Open AccessFrequent Placental SARS-CoV-2 in Patients with COVID-19-Associated Hypertensive Disorders of Pregnancy
Author(s) -
Marta Fabre,
Pilar Calvo,
S. Ruiz,
María Peran,
Daniel Orós,
Ana Medel-Martínez,
Mark Strunk,
Rafael Benito Ruesca,
Jon Schoorlemmer,
Cristina Paulés
Publication year - 2021
Publication title -
fetal diagnosis and therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.976
H-Index - 60
eISSN - 1421-9964
pISSN - 1015-3837
DOI - 10.1159/000520179
Subject(s) - medicine , pregnancy , preeclampsia , gestation , covid-19 , gestational hypertension , placenta , viral load , gestational age , obstetrics , gastroenterology , fetus , immunology , virus , biology , disease , genetics , infectious disease (medical specialty)
Studies described an increased frequency of hypertensive disorders of pregnancy (HDP) after a COVID-19 episode. There is limited evidence about SARS-CoV-2 viral load in placenta. This study aimed to investigate the relationship between SARS-CoV-2 viral load in the placenta and clinical development of HDP after COVID-19 throughout different periods of gestation. Methods: This is a case-control study in women with and without gestational hypertensive disorders after SARS-CoV-2 infection diagnosed by RT-PCR during pregnancy. Patients were matched by gestational age at the moment of COVID-19 diagnosis. We performed an analysis of SARS-CoV-2 RNA levels in placenta. Results: A total of 28 women were enrolled. Sixteen patients were diagnosed with COVID-19 during the third trimester and the remaining 12 patients in the other trimesters. Ten placentas (35.7%) were positive for SARS-CoV-2, 9 of them (9/14, 64.3%) belonged to the HDP group versus 1 (1/14, 7.2%) in the control group ( p = 0.009). Those cases with the highest loads of viral RNA developed severe preeclampsia (PE). Conclusion: Among women diagnosed with COVID-19 during pregnancy, the presence of SARS-CoV-2 in the placenta was more frequent among women suffering from PE or gestational hypertension. Furthermore, the most severe cases of HDP were associated with high placental viral load, not necessarily associated with a positive nasopharyngeal RT-PCR at delivery. Our data suggest that SARS-CoV-2 infection during pregnancy could trigger gestational hypertensive disorders through persistent placental infection and resulting placental damage.