Visualization of severe acute respiratory syndrome coronavirus 2 invading the human placenta using electron microscopy

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

doi:10.1016/j.ajog.2020.05.023

Cited by 215 publications

(221 citation statements)

References 7 publications

(9 reference statements)

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“…Algarroba et al showed potential viral transmission in the placenta by identifying coronavirus virions in placental villi using electron microscopy, but the newborn was COVID-19 RT-PCR negative and asymptomatic. 25 So, from these limited data we agree with Mimouni et al that vertical transmission from maternal infection to fetus probably occurs rarely. 54 Currently, AAP recommends testing the Algarroba et al 25 1 0…”

Section: Discussionsupporting

confidence: 89%

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Outcomes in COVID-19 Positive Neonates and Possibility of Viral Vertical Transmission: A Narrative Review

2020

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Objective Novel coronavirus disease 2019 (COVID-19) seems to affect adults and pediatric patients differently. While neonates are a special population, little is known about the neonatal outcomes. This study aimed to investigate the outcomes in COVID-19 positive neonates and incidence of vertical transmission of the virus by reviewing available literature. Study Design This study is a narrative review of available literature on “COVID-19 in neonates,” for which PubMed and Google Scholar were used to search the published articles. Results We summarized the data from 39 published studies that are comprised of 326 COVID-19 positive peripartum mothers with respective neonatal outcomes. Twenty-three neonates have been reported to be COVID-19 positive. Male neonates were affected significantly more (79%) than female neonates. Approximately 3% neonates acquired infection through suspected vertical transmission. Strict infection prevention measures during the perinatal time can significantly reduce the chance of horizontal transmission of the virus. Overall, neonates were asymptomatic or mildly symptomatic regardless of gestational age at birth and required only supportive measures. There was 0% mortality in COVID-19 positive neonates. Conclusion From available published data to date, we can conclude that the prognosis of COVID-19 positive neonates is good with no mortality. There appears to be minimal vertical transmission of the infection. Key Points

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Section: Discussionsupporting

confidence: 89%

“…25 So, from these limited data we agree with Mimouni et al that vertical transmission from maternal infection to fetus probably occurs rarely. 54 Currently, AAP recommends testing the Algarroba et al 25 1 0…”

Section: Discussionsupporting

confidence: 89%

Outcomes in COVID-19 Positive Neonates and Possibility of Viral Vertical Transmission: A Narrative Review

2020

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“…Conversely, the rising expression of TMPRSS2 with age in both the conducting airways and alveolar epithelium may explain the increased susceptibility to symptomatic infection and severe ARDS observed in adults relative to children. To date, there have been very few cases of vertical transmission of SARS-CoV-2 to newborns 22 , despite viral particles being identified in the placentas of women who were infected with SARS-CoV-2 23 . In light of the very low expression of ACE2 in ciliated epithelial cells, our data raise the possibility Figure 3.…”

Section: Secretory Cells Ciliated Cells At2 Cells At1 Cellsmentioning

confidence: 99%

Age-determined expression of priming protease TMPRSS2 and localization of SARS-CoV-2 infection in the lung epithelium

Schuler

Habermann

Plosa

et al. 2020

Preprint

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The emergence of the SARS-CoV-2 novel coronavirus has led to a global pandemic , with more than 5 million cases as of May 2020 1 . Available data suggest that severe illness and death from COVID-19 are rare in the pediatric population 2 . Integrating single-cell RNA sequencing of the developing mouse lung with temporally-resolved RNA-in-situ hybridization (ISH) in mouse and human lung tissue, we found expression of SARS-CoV-2 Spike protein primer TMPRSS2 was highest in ciliated cells and type I alveolar epithelial cells (AT1) and increased with aging in mice and humans. SARS-CoV-2 RNA colocalized with TMPRSS2 mRNA in lung cells from a patient who died of SARS-CoV-2. Together, these data suggest developmental regulation of TMPRSS2 may underlie the relative protection of infants and children from severe respiratory illness. * *

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“…Zeng and colleagues reported the outcome of 33 neonates born to mothers with COVID-19 nding despite implementing strict infection control measures 3 neonates (9%) presented with early onset SARS-CoV-2 infection 7 . Transplacental transmission is feasible as virions invading syncytiotrophoblast in placental villi have been documented by electron microscopy 8 No speci c clinical nding has been described in newborns, but severe neonatal infections are possible. Variable body temperature, respiratory symptoms (cough, tachypnea, apnea, grunting, nasal aring), tachycardia, lethargy, vomiting, diarrhea, and abdominal distention have been described.…”

Section: Discussionmentioning

confidence: 99%

Lung ultrasound and neonatal COVID-19 pneumonia: A case report.

Ibarra-Ríos

García

Solano

et al. 2020

Preprint

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Introduction: Severe Novel Coronavirus Disease 2019 (COVID-19) infection in neonates is possible but reports are scarce. Lung ultrasound (LUS) has been reported useful for triaging, diagnosing, and monitoring of patients with COVID-19.Material and methods: We describe SARS-CoV-2 confirmed infection on a term newborn that developed pneumonia and pulmonary hypertension requiring mechanical ventilation. Ultrasonographic follow up of COVID-19 pneumonia and pulmonary hypertension was carried out. Histopathological and genetic study of the placenta was performed. Results: A 3,140-g male infant born at 40.3 weeks’ gestation developed progressive respiratory distress (pulmonary hypertension) requiring mechanical ventilation. Real time PCR respiratory tract swabs for SARS COV 2 sampled on day 3 were positive for the baby and both parents. Lung ultrasound showed an irregular pleural line (shred sign), multiple confluent B-lines and bilateral ≥ 0.5 cm subpleural consolidations. Improvement of the lung and cardiac conditions were documented by ultrasound. The newborn was supported 6 days with mechanical ventilation, 3 days on CPAP and 3 days on oxygen. No antibiotics were used. The placenta showed histological findings linked to SARS-CoV-2 infection. RT-PCR from placental tissue showed amplification of viral E gene.Conclusion: Our case represents a severe presentation of COVID-19 pneumonia with pulmonary hypertension requiring mechanical ventilation. LUS showed to be useful for diagnosis and follow up. Transversal infection was possible.

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Visualization of severe acute respiratory syndrome coronavirus 2 invading the human placenta using electron microscopy

Abstract: This area was used for transmission electron microscopy.Algarroba. Visualization of SARS-CoV-2 invading the human placenta using electron microscopy. Am J Obstet Gynecol 2020.

Cited by 215 publications

References 7 publications

Outcomes in COVID-19 Positive Neonates and Possibility of Viral Vertical Transmission: A Narrative Review

Outcomes in COVID-19 Positive Neonates and Possibility of Viral Vertical Transmission: A Narrative Review

Age-determined expression of priming protease TMPRSS2 and localization of SARS-CoV-2 infection in the lung epithelium

Lung ultrasound and neonatal COVID-19 pneumonia: A case report.

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