Confirmatory evidence of the visualization of severe acute respiratory syndrome coronavirus 2 invading the human placenta using electron microscopy

Algarroba, Gabriela N.; Hanna, Nazeeh; Rekawek, Patricia; Vahanian, Sevan A.; Khullar, Poonam; Palaia, Thomas; Peltier, Morgan R.; Chavez, Martin; Vintzileos, Anthony M.

doi:10.1016/j.ajog.2020.08.106

Cited by 24 publications

(24 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A recent meta-analysis calculated a 5.3% rate of vertical transmission and a positive SARS-CoV-2 test rate of 8% in neonates from mothers with COVID-19 [ 41 ]. However, Algarroba et al [ 42 ] recently reported the presence of SARS-CoV-2 in the placenta, using electron microscopy, in a gravid with pneumonia treated with corticosteroids for fetal lung maturity before a preterm cesarean delivery.…”

Section: Discussionmentioning

confidence: 99%

Screening of severe acute respiratory syndrome coronavirus-2 infection during labor and delivery using polymerase chain reaction and immunoglobulin testing

Savirón-Cornudella¹,

Villalba²,

Esteban

et al. 2021

Life Sciences

View full text Add to dashboard Cite

Aims To assess severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection during labor and delivery with polymerase chain reaction (PCR) and using immunoglobulin G and M testing to correlate with maternal and perinatal outcomes. Main methods Pregnant women admitted for labor and delivery at two Spanish hospitals were screened for SARS-CoV-2 infection by PCR test and by detection of serum immunoglobulins G and M. Maternal and perinatal outcomes were compared in women with laboratory evidence of SARS-CoV-2 infection with those with negative tests. Key findings Between March 31st and September 30th, 2020, 1211 pregnant women were screened for SARS-CoV-2 infection. The prevalence of laboratory evidence of SARS-CoV-2 infections was 5.4% ( n = 65), corresponding to (i) 22 ongoing infections at admission, including two with mild clinical symptoms and 20 asymptomatic women; (ii) 43 cases of previous SARS-CoV-2 exposure; (iii) and 1146 women who were negative for both SARS-CoV-2 PCR and serological test. None of the screened mothers required hospital admission for coronavirus disease before or after delivery, nor were any of the newborns admitted to the intensive care unit. All newborns from mothers with positive PCR on admission were PCR negative. There were no significant differences in maternal or perinatal outcomes among the three studied groups. Significance Ongoing or previous SARS-CoV-2 infection with asymptomatic or mild clinical symptoms detected during screening in pregnant women at labor and delivery do not have a higher rate of adverse maternal or perinatal outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Screening of severe acute respiratory syndrome coronavirus-2 infection during labor and delivery using polymerase chain reaction and immunoglobulin testing

Savirón-Cornudella¹,

Villalba²,

Esteban

et al. 2021

Life Sciences

View full text Add to dashboard Cite

show abstract

“…Electron microscopy revealed rare, individual virions in cells of the syncytiotrophoblast as well as in fibroblastic-type cells in the placental villi [37]. In response to a published inquiry [38], additional evaluation of the placenta was performed which revealed that the virus was detected using immunogold electron microscopy; immunohistochemistry was positive for SARS-CoV-2 antigen; and the virus was identified in the placenta using RT-PCR primers [39]. However, the localization of the virus in the placenta using RT-PCR and immunohistochemistry was not described.…”

Section: Placental Pathology From Mothers With Covid-19 In the Absencmentioning

confidence: 99%

Placental Pathology of COVID-19 with and without Fetal and Neonatal Infection: Trophoblast Necrosis and Chronic Histiocytic Intervillositis as Risk Factors for Transplacental Transmission of SARS-CoV-2

Schwartz

Morotti

2020

Viruses

115

112

View full text Add to dashboard Cite

The mechanism(s) by which neonates testing positive for coronavirus disease 2019 (COVID-19) acquire their infection has been largely unknown. Transmission of the etiological agent, SARS-CoV-2, from mother to infant has been suspected but has been difficult to confirm. This communication summarizes the spectrum of pathology findings from pregnant women with COVID-19 based upon the infection status of their infants and addresses the potential interpretation of these results in terms of the effects of SARS-CoV-2 on the placenta and the pathophysiology of maternal-fetal infection. Placentas from pregnant women with COVID-19 and uninfected neonates show significant variability in the spectrum of pathology findings. In contrast, placentas from infected maternal-neonatal dyads are characterized by the finding of mononuclear cell inflammation of the intervillous space, termed chronic histiocytic intervillositis, together with syncytiotrophoblast necrosis. These placentas show prominent positivity of syncytiotrophoblast by SARS-CoV-2, fulfilling the published criteria for transplacental viral transmission as confirmed in fetal cells through identification of viral antigens by immunohistochemistry or viral nucleic acid using RNA in situ hybridization. The co-occurrence of chronic histiocytic intervillositis and trophoblast necrosis appears to be a risk factor for placental infection with SARS-CoV-2 as well as for maternal-fetal viral transmission, and suggests a potential mechanism by which the coronavirus can breach the maternal-fetal interface.

show abstract

“…Autopsy studies have established the morphological changes associated with COVID-19 and have tried to visualise the virus in tissues. [5][6][7][8][9] Transmission electron microscopy (TEM) seems to be a logical tool to look for SARS-CoV-2 infection, but some of the published results are highly contested (kidney, 8,[10][11][12][13][14][15][16][17][18][19][20][21][22] endothelium, 8,9,[23][24][25][26][27][28] intestine, 8 liver [29][30][31][32] and placenta [33][34][35][36][37] ). Because most of us are not virologists or electron microscopists dedicated to the study of viral diseases, this review aims at combining multidisciplinary expertise of SARS-CoV-2 pathology, virology and electron microscopy.…”

Section: Introductionmentioning

confidence: 99%

Hunting coronavirus by transmission electron microscopy – a guide to SARS‐CoV‐2‐associated ultrastructural pathology in COVID‐19 tissues

et al. 2020

View full text Add to dashboard Cite

Transmission electron microscopy has become a valuable tool to investigate tissues of COVID‐19 patients because it allows visualisation of SARS‐CoV‐2, but the “virus‐like particles” described in several organs have been highly contested. Because most electron microscopists in pathology are not accustomed to analysing viral particles and subcellular structures, our review aims to discuss the ultrastructural changes associated with SARS‐CoV‐2 infection and COVID‐19 with respect to pathology, virology, and electron microscopy. Using micrographs from infected cell cultures and autopsy tissues, we show how coronavirus replication affects ultrastructure and put the morphological findings in the context of viral replication, which induces extensive remodelling of the intracellular membrane systems. Virions assemble by budding into the endoplasmic reticulum‐Golgi intermediate complex and are characterized by electron dense dots of cross‐sections of the nucleocapsid inside the viral particles. Physiological mimickers such as multivesicular bodies or coated vesicles serve as perfect decoys. Compared to other in‐situ techniques, transmission electron microscopy is the only method to visualize assembled virions in tissues and will be required to prove SARS‐CoV‐2 replication outside the respiratory tract. In practice, documenting in tissues the characteristic features seen in infected cell cultures, seems to be much more difficult than anticipated. In our view, the hunt for coronavirus by transmission electron microscopy is still on.

show abstract

Confirmatory evidence of the visualization of severe acute respiratory syndrome coronavirus 2 invading the human placenta using electron microscopy

Cited by 24 publications

References 8 publications

Screening of severe acute respiratory syndrome coronavirus-2 infection during labor and delivery using polymerase chain reaction and immunoglobulin testing

Screening of severe acute respiratory syndrome coronavirus-2 infection during labor and delivery using polymerase chain reaction and immunoglobulin testing

Placental Pathology of COVID-19 with and without Fetal and Neonatal Infection: Trophoblast Necrosis and Chronic Histiocytic Intervillositis as Risk Factors for Transplacental Transmission of SARS-CoV-2

Hunting coronavirus by transmission electron microscopy – a guide to SARS‐CoV‐2‐associated ultrastructural pathology in COVID‐19 tissues

Contact Info

Product

Resources

About