Detection of SARS-CoV-2 in placental but not fetal tissues i
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The data on placental and fetal involvement in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy is limited. Researchers analyzed placental and fetal tissues for the presence of SARS-CoV-2 in two infected women who presented with a miscarriage and preterm labor in the second trimester.

A 29-year-old gravida 1 para 0 presented in labor at 23+ weeks and delivered a male neonate with Apgar scores 2, 2, and 2. A cardiac arrest was registered on 8 min of life and resuscitation was unsuccessful. The neonatal nasal swab test for SARS-CoV-2 was negative.

SARS-CoV-2 qRT-PCR was positive in placentas and negative in fetal organs in both cases. Neither placentas nor fetal organs stained for the virus by IHC and ISH. This discrepancy can be explained by a much lower sensitivity of IHC and ISH, comparing to RT-PCR. To date, they found at least ten reported cases of SARS-CoV-2 detected in the placental tissue by RT-PCR, and only in five cases was the virus demonstrated by IHC and/or ISH. Lack of viral sequences in umbilical cords and fetal organs argues against vertical transmission of SARS-CoV-2, while the presence of placental and fetal pathologies previously established to be associated with fetal demise can explain the abortion and the preterm labor. In the 1st case, the placenta showed chronic deciduitis, which is known to be associated with an abnormal immune response to pregnancy and spontaneous abortions with normal karyotype. The author demonstrated the SARS-CoV-2 involvement of placentas detectable by qRT-PCR in asymptomatic COVID-19-infected pregnant women in the second trimester.