Decreased Fetal Movements: A Sign of Placental SARS-CoV-2 Infection with Perinatal Brain Injury

Guillaume Favre; Sara Mazzetti; Carole Gengler; Claire Bertelli; Juliane Schneider; Bernard Laubscher; Romina Capoccia; Fatemeh Pakniyat; Inès Ben Jazia; Béatrice Eggel-Hort; Laurence de Leval; Léo Pomar; Gilbert Greub; David Baud; Eric Giannoni

doi:10.3390/v13122517

Decreased Fetal Movements: A Sign of Placental SARS-CoV-2 Infection with Perinatal Brain Injury

Viruses. 2021 Dec 15;13(12):2517. doi: 10.3390/v13122517.

Authors

Guillaume Favre¹, Sara Mazzetti², Carole Gengler³, Claire Bertelli⁴, Juliane Schneider⁵, Bernard Laubscher^{2

6}, Romina Capoccia⁷, Fatemeh Pakniyat⁷, Inès Ben Jazia⁷, Béatrice Eggel-Hort⁸, Laurence de Leval³, Léo Pomar^{1

9}, Gilbert Greub^{4

10}, David Baud¹, Eric Giannoni⁵

Affiliations

¹ Materno-Fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland.
² Clinic of Pediatrics, Department Mother-Woman-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland.
³ Department of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland.
⁴ Institute of Microbiology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland.
⁵ Clinic of Neonatology, Department Mother-Woman-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland.
⁶ Department of Pediatrics, Réseau Hospitalier Neuchâtelois, 2000 Neuchâtel, Switzerland.
⁷ Department of Obstetrics and Gynecology, Réseau Hospitalier Neuchâtelois, 2000 Neuchatel, Switzerland.
⁸ Department of Obstetrics and Gynecology, Hôpital du Valais-Centre Hospitalier du Valais Romand-Site de Sion, 1951 Sion, Switzerland.
⁹ Midwifery Department, School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland, 1011 Lausanne, Switzerland.
¹⁰ Infectious Diseases Service, Department of Internal Medicine, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland.

Abstract

Neonatal COVID-19 is rare and mainly results from postnatal transmission. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), however, can infect the placenta and compromise its function. We present two cases of decreased fetal movements and abnormal fetal heart rhythm 5 days after mild maternal COVID-19, requiring emergency caesarean section at 29 + 3 and 32 + 1 weeks of gestation, and leading to brain injury. Placental examination revealed extensive and multifocal chronic intervillositis, with intense cytoplasmic positivity for SARS-CoV-2 spike antibody and SARS-CoV-2 detection by RT-qPCR. Vertical transmission was confirmed in one case, and both neonates developed extensive cystic peri-ventricular leukomalacia.

Keywords: COVID-19; MRI; SARS-CoV-2; brain injury; fetal movements; neurosonography; perinatal; placental.

Publication types

Case Reports

MeSH terms

Adult
Brain Injuries / etiology*
Brain Injuries / pathology
COVID-19 / complications*
COVID-19 / physiopathology
COVID-19 / virology
Cesarean Section
Female
Fetal Movement
Humans
Infant, Newborn
Infant, Premature
Infectious Disease Transmission, Vertical
Leukomalacia, Periventricular / etiology
Leukomalacia, Periventricular / pathology
Placenta / pathology
Placenta / virology*
Pregnancy
Pregnancy Complications, Infectious / physiopathology
Pregnancy Complications, Infectious / virology*
SARS-CoV-2 / isolation & purification