The coronavirus disease 2019 (COVID-19) pandemic affected people at all ages. Whereas pregnant women seemed to have a worse course of disease than age-matched non-pregnant women, the risk of feto-placental infection is low. Using a cohort of 66 COVID-19-positive women in late pregnancy, we correlated clinical parameters with disease severity, placental histopathology, and the expression of viral entry and Interferon-induced transmembrane (IFITM) antiviral transcripts. All newborns were negative for SARS-CoV-2. None of the demographic parameters or placental histopathological characteristics were associated with disease severity. The fetal-maternal transfer ratio for IgG against the N or S viral proteins was commonly less than one, as recently reported. We found that the expression level of placental ACE2, but not TMPRSS2 or Furin, was higher in women with severe COVID-19. Placental expression of IFITM1 and IFITM3, which have been implicated in antiviral response, was higher in participants with severe disease. We also showed that IFITM3 protein expression, which localized to early and late endosomes, was enhanced in severe COVID-19. Our data suggest an association between disease severity and placental SARS-CoV-2 processing and antiviral pathways, implying a role for these proteins in placental response to SARS-CoV-2.

Ocean acidification can affect the ability of calcifying organisms to build and maintain mineralized tissue. In decapod crustaceans, the exoskeleton is a multilayered structure composed of chitin, protein and mineral, predominately magnesian calcite or amorphous calcium carbonate (ACC). We investigated the effects of acidification on the exoskeleton of mature (post-terminal-molt) female southern Tanner crabs, Chionoecetes bairdi. Crabs were exposed to one of three pH levels – 8.1, 7.8 or 7.5 – for 2 years. Reduced pH led to a suite of body region-specific effects on the exoskeleton. Microhardness of the claw was 38% lower in crabs at pH 7.5 compared with those at pH 8.1, but carapace microhardness was unaffected by pH. In contrast, reduced pH altered elemental content in the carapace (reduced calcium, increased magnesium), but not the claw. Diminished structural integrity and thinning of the exoskeleton were observed at reduced pH in both body regions; internal erosion of the carapace was present in most crabs at pH 7.5, and the claws of these crabs showed substantial external erosion, with tooth-like denticles nearly or completely worn away. Using infrared spectroscopy, we observed a shift in the phase of calcium carbonate present in the carapace of pH 7.5 crabs: a mix of ACC and calcite was found in the carapace of crabs at pH 8.1, whereas the bulk of calcium carbonate had transformed to calcite in pH 7.5 crabs. With limited capacity for repair, the exoskeleton of long-lived crabs that undergo a terminal molt, such as C. bairdi, may be especially susceptible to ocean acidification.

OBJECTIVE: To determine if Vitamin D prophylaxis decreases the incidence of hypertensive disorders of pregnancy. STUDY DESIGN: A single center, parallel, open label, randomized control trial was performed in which pregnant women received Vitamin D3 3000 IU daily or no supplement. The primary outcome was the incidence of hypertensive disorders of pregnancy. Based on a power analysis set at 80%, a sample size of 206 women in each group (n¼412) was planned for comparison. Maternal serum and cord blood were collected for 25-hydroxyvitamin D assessment. Patients were called to assess compliance with the study protocol. Maternal demographics and pregnancy outcomes were collected from the electronic medical record. Statistical analyses were performed using SPSS V24. Student's t tests and ANOVA analyses were performed for continuous variables that were normally distributed. Chi-Square or Fisher's exact tests were performed for categorical variables. Binary logistic regression for the primary outcome was performed adjusting for confounders. The analysis was conducted with an intent to treat model with omission of missing variables. A P value of <0.05 was statistically significant. RESULTS: Enrollment occurred between October 2016 and September 2019. Of the 412 women enrolled, 392 (95.1%) had completed pregnancies for analysis. Demographic characteristics including baseline maternal 25-hydroxyvitamin D (25(OH)D) levels were similar between groups. Compared to women who did not receive Vitamin D prophylaxis, those who did had a significantly higher 25(OH)D delivery serum level (29.18 +/-11.87 ng/mL vs. 23.79 +/-9.29 ng/mL; P<0.001) and cord blood level (33.73 +/-13.68 ng/mL vs. 26.06 +/-9.72 ng/mL; P<0.001). The incidence of hypertensive disorders of pregnancy was 10.5% (41/392). Vitamin D prophylaxis did not decrease the incidence of hypertensive disorders of pregnancy when compared to controls (13.1% vs. 7.7%; RR 1.7, 95% CI 0.9-2.9; P¼0.10). CONCLUSION: Vitamin D prophylaxis does not prevent hypertensive disorders of pregnancy, but does increase maternal and cord blood Vitamin D levels.

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BackgroundAnimal studies have demonstrated the toxicology and pathology of mercury in relation to brain function. However, human studies provided mixed findings in relation to cognitive aging. This study aims to examine the association between serum mercury concentration and the incidence of mild cognitive impairment (MCI).MethodParticipants were from a random sub‐cohort (n = 2666) of the REasons for Geographic and Racial Differences in Stroke cohort study (2003–present). After excluding participants with baseline MCI and stroke, and those with missing baseline serum mercury concentration, the final sample size was 2136. Participants were classified into tertiles based on serum mercury concentration (<0.023, 0.023–0.049, and >0.049 µg/dL). MCI was determined primarily based on most recent performance on the enhanced cognitive battery (ECB) containing assessments of Word List Learning, Delayed Recall, Animal Fluency, and letter F Fluency. For those who did not have a score on ECB (n = 474), the Six Item Screener (SIS) was used to determine MCI instead. Therefore, the outcome included three levels: MCI based on the ECB, MCI based on the SIS, and control. Multinomial logistic regression was used to assess serum mercury concentration in relation to incident MCI. We also performed stratified analyses to assess whether gender and race modified the potential associations. All tests were two‐sided with α = 0.05.ResultThe number of participants with MCI on the ECB and SIS were 48 and 36, respectively. After adjustment for the demographic and clinical characteristics in model 2 (Table 1), the direction suggests a positive association between mercury and incident MCI, although this is not statistically significant presumably due to insufficient statistical power (Tertile 3 vs. tertile 1: odds ratio (OR), 1.68; 95% confidence interval (CI), 0.79–3.55; P for trend = 0.025). After further adjustment for fish oil intake, the association became significant (OR: 2.56; 95% CI: 1.003‐6.55; P for trend = 0.043). The observed association was not materially modified by sex or race. We did not observe an association between serum mercury and impairment on SIS.ConclusionThis prospective study suggests that serum mercury concentrations are associated with incident MCI assessed by ECB in US population.