Vertical Transmission of SARS-CoV-2 (COVID-19): Are Hypotheses More than Evidences?

Auriti, Cinzia; Rose, Domenico Umberto De; Tzialla, Chryssoula; Caforio, Leonardo; Ciccia, Matilde; Manzoni, Paolo; Stronati, Mauro

doi:10.1055/s-0040-1714346

Cited by 45 publications

(56 citation statements)

References 38 publications

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“…13,14 However, as COVID-19 continued to extend throughout China and other parts of the world accompanied by increasing numbers of neonates testing positive for the virus in China and elsewhere, [15][16][17][18][19][20] the possibility of determining whether vertical transmission was occurring became of even greater importance. [21][22][23] Because vertical transmission can occur through intrauterine, intrapartum and postpartum mechanisms, the possibility that intrauterine transplacental transmission with SARS-CoV-2 was occurring in some cases was of particular interest.…”

Section: Introductionmentioning

confidence: 99%

Chronic Histiocytic Intervillositis With Trophoblast Necrosis Is a Risk Factor Associated With Placental Infection From Coronavirus Disease 2019 (COVID-19) and Intrauterine Maternal-Fetal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Transmission in Live-Born and Stillborn Infants

Schwartz

Baldewijns

Benachi

et al. 2020

Archives of Pathology &Amp; Laboratory Medicine

145

163

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Context: Increasing numbers of neonates with systemic acute respiratory coronavirus 2 (SARS-CoV-2) infection are occurring, and in a small number there are reports of intrauterine infection. Objective: To characterize the placental pathology findings in a preselected cohort of neonates infected by transplacental transmission arising from maternal infection with SARS-CoV-2, and to identify pathology risk factors for placental and fetal infection. Design: Case-based retrospective analysis by a multinational group of 19 perinatal specialists of the placental pathology findings from 2 cohorts of infants delivered to mothers testing positive for SARS-CoV-2 - liveborn neonates infected via transplacental transmission who tested positive for SARS-CoV-2 after delivery and had SARS-CoV-2 identified in cells of the placental fetal compartment by molecular pathology; and stillborn infants with syncytiotrophoblast positive for SARS-CoV-2. Results: In placentas from all 6 liveborn neonates acquiring SARS-CoV-2 via transplacental transmission the syncytiotrophoblast was positive for coronavirus using immunohistochemistry, RNA in situ hybridization, or both. All 6 placentas had chronic histiocytic intervillositis and necrosis of the syncytiotrophoblast. The 5 stillborn/terminated infants had placental pathology findings that were similar including SARS-CoV-2 infection of the syncytiotrophoblast, chronic histiocytic intervillositis and syncytiotrophoblast necrosis. Conclusions: Chronic histiocytic intervillositis together with syncytiotrophoblast necrosis accompany SARS-CoV-2 infection of syncytiotrophoblast in liveborn and stillborn infants. Their coexistence in all placentas from liveborn infants acquiring their infection prior to delivery indicates that that these findings constitute a pathology risk factor for transplacental fetal infection. Potential mechanisms of infection of the placenta and fetus with SARS-CoV-2, and potential future studies, are discussed.

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Section: Introductionmentioning

confidence: 99%

Chronic Histiocytic Intervillositis With Trophoblast Necrosis Is a Risk Factor Associated With Placental Infection From Coronavirus Disease 2019 (COVID-19) and Intrauterine Maternal-Fetal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Transmission in Live-Born and Stillborn Infants

Schwartz

Baldewijns

Benachi

et al. 2020

Archives of Pathology &Amp; Laboratory Medicine

145

163

View full text Add to dashboard Cite

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“…Although COVID-19 infections among pregnant women (7,8) and newborns (9) have been reported, vertical intrauterine transmission is still a controversial issue (10,11). In certain cases, such as the one described by Kirtsman et al (12), SARS-CoV-2 RNA was detected from a nasopharyngeal swab sample collected on the day of birth before skin-to-skin contact with the mother.…”

Section: Introductionmentioning

confidence: 99%

Neonatal Infection Due to SARS-CoV-2: An Epidemiological Study in Spain

et al. 2020

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Objective: Coronavirus disease 2019 (COVID-19) cases caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to increase worldwide. Although some data from pediatric series are available, more evidence is required, especially in neonates, a group with specific characteristics that deserve special attention. This study aimed to describe general and clinical characteristics, management, and treatment of postnatal-acquired (community and nosocomial/hospital-acquired) COVID-19 neonatal cases in Spain. Methods: This was a national prospective epidemiological study that included cases from a National Registry supported by the Spanish Society of Neonatology. Neonates with postnatal SARS-CoV-2 infection were included in this study. General data and infection-related information (mode and source of transmission, age at diagnosis, clinical Fernández Colomer et al. Neonatal Infection Due to SARS-CoV-2 manifestations, need for hospitalization, admission unit, treatment administered, and complementary studies performed, hospital stay associated with the infection) were collected. Results: A total of 40 cases, 26 community-acquired and 14 nosocomial were registered. Ten were preterm newborns (2 community-acquired and 8 nosocomial COVID-19 cases). Mothers (in both groups) and healthcare workers (in nosocomial cases) were the main source of infection. Hospital admission was required in 22 community-acquired cases [18 admitted to the neonatal intermediate care unit (NIMCU) and 4 to the neonatal intensive care unit (NICU)]. Among nosocomial COVID-19 cases (n = 14), previously admitted for other reasons, 4 were admitted to the NIMCU and 10 to the NICU. Ten asymptomatic patients were registered (5 in each group). In the remaining cases, clinical manifestations were generally mild in both groups, including upper respiratory airways infection, febrile syndrome or acute gastroenteritis with good overall health. In both groups, most severe cases occurred in preterm neonates or neonates with concomitant pathologies. Most of the cases did not require respiratory support. Hydroxychloroquine was administered to 4 patients in the community-acquired group and to 2 patients in the nosocomial group. Follow-up after hospital discharge was performed in most patients. Conclusions: This is the largest series of COVID-19 neonatal cases in Spain published to date. Although clinical manifestations were generally mild, prevention, treatment, and management in this group are essential.

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“…It has been shown that the expression of ACE-2 and transmembrane protease serine type 2 receptors, which are used by the virus to enter the host cell, increases in placental and fetal tissues as the gestational age progresses [ 19 ]. Future studies are needed to investigate whether low receptor levels are protective for SARS-CoV-2 vertical transmission in early pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Investigating the risk of maternal-fetal transmission of SARS-CoV-2 in early pregnancy

et al. 2021

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Introduction The possibility of vertical transmission of SARS-CoV-2 from the mother to the fetus is one of the most crucial issues regarding the COVID-19 effects on pregnancy. In this study, we aimed to explore the risk of maternal-fetal transmission before 24 weeks of gestation, through analysis of abortion materials collected from PCR-positive women with pregnancy loss. To the best of our knowledge, apart from case reports, this study is the first prospective work on the vertical transmission of SARS-CoV-2 in early pregnancy. Methods The patients who had attended our clinic with the diagnosis of pregnancy loss before 24 weeks of gestation were screened for COVİD-19. Vertical transmission in PCR-positive women was assessed through the presence of SARS-CoV-2 RNA in fetal-placental tissues by rt-PCR test. Results 24 of 210 (%11,4) pregnant women participating in the study had positive rt-PCR results. Placenta and curettage material samples of these PCR-positive patients were analyzed and all valid test results (21 samples) were negative for SARS CoV-2 RNA. In three cases, the rt-PCR results were invalid due to failed internal controls.

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Vertical Transmission of SARS-CoV-2 (COVID-19): Are Hypotheses More than Evidences?

Cited by 45 publications

References 38 publications

Chronic Histiocytic Intervillositis With Trophoblast Necrosis Is a Risk Factor Associated With Placental Infection From Coronavirus Disease 2019 (COVID-19) and Intrauterine Maternal-Fetal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Transmission in Live-Born and Stillborn Infants

Chronic Histiocytic Intervillositis With Trophoblast Necrosis Is a Risk Factor Associated With Placental Infection From Coronavirus Disease 2019 (COVID-19) and Intrauterine Maternal-Fetal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Transmission in Live-Born and Stillborn Infants

Neonatal Infection Due to SARS-CoV-2: An Epidemiological Study in Spain

Investigating the risk of maternal-fetal transmission of SARS-CoV-2 in early pregnancy

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