 05 01 2023
accepted: 09 01 2023
pubmed: 31 1 2023
medline: 31 1 2023
entrez: 30 1 2023
Statut: ppublish

Résumé

There are known complications for fetuses after infection with SARS-CoV-2 during pregnancy. However, previous studies of SARS-CoV-2 in pregnancy have largely been limited to histopathologic studies of placentas and prenatal studies on the effects of different SARS-CoV-2 variants are scarce to date. To examine the effects of SARS-CoV-2 variants on the placenta and fetus, we investigated fetal and extra-fetal structures using prenatal MRI. For this prospective case-control study, two obstetric centers consecutively referred pregnant women for prenatal MRI after confirmed SARS-CoV-2 infection. Thirty-eight prenatal MRI examinations were included after confirmed infection with SARS-CoV-2 and matched 1:1 with 38 control cases with respect to sex, MRI field strength, and gestational age (average deviation 1.76 ± 1.65, median 1.5 days). Where available, the pathohistological examination and vaccination status of the placenta was included in the analysis. In prenatal MRI, the shape and thickness of the placenta, possible lobulation, and vascular lesions were quantified. Fetuses were scanned for organ or brain abnormalities. Of the 38 included cases after SARS-CoV-2 infection, 20/38 (52.6%) were infected with pre-Omicron variants and 18/38 (47.4%) with Omicron. Prenatal MRIs were performed on an average of 83 days (±42.9, median 80) days after the first positive PCR test. Both pre-Omicron ( SARS-CoV-2 infections in pregnancy can lead to placental lesions based on vascular events, which can be well visualized on prenatal MRI. Pre-Omicron variants cause greater damage than Omicron sub-lineages in this regard. Vienna Science and Technology Fund.

Sections du résumé

Background UNASSIGNED
There are known complications for fetuses after infection with SARS-CoV-2 during pregnancy. However, previous studies of SARS-CoV-2 in pregnancy have largely been limited to histopathologic studies of placentas and prenatal studies on the effects of different SARS-CoV-2 variants are scarce to date. To examine the effects of SARS-CoV-2 variants on the placenta and fetus, we investigated fetal and extra-fetal structures using prenatal MRI.
Methods UNASSIGNED
For this prospective case-control study, two obstetric centers consecutively referred pregnant women for prenatal MRI after confirmed SARS-CoV-2 infection. Thirty-eight prenatal MRI examinations were included after confirmed infection with SARS-CoV-2 and matched 1:1 with 38 control cases with respect to sex, MRI field strength, and gestational age (average deviation 1.76 ± 1.65, median 1.5 days). Where available, the pathohistological examination and vaccination status of the placenta was included in the analysis. In prenatal MRI, the shape and thickness of the placenta, possible lobulation, and vascular lesions were quantified. Fetuses were scanned for organ or brain abnormalities.
Findings UNASSIGNED
Of the 38 included cases after SARS-CoV-2 infection, 20/38 (52.6%) were infected with pre-Omicron variants and 18/38 (47.4%) with Omicron. Prenatal MRIs were performed on an average of 83 days (±42.9, median 80) days after the first positive PCR test. Both pre-Omicron (
Interpretation UNASSIGNED
SARS-CoV-2 infections in pregnancy can lead to placental lesions based on vascular events, which can be well visualized on prenatal MRI. Pre-Omicron variants cause greater damage than Omicron sub-lineages in this regard.
Funding UNASSIGNED
Vienna Science and Technology Fund.

Identifiants

pubmed: 36713638
doi: 10.1016/j.lanepe.2023.100587
pii: S2666-7762(23)00005-4
pmc: PMC9860502
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100587

Informations de copyright

© 2023 The Authors.

Déclaration de conflit d'intérêts

The authors declare no conflict of interest.

Références

Ann Hepatol. 2005 Apr-Jun;4(2):70-6
pubmed: 16010240
Placenta. 2022 Jan;117:72-77
pubmed: 34773743
Radiol Clin North Am. 2013 Nov;51(6):955-66
pubmed: 24210438
J Perinat Med. 2018 Aug 28;46(6):613-630
pubmed: 30044764
Abdom Imaging. 2013 Jun;38(3):573-87
pubmed: 22797659
Placenta. 2014 Aug;35(8):611-7
pubmed: 24862569
Lancet Respir Med. 2022 Apr;10(4):e36-e37
pubmed: 35305309
J Trop Pediatr. 2021 Oct 6;67(5):
pubmed: 34748020
Am J Obstet Gynecol. 2021 Jan;224(1):35-53.e3
pubmed: 32739398
Front Immunol. 2022 Mar 11;13:861245
pubmed: 35359975
Res Pract Thromb Haemost. 2020 Oct 13;4(7):1178-1191
pubmed: 33043231
J Clin Ultrasound. 2022 Oct 28;:
pubmed: 36305509
Obstet Gynecol. 2020 Aug;136(2):303-312
pubmed: 32516273
Res Pract Thromb Haemost. 2022 Feb 15;6(2):e12666
pubmed: 35224417
Magn Reson Med Sci. 2016;15(2):212-9
pubmed: 26607809
Lancet Glob Health. 2021 Jun;9(6):e759-e772
pubmed: 33811827
J Thromb Haemost. 2021 Apr;19(4):1038-1048
pubmed: 33534149
Histopathology. 2020 Dec;77(6):994-999
pubmed: 32692408
N Engl J Med. 2020 Jul 9;383(2):120-128
pubmed: 32437596
JAMA. 2022 May 24;327(20):1983-1991
pubmed: 35499852
J Matern Fetal Neonatal Med. 2022 Dec;35(23):4526-4533
pubmed: 33261528
Placenta. 2009 Jun;30(6):473-82
pubmed: 19375795
Placenta. 2004 Apr;25 Suppl A:S102-5
pubmed: 15033316
Diagnostics (Basel). 2022 Apr 13;12(4):
pubmed: 35454021
Am J Clin Pathol. 2020 Jun 8;154(1):23-32
pubmed: 32441303
Arch Pathol Lab Med. 2016 Jul;140(7):698-713
pubmed: 27223167
Cell. 2020 Apr 16;181(2):271-280.e8
pubmed: 32142651
Placenta. 2020 Nov;101:13-29
pubmed: 32911234
Front Immunol. 2021 Sep 15;12:743022
pubmed: 34603330
Int J Surg Pathol. 2022 May 29;:10668969221102534
pubmed: 35645148
Arch Dis Child Fetal Neonatal Ed. 2021 Jan;106(1):112-113
pubmed: 32586828

Auteurs

Patric Kienast (P)

Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria.

Daniela Prayer (D)

Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria.

Julia Binder (J)

Department of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, Vienna, Austria.

Florian Prayer (F)

Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria.

Sabine Dekan (S)

Department of Pathology, Medical University of Vienna, Vienna, Austria.

Eva Langthaler (E)

Department of Pathology, Medical University of Vienna, Vienna, Austria.

Benjamin Sigl (B)

Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria.

Sabine Eichinger (S)

Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria.

Nicole Perkmann-Nagele (N)

Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.

Ingrid Stuempflen (I)

Department of Obstetrics & Gynecology, Klinik Floridsdorf, Vienna, Austria.

Marlene Stuempflen (M)

Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria.

Nawa Schirwani (N)

Department of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, Vienna, Austria.

Petra Pateisky (P)

Department of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, Vienna, Austria.

Christian Mitter (C)

Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria.

Gregor Kasprian (G)

Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria.

Classifications MeSH