Placental Tissue Destruction and Insufficiency From COVID-19 Causes Stillbirth and Neonatal Death From Hypoxic-Ischemic Injury: A Study of 68 Cases With SARS-CoV-2 Placentitis From 12 Countries

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Placental Tissue Destruction and Insufficiency From COVID-19 Causes Stillbirth and Neonatal Death From Hypoxic-Ischemic Injury : A Study of 68 Cases With SARS-CoV-2 Placentitis From 12 Countries

Schwartz, David A. (author): Perinatal Pathol, Consultat Practice, Atlanta, GA 30322 USA.,Atlanta Diabetes Associates

Avvad-Portari, Elyzabeth (author): Fiocruz MS, Dept Pathol, Fernandes Figueira Inst, Rio De Janeiro, Brazil.,Fernandes Figueira National Institute of Health for Women, Children and Adolescents (IFF/Fiocruz)

Babal, Pavel (author): Comenius Univ, Fac Med, Dept Pathol, Bratislava, Slovakia.,Comenius University

Baldewijns, Marcella (author): Univ Hosp Leuven, Dept Pathol, Leuven, Belgium.,University Hospitals Leuven

Blomberg, Marie (author): Linköping University

Bouachba, Amine (author): Hosp Civils Lyon, Inst Pathol Multisite, Lyon, France.;SOFFOET Soc Francaise Fooetopathol, Paris, France.,Lyon Civil Hospital / Hospices Civils de Lyon

Camacho, Jessica (author): Hosp Univ Vall dHebron, Pathol Dept, Barcelona, Spain.,Vall d'Hebron University Hospital

Collardeau-Frachon, Sophie (author): SOFFOET Soc Francaise Fooetopathol, Paris, France.;Univ Claude Bernard Lyon 1, Hosp Civils Lyon, Dept Pathol, Hop Femme Mere Enfant, Bron, France.,Lyon Civil Hospital / Hospices Civils de Lyon

Colson, Arthur (author): Catholic Univ Louvain, Inst Expt & Clin Res IREC, Dept Obstet, Brussels, Belgium.,Catholic University of Louvain

Dehaene, Isabelle (author): Ghent Univ Hosp, Dept Obstet & Gynaecol, Ghent, Belgium.,Ghent University Hospital

Carles Ferreres, Joan (author): Parc Tauli Hosp Univ, Inst Invest & Innovacio Parc Tauli I3PT, Pathol Dept, Barcelona, Spain.;Univ Autonoma Barcelona, Sch Med, Dept Morphol Sci, Sabadell, Spain.

Fitzgerald, Brendan (author): Cork Univ Hosp, Dept Pathol, Cork, Ireland.

Garrido-Pontnou, Marta (author): Hosp Univ Vall dHebron, Pathol Dept, Barcelona, Spain.;Univ Autonoma Barcelona, Sch Med, Dept Morphol Sci, Barcelona, Spain.

Gergis, Hazem (author): Doncaster & Bassetlaw NHS Teaching Hosp, Womens Hosp, Dept Obstet & Gynaecol, Doncaster, England.

Hargitai, Beata (author): NHS Fdn Trust, Birmingham Womens & Childrens Hosp, Dept Cellular Pathol, Div Perinatal Pathol, Birmingham, W Midlands, England.

Cecilia Helguera-Repetto, A. (author): Natl Inst Perinatol, Dept Immunobiochem, Mexico City, DF, Mexico.

Holmström, Sandra (author): Halland Hosp, Dept Obstet & Gynaecol, Varberg, Sweden.,Hallands sjukhus, Varberg

Liliane Irles, Claudine (author): Natl Inst Perinatol Isidro Espinosa de los Reyes, Dept Physiol & Cellular Dev, Mexico City, DF, Mexico.

Leijonhfvud, Åsa (author): Lund Univ, Helsingborg Hosp, Dept Obstet & Gynaecol, Dept Clin Sci Helsingborg, Lund, Sweden.

Libbrecht, Sasha (author): Antwerp Univ Hosp, Dept Pathol Anat, Edegem, Belgium.

Marton, Tamas (author): Birmingham Womens Hosp, Cellular Pathol Dept, Birmingham, W Midlands, England.

McEntagart, Noel (author): Rotunda Hosp, Histopathol, Dublin, Ireland.

Molina, James T. (author): CHRISTUS Hosp St Elizabeth, Pathol & Lab Med, Beaumont, TX USA.

Morotti, Raffaella (author): Yale Univ, Sch Med, Dept Pathol & Pediat, Autopsy Serv, New Haven, CT USA.

Nadal, Alfons (author): Hosp Clin Barcelona, Pathol Dept, Barcelona, Spain.;Univ Barcelona, Sch Med, Dept Basic Clin Practice, Barcelona, Spain.;August Pi & Sunyer Biomed Res Inst IDIBAPS, Barcelona, Spain.

Navarro, Alexandra (author): Hosp Univ Vall dHebron, Pathol Dept, Barcelona, Spain.

Nelander, Maria (author): Uppsala universitet,Klinisk obstetrik

Oviedo, Angelica (author): Burrell Coll Osteopath Med, Dept Pathol & Lab Med, Las Cruces, NM USA.

Oyamada Otani, Andre Ricardo (author): Lab Ferdinando Costa, Sao Paulo, Brazil.

Papadogiannakis, Nikos (author): Karolinska Inst, Dept Lab Med, Div Pathol, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Pathol, Stockholm, Sweden.

Petersen, Astrid C. (author): Aalborg Univ Hosp, Dept Pathol, Aalborg, Denmark.

Roberts, Drucilla J. (author): Harvard Med Sch, Massachusetts Gen Hosp, Dept Pathol, Boston, MA 02115 USA.

Saad, Ali G. (author): Univ Miami, Miller Sch Med, Dept Pathol,Holtz Childrens Hosp, Pediat Pathol & Neuropathol,Jackson Hlth Syst, Miami, FL 33136 USA.

Sand, Anna (author): Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Obstet & Gynaecol, Stockholm, Sweden.

Schoenmakers, Sam (author): Erasmus MC Univ Med Ctr Rotterdam, Dept Obstet & Gynaecol, Rotterdam, Netherlands.

Sehn, Jennifer K. (author): St Louis Univ, Sch Med, Dept Pathol, St Louis, MO 63104 USA.

Simpson, Preston R. (author): CHRISTUS Hosp St Elizabeth, Dept Pathol, Beaumont, TX USA.

Thomas, Kristen (author): NYU, Sch Med, Dept Pathol, NYU Langone Hlth Main Campus, New York, NY USA.;NYU, Sch Med, Bellevue Hosp Ctr, New York, NY USA.

Yolotzin Valdespino-Vazquez, M. (author): Univ Hosp Leuven, Dept Pathol, Leuven, Belgium.;Natl Inst Perinatol, Dept Anat Pathol, Mexico City, DF, Mexico.

van der Meeren, Lotte E. (author): Leiden Univ Med Ctr, Dept Pathol, Leiden, Netherlands.;Univ Med Ctr Utrecht, Dept Pathol, Utrecht, Netherlands.

Van Dorpe, Jo (author): Ghent Univ Hosp, Dept Pathol, Ghent, Belgium.

Verdijk, Robert M. (author): Erasmus MC Univ Med Ctr Rotterdam, Dept Obstet & Gynaecol, Rotterdam, Netherlands.

Watkins, Jaclyn C. (author): Harvard Med Sch, Massachusetts Gen Hosp, Dept Pathol, Boston, MA 02115 USA.

Zaigham, Mehreen (author): Lund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital

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Perinatal Pathol, Consultat Practice, Atlanta, GA 30322 USA Atlanta Diabetes Associates (creator_code:org_t)

Archives of Pathology and Laboratory Medicine, 2022
2022
English.
In: Archives of Pathology & Laboratory Medicine. - : Archives of Pathology and Laboratory Medicine. - 0003-9985 .- 1543-2165. ; 146:6, s. 660-676

Related links:: https://doi.org/10.5...; show more...; https://uu.diva-port... (primary) (Raw object); http://dx.doi.org/10... (free); https://urn.kb.se/re...; https://doi.org/10.5...; https://lup.lub.lu.s...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Context: Perinatal death is an increasingly important problem as the coronavirus disease 2019 (COVID-19) pandemic continues, but the mechanism of death has been unclear.Objective: To evaluate the role of the placenta in causing stillbirth and neonatal death following maternal infection with COVID-19 and confirmed placental positivity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Design: Case-based retrospective clinicopathologic analysis by a multinational group of 44 perinatal specialists from 12 countries of placental and autopsy pathology findings from 64 stillborns and 4 neonatal deaths having placentas testing positive for SARS-CoV-2 following delivery to mothers with COVID-19.Results: Of the 3 findings constituting SARS-CoV-2 placentitis, all 68 placentas had increased fibrin deposition and villous trophoblast necrosis and 66 had chronic histiocytic intervillositis. Sixty-three placentas had massive perivillous fibrin deposition. Severe destructive placental disease from SARS-CoV-2 placentitis averaged 77.7% tissue involvement. Other findings included multiple intervillous thrombi (37%; 25 of 68) and chronic villitis (32%; 22 of 68). The majority (19; 63%) of the 30 autopsies revealed no significant fetal abnormalities except for intrauterine hypoxia and asphyxia. Among all 68 cases, SARS-CoV-2 was detected from a body specimen in 16 of 28 cases tested, most frequently from nasopharyngeal swabs. Four autopsied stillborns had SARS-CoV-2 identified in internal organs.Conclusions: The pathology abnormalities composing SARS-CoV-2 placentitis cause widespread and severe placental destruction resulting in placental malperfusion and insufficiency. In these cases, intrauterine and perinatal death likely results directly from placental insufficiency and fetal hypoxic-ischemic injury. There was no evidence that SARS-CoV-2 involvement of the fetus had a role in causing these deaths.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)

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By the author/editor: Schwartz, David ...; Avvad-Portari, E ...; Babal, Pavel; Baldewijns, Marc ...; Blomberg, Marie; Bouachba, Amine; show more...; Camacho, Jessica; Collardeau-Frach ...; Colson, Arthur; Dehaene, Isabell ...; Carles Ferreres, ...; Fitzgerald, Bren ...; Garrido-Pontnou, ...; Gergis, Hazem; Hargitai, Beata; Cecilia Helguera ...; Holmström, Sandr ...; Liliane Irles, C ...; Leijonhfvud, Åsa; Libbrecht, Sasha; Marton, Tamas; McEntagart, Noel; Molina, James T.; Morotti, Raffael ...; Nadal, Alfons; Navarro, Alexand ...; Nelander, Maria; Oviedo, Angelica; Oyamada Otani, A ...; Papadogiannakis, ...; Petersen, Astrid ...; Roberts, Drucill ...; Saad, Ali G.; Sand, Anna; Schoenmakers, Sa ...; Sehn, Jennifer K ...; Simpson, Preston ...; Thomas, Kristen; Yolotzin Valdesp ...; van der Meeren, ...; Van Dorpe, Jo; Verdijk, Robert ...; Watkins, Jaclyn ...; Zaigham, Mehreen; show less...

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