Detection of severe acute respiratory syndrome coronavirus 2 in placental and fetal membrane samples

Penfield, Christina A.; Brubaker, Sara G.; Limaye, Meghana; Lighter, Jennifer; Ratner, Adam J.; Thomas, Kristen; Meyer, Jessica A.; Roman, Ashley S.

doi:10.1016/j.ajogmf.2020.100133

Cited by 290 publications

(323 citation statements)

References 5 publications

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“…Laparoscopic cholecystectomy was preferred to open cholecystectomy because of the lack of evidence about an increased risk of SARS-CoV-2 infection during laparoscopy 9 . Finally, SARS-CoV-2 RNA was detected from a variety respiratory sources such as throat, nasal nasopharyngeal, sputum and bronchoalveolar lavage uid, but it was also detected in feces 13 , placental and fetal membrane 14 . In our acknowledgement this is the rst case of attempt at trying to demonstrate the presence of viral RNA in the bile but the result was negative and this highlights that SARS-CoV-2 is not eliminated with the bile while it probably infects small intestinal enterocytes 15 which is responsible of gastrointestinal symptoms such as anorexia, nausea, vomiting, and diarrhea 16 .…”

Section: Discussionmentioning

confidence: 99%

Acute acalculous cholecystitis on a COVID-19 patient: a case report

Mattone

Sofia

Schembari

et al. 2020

Preprint

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Background coronavirus disease-19 (COVID-19) has spread to several countries around the world and has become an unprecedented pandemic. We report an extremely rare case of acute acalculous cholecystitis on a COVID-19 patient. In our knowledge, this is the first report of laparoscopic cholecystectomy performed on a COVID-19 patient. Case presentation: a COVID-19 patient was diagnosed with acute acalculous cholecystitis and a multidisciplinary team decided to perform a percutaneous transhepatic biliary drainage (PTBD) as the first treatment. SARS-CoV-2 RNA was not found in the bile fluid. Because of deterioration of the patient’s clinical conditions, laparoscopic cholecystectomy had to be performed and since the gallbladder was gangrenous, the severe inflammation made surgery difficult to perform. Conclusions acalculous cholecystitis was related with mechanical ventilation and prolonged total parenteral nutrition, in this case the gangrenous histopathology pattern and the gallbladder wall ischemia was probably caused by vascular insufficiency secondary to severe acute respiratory distress syndrome of COVID-19 pneumonia. The percutaneous transhepatic gallbladder drainage (PTBD) was performed according to Tokyo Guidelines because of high surgical risk. Laparoscopic cholecystectomy was next performed due to no clinical improvement. The absence of viral RNA in the bile highlights that SARS-CoV-2 is not eliminated with the bile while it probably infects small intestinal enterocytes which is responsible of gastrointestinal symptoms such as anorexia, nausea, vomiting, and diarrhea. Although the lack of evidence and guidelines about the management of patient with acute cholecystitis during COVID-19 pandemic, laparoscopic cholecystectomy, at most preceded by PTGBD on high surgical risk patients, remains the gold standard for the treatment of acute cholecystitis on COVID-19 patients.

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Section: Discussionmentioning

confidence: 99%

Acute acalculous cholecystitis on a COVID-19 patient: a case report

Mattone

Sofia

Schembari

et al. 2020

Preprint

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“…According to the published studies, people with COVID-19 can infect others through respiratory droplets. Also human-to-human transmission is proved as a way of spreading the disease [13] but, there is limited data about intrauterine vertical transmission and 2019-nCoV has not been detected in placental and fetal membrane samples [14]. Previous studies on vaginal swab samples of pregnant women who infected with human coronavirus (HCoV) have shown the possibility of maternal transmission of this virus.…”

Section: Discussionmentioning

confidence: 99%

Two infants with COVID-19 acquired from infected mothers: The incompatibility of maternal intensity and infant lung involvement: A case report

Moeindarbary

Pourhoseini

Layegh.MD

et al. 2020

Preprint

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IntroductionThe outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared a public health emergency by world health organization (WHO) on 30 January 2020. Recent studies have suggested that infants present the symptoms of COVID-19. Although the presentation of the disease in babies is variable, there are limited studies about the infected babies with 2019-nCoV.Case presentationIn this study, we have presented a case report of two infants with COVID-19. According to the simultaneity of maternal infection, maternal-fetal transmission or postnatal transmission was suggested. The chest radiography of one of the neonates suggested severe lung involvement. Despite the supportive and resuscitation attempts, poor clinical condition of him led to his death. Fortunately, the two mothers and one of the babies were discharged from the hospital with a good general condition.ConclusionIn this paper, we have reported two infants who had positive results of COVID-19 testing at day one of life. The babies had worse clinical conditions than their mothers and the intensity of pneumonia and the level of lung involvement of the infants were not associated with the stage and disease severity of the mothers who infected with 2019-nCoV.

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“…Both of these mothers displayed signs and symptoms of SARS-CoV-2 [14]. Pen eld et al reported 3 positive placentas in women with severe to critical SARS-CoV-2 [13]. Interestingly, SARS-CoV-2 was also identi ed in the placentas of both mothers who did not deliver their neonate due to severe preeclampsia and a miscarriage [15,17].…”

Section: Laboratory Investigationsmentioning

confidence: 96%

“…This literature review comprises 45 COVID-19 positive pregnant women whose placentas and neonates were also analysed by RT-PCR for the presence of SARS-CoV-2. We report no maternal mortality [9][10][11][12][13][14][15][16][17][18][19].…”

Section: Maternal Outcomementioning

confidence: 99%

Significance of placental swab in diagnosing vertical transmission in SARS-CoV-2 positive mothers.

Sweeney

Assaf

Khan

2020

Preprint

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AimsCurrently, there is limited date on the effects of COVID-19 on pregnancy and neonatal outcome. This literature review aims to investigate the possibility of fetal vertical transmission in COVID-19 positive pregnant mothers by diagnosing through placental swabs.MethodsThe search terms ‘pregnant COVID-19 positive mothers’, ‘fetal vertical transmission’ and ‘placental swabs’ were used. 11 papers were selected for this review.ResultsThis literature review comprises 45 COVID-19 positive pregnant women whose placentas and neonates were also analysed by RT-PCR for the presence of SARS-CoV-2. 43 neonates were successfully delivered primarily via caesarean section out of 45 expectant mothers (96%). 2 mothers did not deliver due to severe preeclampsia and a miscarriage both occurring in the second trimester. 3 neonates tested positive for SARS-CoV-2 (7%). We report no neonatal mortality after birth and no maternal mortality. 8 female’s placentas tested positive for SARS-CoV-2 out of a total of 45 tested (18%). Of these 8, 2 cases of SARS-CoV-2 were identified in the maternal, neonatal and placental tissue.ConclusionAfter reviewing multiple studies and investigating the nature of placental physiology in SARS-CoV-2 positive mothers we conclude that there is no concrete evidence of vertical transmission occurring between mother and infant. However, there are inconsistencies across the different papers used for this review and further research investigating the effects of COVID-19 on pregnant women by using RT-PCR to test the mother, placenta, vaginal fluid, breast milk and infant for SARS-CoV-2 at various stages of transmission is urgently needed.

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Detection of severe acute respiratory syndrome coronavirus 2 in placental and fetal membrane samples

Cited by 290 publications

References 5 publications

Acute acalculous cholecystitis on a COVID-19 patient: a case report

Acute acalculous cholecystitis on a COVID-19 patient: a case report

Two infants with COVID-19 acquired from infected mothers: The incompatibility of maternal intensity and infant lung involvement: A case report

Significance of placental swab in diagnosing vertical transmission in SARS-CoV-2 positive mothers.

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