Fetal demise and SARS-CoV-2 infection during pregnancy: Histopathological and immunohistochemical findings of three cases referred to the Colombian National Institute of Health

Marcela Daza; Sheryll Corchuelo; Johana Osorio; Luis Alberto Gómez; Edgar Parra; Ángela Alarcón; Marcela Mercado

doi:10.1016/j.clinpr.2023.100219

Fetal demise and SARS-CoV-2 infection during pregnancy: Histopathological and immunohistochemical findings of three cases referred to the Colombian National Institute of Health

Clin Infect Pract. 2023 Jan:17:100219. doi: 10.1016/j.clinpr.2023.100219. Epub 2023 Jan 18.

Authors

Marcela Daza¹, Sheryll Corchuelo², Johana Osorio¹, Luis Alberto Gómez³, Edgar Parra⁴, Ángela Alarcón⁵, Marcela Mercado⁶

Affiliations

¹ Maternal and Perinatal Research Group, Public Health Research Division, Instituto Nacional de Salud, Bogotá, Colombia.
² Cell Morphology Research Group, Public Health Research Division, Instituto Nacional de Salud, Bogotá, Colombia.
³ Molecular Physiology Research Group, Public Health Research Division, Instituto Nacional de Salud, Bogotá, Colombia.
⁴ Pathology Laboratory, Public Health Laboratory Network, Instituto Nacional de Salud, Bogotá, Colombia.
⁵ Public Health Surveillance Division, Instituto Nacional de Salud, Bogotá, Colombia.
⁶ Public Health Research Director, Public Health Research Division, Instituto Nacional de Salud, Bogotá, Colombia.

Abstract

Background: Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection during pregnancy is related with adverse maternal, fetal, and neonatal outcomes. Placental SARS-CoV-2 involvement may include various degrees of inflammation and malperfusion leading to diverse pregnancy complications.

Methods: Placental, fetal and umbilical cord samples of three fetal demise cases that occurred in the context of maternal SARS-CoV-2 infections were analyzed. Cases were notified to the Colombian SARS-CoV-2 National Surveillance System. RT-PCR and immunohistochemistry (IHC) analysis were employed to identify potential tissue viral involvement.

Results: RT-PCR and IHC confirmed the presence of viral genomes and antigens in placental and umbilical cord tissues. Histopathological analysis revealed findings consistent with placental malperfusion and inflammation.

Conclusions: SARS-CoV-2 infection during pregnancy can lead to placental dysfunction and damage compromising fetal survival. Many questions regarding SARS-CoV-2 dynamics during pregnancy including placental physiopathology and in utero transmission are still pending definitive answers.

Keywords: Fetus; Pathology; Placenta; Pregnancy; SARS-CoV-2.

Publication types

Case Reports