SARS-CoV-2 Infection: A Clinical and Histopathological Study in Pregnancy

During pregnancy, SARS-CoV-2 infection is associated with several adverse outcomes, including an increased risk of pre-eclampsia, preterm delivery, hypertensive disorders, gestational diabetes, and fetal growth restriction related to the development of placenta vascular abnormalities. We analyzed hu...

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Main Authors: Angelica Perna, Eleonora Hay, Paolo De Blasiis, Marco La Verde, Francesca Caprio, Marco Torella, Maddalena Morlando, Carmine Sellitto, Germano Guerra, Angela Lucariello, Alfonso Baldi, Antonio De Luca
Format: Article
Language:English
Published: MDPI AG 2023-01-01
Series:Biology
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Online Access:https://www.mdpi.com/2079-7737/12/2/174
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author Angelica Perna
Eleonora Hay
Paolo De Blasiis
Marco La Verde
Francesca Caprio
Marco Torella
Maddalena Morlando
Carmine Sellitto
Germano Guerra
Angela Lucariello
Alfonso Baldi
Antonio De Luca
author_facet Angelica Perna
Eleonora Hay
Paolo De Blasiis
Marco La Verde
Francesca Caprio
Marco Torella
Maddalena Morlando
Carmine Sellitto
Germano Guerra
Angela Lucariello
Alfonso Baldi
Antonio De Luca
author_sort Angelica Perna
collection DOAJ
description During pregnancy, SARS-CoV-2 infection is associated with several adverse outcomes, including an increased risk of pre-eclampsia, preterm delivery, hypertensive disorders, gestational diabetes, and fetal growth restriction related to the development of placenta vascular abnormalities. We analyzed human placenta from full-term, uncomplicated pregnancies with SARS-CoV-2 infection during the first, second, or third trimesters of gestation. We studied, by the immunohistochemistry technique, the expression of CD34 and podoplanin (PDPN) as markers of vasculogenesis to find any differences. As secondary outcomes, we correlated maternal symptoms with placental histological alterations, including fibrin deposits, lymphocyte infiltration in the villi, edema, and thrombi. Our results showed a PDPN expression around the villous stroma as a plexiform network around the villous nucleus of fetal vessels; significant down-regulation was observed in the villous stroma of women infected during the third trimester. CD34 showed no changes in expression levels. During SARS-CoV-2 infection, the most common maternal symptoms were fever, anosmia, ageusia and asthenia, and the majority were treated with paracetamol, corticosteroids and azithromycin. Patients that required multiple symptomatic treatments evidenced a large amount of fibrin deposition in the villi. Certainly, PDPN plays a key role in healthy placental vasculogenesis and thus in its proper physiology, and SARS-CoV-2 surely alters its normal expression. Further studies are necessary to understand what mechanisms are being altered to try to avoid possible complications for both the mother and fetus in terms of the contagions that will still occur.
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spelling doaj.art-097482ab9a9543c09a2814ca0f6ef6cd2023-11-16T19:12:38ZengMDPI AGBiology2079-77372023-01-0112217410.3390/biology12020174SARS-CoV-2 Infection: A Clinical and Histopathological Study in PregnancyAngelica Perna0Eleonora Hay1Paolo De Blasiis2Marco La Verde3Francesca Caprio4Marco Torella5Maddalena Morlando6Carmine Sellitto7Germano Guerra8Angela Lucariello9Alfonso Baldi10Antonio De Luca11Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, ItalyDepartment of Mental and Physical Health and Preventive Medicine, Section of Human Anatomy, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyDepartment of Mental and Physical Health and Preventive Medicine, Section of Human Anatomy, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyObstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyObstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyObstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyObstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyDepartment of Mental and Physical Health and Preventive Medicine, Section of Human Anatomy, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyDepartment of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, ItalyDepartment of Sport Sciences and Wellness, University of Naples “Parthenope”, 80133 Naples, ItalyDepartment of Environmental, Biological and Pharmaceutical Sciences and Technologies, Università degli Studi della Campania “L. Vanvitelli”, 81100 Caserta, ItalyDepartment of Mental and Physical Health and Preventive Medicine, Section of Human Anatomy, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyDuring pregnancy, SARS-CoV-2 infection is associated with several adverse outcomes, including an increased risk of pre-eclampsia, preterm delivery, hypertensive disorders, gestational diabetes, and fetal growth restriction related to the development of placenta vascular abnormalities. We analyzed human placenta from full-term, uncomplicated pregnancies with SARS-CoV-2 infection during the first, second, or third trimesters of gestation. We studied, by the immunohistochemistry technique, the expression of CD34 and podoplanin (PDPN) as markers of vasculogenesis to find any differences. As secondary outcomes, we correlated maternal symptoms with placental histological alterations, including fibrin deposits, lymphocyte infiltration in the villi, edema, and thrombi. Our results showed a PDPN expression around the villous stroma as a plexiform network around the villous nucleus of fetal vessels; significant down-regulation was observed in the villous stroma of women infected during the third trimester. CD34 showed no changes in expression levels. During SARS-CoV-2 infection, the most common maternal symptoms were fever, anosmia, ageusia and asthenia, and the majority were treated with paracetamol, corticosteroids and azithromycin. Patients that required multiple symptomatic treatments evidenced a large amount of fibrin deposition in the villi. Certainly, PDPN plays a key role in healthy placental vasculogenesis and thus in its proper physiology, and SARS-CoV-2 surely alters its normal expression. Further studies are necessary to understand what mechanisms are being altered to try to avoid possible complications for both the mother and fetus in terms of the contagions that will still occur.https://www.mdpi.com/2079-7737/12/2/174COVID-19pregnancyplacentaimmune cellsplacenta vascular abnormalitiesplacental histological alterations
spellingShingle Angelica Perna
Eleonora Hay
Paolo De Blasiis
Marco La Verde
Francesca Caprio
Marco Torella
Maddalena Morlando
Carmine Sellitto
Germano Guerra
Angela Lucariello
Alfonso Baldi
Antonio De Luca
SARS-CoV-2 Infection: A Clinical and Histopathological Study in Pregnancy
Biology
COVID-19
pregnancy
placenta
immune cells
placenta vascular abnormalities
placental histological alterations
title SARS-CoV-2 Infection: A Clinical and Histopathological Study in Pregnancy
title_full SARS-CoV-2 Infection: A Clinical and Histopathological Study in Pregnancy
title_fullStr SARS-CoV-2 Infection: A Clinical and Histopathological Study in Pregnancy
title_full_unstemmed SARS-CoV-2 Infection: A Clinical and Histopathological Study in Pregnancy
title_short SARS-CoV-2 Infection: A Clinical and Histopathological Study in Pregnancy
title_sort sars cov 2 infection a clinical and histopathological study in pregnancy
topic COVID-19
pregnancy
placenta
immune cells
placenta vascular abnormalities
placental histological alterations
url https://www.mdpi.com/2079-7737/12/2/174
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