Histopathology of Third Trimester Placenta from SARS-CoV-2-Positive Women

Abstract

Background: This study aims to investigate whether maternal SARS-CoV-2 status affects placental pathology. Methods: A retrospective case-control study was conducted by reviewing charts and slides of placentas delivered between April 1 to July 24, 2020. Clinical history of "COVID-19" was searched in Pathology Database (CoPath). Controls were matched with SARS-CoV-2-negative women with singleton deliveries in the 3 rd-trimester. Pathological features were extracted from placental pathology reports. Results: Twenty-one 3 rd trimester placentas from SARS-CoV-2-positive women were identified and compared to 20 placentas from SARS-CoV-2-negative women. There were no significant differences in individual or group gross or microscopic pathological features. Within the SARS-CoV-2þ group, there are no differences between symptomatic and asymptomatic women. Conclusion: Placentas from SARS-CoV-2-positive women do not demonstrate a specific pathological pattern. Pregnancy complicated with COVID-19 during the 3 rd trimester does not have a demonstrable effect on placental structure and pathology.

Histologic and Immunohistochemical Evaluation of 65 Placentas From Women With Polymerase Chain Reaction–Proven Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection

“…Our findings are consistent with Hecht et al, 23 Gulerson et al, 35 and He et al 36 The first of the aforementioned studies, found no characteristic histopathologic findings in 19 placentas from women with proven SARS-CoV-2 infection, despite RNA evidence of the virus in syncytiotrophoblast in two of the cases. 23 Gulerson et al examined 50 placentas from women diagnosed with SARS-CoV-2 in the third trimester and found no difference in the prevalence of various placental pathology between women with and without SARS-CoV-2 infection.…”

Placental pathology in COVID-19 affected pregnant women: A prospective case-control study

“…Herein we report no relevant differences in placental histopathologic patterns between SARS-CoV-2 infected pregnant women and non-infected controls with similar maternal characteristics. Previous studies have also suggested no specific histopathologic differences in placentas from infected patients [ 14 , 15 , 16 , 17 , 18 , 19 ], but these reports were lacking appropriately selected controls group.…”

“…Several authors suggest that COVID-19 may trigger a severe systemic inflammatory response, with consequent MVM caused by the SARS-CoV-2 infection derived-hypoxia [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. We also recently reported [ 32 ] evidence of an increased immune activation profile in SARS-CoV-2 positive subjects, with higher levels of cytokines and chemokines in placental tissue, maternal and funicular plasma.…”

“…Although Patberg and colleagues reported that FVM and maternal vascular malperfusions (MVM) may be more frequent in placentas of SARS-CoV-2 infected patients [ 20 ], no specific pathological pattern results from placentas of SARS-CoV-2-positive women according to the few retrospective studies available [ 14 , 15 , 16 , 17 , 18 , 19 ].…”

Being pregnant in the COVID‐19 pandemic: Effects on the placenta in all aspects

“…A group of researchers stated that the SARS-CoV-2 localized predominantly in STBs, 36 but despite that, they reported that there was no statistically significant difference in placental histopathological evaluations through the placentas of COVID-19 positive women following the second opinion mentioned above. [37][38][39]…”