Open AccessHistologic and Immunohistochemical Evaluation of 65 Placentas From Women With Polymerase Chain Reaction–Proven Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection
Author(s) -
Daniel Levitan,
Viktoriya London,
Rodney A. McLaren,
Justin David Mann,
Ke Cheng,
Michael Silver,
Kimen Singh Balhotra,
Sandra McCalla,
Kristina Loukeris
Publication year - 2021
Publication title -
archives of pathology and laboratory medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.79
H-Index - 117
eISSN - 1543-2165
pISSN - 0003-9985
DOI - 10.5858/arpa.2020-0793-sa
Subject(s) - histopathology , pathology , coronavirus , medicine , immunohistochemistry , placenta , fetal membrane , polymerase chain reaction , fetus , immunology , biology , pregnancy , disease , covid-19 , infectious disease (medical specialty) , genetics , biochemistry , gene
Context.— Coronavirus disease 2019 (COVID-19) has been shown to have effects outside of the respiratory system. Placental pathology in the setting of maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains a topic of great interest because earlier studies have shown mixed results. Objective.— To ascertain whether maternal SARS-CoV-2 infection is associated with any specific placental histopathology, and to evaluate the virus's propensity for direct placental involvement. Design.— Placentas from 65 women with polymerase chain reaction–proven SARS-CoV-2 infection underwent histologic evaluation using Amsterdam consensus group criteria and terminology. Another 85 placentas from women without SARS-CoV-2 constituted the negative control group. A total of 64 of the placentas from the SARS-CoV-2–positive group underwent immunohistochemical staining for SARS-CoV-2 nucleocapsid protein. Results.— Pathologic findings were divided into maternal vascular malperfusion, fetal vascular malperfusion, chronic inflammatory lesions, amniotic fluid infection sequence, increased perivillous fibrin, intervillous thrombi, increased subchorionic fibrin, meconium-laden macrophages (M-LMs) within fetal membranes, and chorangiosis. There was no statistically significant difference in prevalence of any specific placental histopathology between the SARS-CoV-2–positive and SARS-CoV-2–negative groups. There was no immunohistochemical evidence of SARS-CoV-2 virus in any of the 64 placentas that underwent staining for viral nucleocapsid protein. Conclusions.— Our study results and a literature review suggest that there is no characteristic histopathology in most placentas from women with SARS-CoV-2 infection. Likewise, direct placental involvement by SARS-CoV-2 is a rare event.