The Immunological Role of the Placenta in SARS-CoV-2 Infection—Viral Transmission, Immune Regulation, and Lactoferrin Activity

Bukowska-Ośko, Iwona; Popiel, Marta; Kowalczyk, Paweł

doi:10.3390/ijms22115799

Cited by 20 publications

(16 citation statements)

References 209 publications

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“…Based on the current COVID-related knowledge, the coagulopathies in patients with SARS-CoV-2 infections are attributed to a combination of different factors rather than one single mechanism [ 1 , 2 , 32 ]. Regarding the fibrin deposits in the intervillous space of the placentas from SASRS-CoV-2-positive mothers with fetal distress, there may be a decrease in local fibrinolysis similar to what is seen in preeclampsia [ 33 , 34 ]. Perivillous fibrin deposition may be triggered by an activation of immune cells and circulating pro-inflammatory cytokines [ 20 ] and potentially microparticles [ 32 ] from the mother as well as by the hypoxic alteration of the villous trophoblast [ 33 , 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the fibrin deposits in the intervillous space of the placentas from SASRS-CoV-2-positive mothers with fetal distress, there may be a decrease in local fibrinolysis similar to what is seen in preeclampsia [ 33 , 34 ]. Perivillous fibrin deposition may be triggered by an activation of immune cells and circulating pro-inflammatory cytokines [ 20 ] and potentially microparticles [ 32 ] from the mother as well as by the hypoxic alteration of the villous trophoblast [ 33 , 35 , 36 ]. Therefore, intervillous fibrin deposition may also be a multifactorial pathogenetic process in placentas affected by SARS-CoV-2 [ 13 , 20 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…Perivillous fibrin deposition may be triggered by an activation of immune cells and circulating pro-inflammatory cytokines [ 20 ] and potentially microparticles [ 32 ] from the mother as well as by the hypoxic alteration of the villous trophoblast [ 33 , 35 , 36 ]. Therefore, intervillous fibrin deposition may also be a multifactorial pathogenetic process in placentas affected by SARS-CoV-2 [ 13 , 20 , 33 ]. In contrast, placentas from mothers without maternal vascular malperfusion may demonstrate unspecific histiocytic intervillositis with marginal fibrin deposits not affecting the fetus.…”

Section: Discussionmentioning

confidence: 99%

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Placental pathology in sudden intrauterine death (SIUD) in SARS-CoV-2-positive oligosymptomatic women

Horn

Krücken

Hiller

et al. 2022

Arch Gynecol Obstet

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Background Pregnant women are also susceptible to SARS-CoV-2. Although an infection of the placenta may be rare, pregnancy may occasionally be affected by intrauterine failure. The knowledge of placental morphology on sudden intrauterine demise is still limited. Methods Fetal and placental tissue of two cases of sudden intrauterine death in the second trimester were analysed morphologically and by immunohistochemistry. One case was evaluated by RT-PCR. Results Both mothers were tested positive for the Alpha variant of SARS-CoV-2 but were oligosymptomatic for COVID-19. Unexpected sudden intrauterine death (SIUD) occurred at 15 + 2 and 27 + 3 weeks of gestation. One fetus demonstrated an intrauterine growth restriction. No malformations nor inflammatory changes were observed in either fetus on autopsy. In contrast to the placentas, the fetal tissue was negative for SARS-CoV-2 on immunohistochemical and RT-PCR analyses. Macroscopically, the placentas showed an increased consistency with a white, reticular cutting surface covering about 95% of the whole placenta. Only very focal histiocytic chronic intervillositis was noted histologically. Massive perivillous fibrin deposits with extensive necroses of the villous trophoblast were present in more than 90% of the placental tissue. Immunohistochemical staining was strong and diffusely positive for SARS-CoV-2 in the villous trophoblast and rarely within the villous stromal cells. Placental SARS-CoV-2 infection was confirmed by RT-PCR. Conclusion Sudden intrauterine death may occur in mothers who are oligosymptomatic for COVID-19. Acute placental failure is responsible for SIUD, demonstrated by massive perivillous fibrin deposits and extensive necroses of the villous trophoblast with SARS-CoV-2-positivity based on immunohistochemical staining and RT-PCR. Detailed histopathological examination of placental and fetal tissue is mandatory to verify SARS-CoV-2 and to evaluate the pathogenesis and functionality of this disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Placental pathology in sudden intrauterine death (SIUD) in SARS-CoV-2-positive oligosymptomatic women

Horn

Krücken

Hiller

et al. 2022

Arch Gynecol Obstet

View full text Add to dashboard Cite

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“…Some clinical studies are showing a strong link between SARS-CoV-2 infection and preeclampsia probability by comparing preeclampsia in severe infected patients versus mild to moderate infected pregnant groups [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Atypical Eclampsia in a Pregnant Woman Infected by COVID-19

Odeh

Abuzneid

Badareen

et al. 2022

Case Reports in Obstetrics and Gynecology

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The coronavirus disease 2019, also called (COVID-19), is an infectious disease which is caused by a virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first report was in December 2019, and on March 12, 2020, the World Health Organization (WHO) declared this disease a pandemic. COVID-19 targets many major organs causing life-threatening systemic complications. It can cause lung damage and respiratory failure in addition to systemic inflammation and immune dysregulation. Hypercoagulable state and numerous neurological abnormalities also have been reported due to this condition. Going through the literature review, we found some cases of pregnant women with novel coronavirus infection, being mostly mild illnesses, and most of these cases were focused on maternal-fetal transmission and neonatal outcomes. In this case report, we present the case of a COVID-19 positive woman who came to our emergency department at 34 weeks of gestation with tonic-clonic seizures. This case was a challenge for us because we faced a new an unknown manifestation of both COVID and eclampsia.

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“…Pregnant women are at higher risk of a severe course of severe acute respiratory syndrome 2 (SARS-CoV-2) infection. Bukowska-Ośko et al, 2021 [ 23 ] focused on the role of the mother–fetal–placenta interface in the protection and potential vertical transmission of SARS-CoV-2. The authors summarized the current knowledge on the antiviral activity of lactoferrin in pregnancy; additionally, they described, in detail, the expression of viral receptors and proteases, SARS-CoV-2 infection-related placental pathologies, and the presence of the virus in neonatal tissues and fluids.…”

mentioning

confidence: 99%