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01-10-2021 | SARS-CoV-2 | Original Article

Placenta histopathology in SARS-CoV-2 infection: analysis of a consecutive series and comparison with control cohorts

Authors: Luca Bertero, Fulvio Borella, Giovanni Botta, Andrea Carosso, Stefano Cosma, Marialuisa Bovetti, Marco Carosso, Giancarlo Abbona, Giammarco Collemi, Mauro Papotti, Paola Cassoni, Chiara Benedetto

Published in: Virchows Archiv | Issue 4/2021

Abstract

Infection by SARS-CoV-2 has been shown to involve a wide range of organs and tissues, leading to a kaleidoscope of clinical conditions. Within this spectrum, an involvement of the fetal-maternal unit could be expected, but, so far, the histopathological evaluation of placentas delivered by women with SARS-CoV-2 infection did not show distinct hallmarks. A consecutive series of 11 placentas, delivered by 10 women with COVID-19 admitted to our Obstetrics and Gynecology clinic have been investigated and compared to a control cohort of 58 pre-COVID-19 placentas and 28 placentas delivered by women who had a previous cesarean section. Four out of eleven placentas showed changes consistent with chronic villitis/villitis of unknown etiology (VUE), while in one case, chronic histiocytic intervillositis was diagnosed. Thrombo-hemorrhagic alterations were observed in a subset of cases. Compared to the control cohort, chronic villitis/VUE (p < 0.001), chronic deciduitis (p = 0.023), microvascular thrombosis (p = 0.003), presence of infarction areas (p = 0.047) and of accelerated villous maturation (p = 0.005) showed higher frequencies in placentas delivered by women with COVID-19. Chronic villitis/VUE (p = 0.003) and accelerated villous maturation (p = 0.019) remained statistically significant by restricting the analysis to placentas delivered after a previous cesarean section. The observed differences in terms of pathological findings could be consistent with SARS-CoV-2 pathogenesis, but just a subset of alterations remained statistically significant after adjusting for a previous cesarean section. A careful consideration of potential confounders is warranted in future studies exploring the relationship between COVID-19 and pregnancy.

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Title: Placenta histopathology in SARS-CoV-2 infection: analysis of a consecutive series and comparison with control cohorts
Authors: Luca Bertero
Fulvio Borella
Giovanni Botta
Andrea Carosso
Stefano Cosma
Marialuisa Bovetti
Marco Carosso
Giancarlo Abbona
Giammarco Collemi
Mauro Papotti
Paola Cassoni
Chiara Benedetto
Publication date: 01-10-2021
Publisher: Springer Berlin Heidelberg
Keywords: SARS-CoV-2
Sectio Ceasarea
COVID-19
Thrombosis
Sectio Caesarea
Published in: Virchows Archiv / Issue 4/2021
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI: https://doi.org/10.1007/s00428-021-03097-3

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Placenta histopathology in SARS-CoV-2 infection: analysis of a consecutive series and comparison with control cohorts

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