WITHDRAWN: A mechanistic analysis placental intravascular thrombus formation in COVID-19 patients

Magro, Cynthia M.; Lucy, X; Nuovo, Gerard J.; Baergen, Rebecca N.

doi:10.1016/j.anndiagpath.2020.151529

Cited by 22 publications

(25 citation statements)

References 42 publications

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“…The most common lesions seen related to fetal vascular malperfusion (9 cases); 5 cases showed lesions of maternal vascular malperfusion [ 20 ]. It is assumed that the 5 cases reported by Mulvey et al are incorporated in the larger report by Baegen and Heller from the same institution [ 20 , 21 ]. Cribiù et al reported placentas from 9 patients [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 placentitis: An uncommon complication of maternal COVID-19

et al. 2021

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Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 placentitis: An uncommon complication of maternal COVID-19

et al. 2021

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“… 36 , 37 Thus far, evidence has not proven that pregnant women with infection are more likely to suffer from venous thromboembolism. On a recent evaluation by Mulvey et al 27 of 5 term placentas from women with SARS-CoV-2 infection who were classified as mostly without typical symptoms related to infection, all 5 indicated evidence of fetal vascular malperfusion with thrombosis. The rate of fetal vascular malperfusion in our study was relatively low and was similar in patients who presented with and without typical symptoms related to the infection.…”

Section: Discussionmentioning

confidence: 99%

“… 20 Characteristic histopathologic findings in placentas from mothers with viral infections have been reported. 21 , 22 , 23 , 24 However, reports on placental evaluation in women with SARS-CoV-2 infection have been limited to a few case series, 25 , 26 , 27 , 28 and the association between infection and abnormal placental findings are not well known. Therefore, the objective of this study was to determine if any significant placental histopathologic changes occur after the diagnosis of SARS-CoV-2 infection in pregnancy and whether these changes are correlated with the presence or absence of symptoms typically related to the infection.…”

Section: Introductionmentioning

confidence: 99%

Histopathologic evaluation of placentas after diagnosis of maternal severe acute respiratory syndrome coronavirus 2 infection

Gulersen

Prasannan

Tam

et al. 2020

American Journal of Obstetrics & Gynecology MFM

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Background The impact of maternal severe acute respiratory syndrome coronavirus 2 infection on placental histopathology is not well known. Objective To determine if any significant placental histopathologic changes occur after the diagnosis of severe acute respiratory syndrome coronavirus 2 infection during pregnancy and whether these changes are correlated with the presence or absence of symptoms associated with the infection. Study Design A retrospective cohort study of women diagnosed as having severe acute respiratory syndrome coronavirus 2 infection who delivered at a single center from April 9, 2020 to April 27, 2020, and had placental specimens reviewed by the Department of Pathology. Women with singleton gestations and laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection were eligible for inclusion. Historical controls selected from a cohort of women who delivered 6 months before the study period were matched in a 1:1 fashion by weeks of gestation at delivery. Histopathologic characteristics were evaluated in each placenta, and the incidence of these findings was compared between placentas of those who received a diagnosis of maternal severe acute respiratory syndrome coronavirus 2 infection and historical controls, and between placentas from patients with or without typical symptoms related to the infection. Statistical analyses included the use of Wilcoxon rank-sum test and Fisher’s exact test for the comparison of categorical and continuous variables. Statistical significance was defined as a P value of <.05. Results A total of 50 placentas after the diagnosis of maternal severe acute respiratory syndrome coronavirus 2 infection and 50 historical controls were analyzed. Among the placentas from patients diagnosed with severe acute respiratory syndrome coronavirus 2 infection, 3 (6%) were preterm (33 3/7, 34 6/7, and 36 6/7 weeks of gestation), 16 (32%) were from patients with typical symptoms related to the infection, and 34 (68%) were from patients without typical symptoms related to the infection. All patients had received a diagnosis of severe acute respiratory syndrome coronavirus 2 infection in the third trimester. Decidual vasculopathy was not visualized in any of the placentas from patients diagnosed as having severe acute respiratory syndrome coronavirus 2 infection. There was no statistically significant difference in placental histopathologic characteristics between the groups. Severe acute respiratory syndrome coronavirus 2 test results for all neonates at 24 hours of life were negative. Conclusion Based on the results of this study, there are no significant placental histopathologic changes that occur after the diagnosis of severe acute respiratory syndrome coronavirus 2 infection in women during the third trimester of pregnancy compared with a gestational age–matched historical control group. Similar incide...

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“…Another analysis of 5 placentas of patients with COVID-19 found focal avascular villi and thrombi in larger fetal vessels responsible for fetal circulation disorder, but the births were with healthy newborns, at term. The absence of complement deposition suggests that in these cases virus-induced procoagulant activity was systemic 49 .…”

Section: Placental Pathological Aspectsmentioning

confidence: 93%

Coagulation disorders in SARS-CoV-2 infection

Mihăilă¹,

Mihaila²

2020

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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A better understanding of the pathogenetic mechanisms triggered by SARS-CoV-2 infection may contribute to a more effective management of patients with COVID-19. Coagulation dysfunction is a key pathogenetic element of this disease as well as a challenge for practitioners. Marked inflammatory process found in severe forms of COVID-19, the complement activation, the cytokine storm, and disruption of the renin-angiotensin-aldosterone system are involved in the onset of thrombotic microangiopathy and large vessel coagulopathy. Virus-induced procoagulant activity occurs at the systemic level. Intravascular microthrombi disrupt vascularization in various tissues and organs, contributing to the occurrence of multiorgan failure and explain the higher morbidity and all-cause mortality of patients. It is estimated that almost 20% of patients with COVID-19 have significant coagulation disorders, and about a quarter of those hospitalized in intensive care units are prone to develop thrombosis events under prophylactic anticoagulant treatment. Some of patients who have been immunized after healing from the SARS-CoV-2 infection have a hypercoagulable state and are prone to develop thrombosis. Hypercoagulability is supported by thrombelastographic analysis: patients have an acceleration of the propagation phase of blood clot formation and higher clot strength. Markers of coagulation dysfunction in SARS-CoV2 are: decreased platelet count, increased INR, presence of fibrin degradation products, and especially higher plasma levels of D-dimers, which predict unfavorable outcome in these patients. Age, pre-existing diseases and associated risk factors, together with careful monitoring of clinical evolution and laboratory parameters allow the choice of the best personalized prophylactic or curative anticoagulant treatment.

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WITHDRAWN: A mechanistic analysis placental intravascular thrombus formation in COVID-19 patients

Cited by 22 publications

References 42 publications

SARS-CoV-2 placentitis: An uncommon complication of maternal COVID-19

SARS-CoV-2 placentitis: An uncommon complication of maternal COVID-19

Histopathologic evaluation of placentas after diagnosis of maternal severe acute respiratory syndrome coronavirus 2 infection

Coagulation disorders in SARS-CoV-2 infection

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