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Placental barrier against COVID-19.
Placenta. 2020 09 15; 99:45-49.P

Abstract

Vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and possible induction of pregnancy complications, including miscarriage, fetal malformations, fetal growth restriction and/or stillbirth, are serious concerns for pregnant individuals with COVID-19. According to clinical information, the incidence of vertical transmission of SARS-CoV-2 is limited to date. However, even if a neonate tests negative for SARS-CoV-2, frequent abnormal findings, including fetal and maternal vascular malperfusion, have been reported in cases of COVID-19-positive mothers. Primary receptor of SARS-CoV-2 is estimated as angiotensin-converting enzyme 2 (ACE2). It is highly expressed in maternal-fetal interface cells, such as syncytiotrophoblasts, cytotrophoblasts, endothelial cells, and the vascular smooth muscle cells of primary and secondary villi. However other route of transplacental infection cannot be ruled out. Pathological examinations have demonstrated that syncytiotrophoblasts are often infected with SARS-CoV-2, but fetuses are not always infected. These findings suggest the presence of a placental barrier, even if it is not completely effective. As the frequency and molecular mechanisms of intrauterine vertical transmission of SARS-CoV-2 have not been determined to date, intensive clinical examinations by repeated ultrasound and fetal heart rate monitoring are strongly recommended for pregnant women infected with COVID-19. In addition, careful investigation of placental samples after delivery by both morphological and molecular methods is also strongly recommended.

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Authors+Show Affiliations

Komine-Aizawa S
Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan. Electronic address: aizawa.shihoko@nihon-u.ac.jp.
Takada K
Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan.
Hayakawa S
Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan.

MeSH

Angiotensin-Converting Enzyme 2Antigens, ViralBetacoronavirusCOVID-19Coronavirus InfectionsFemaleFetal DiseasesHumansInfant, NewbornInfectious Disease Transmission, VerticalMaternal-Fetal ExchangePandemicsPeptidyl-Dipeptidase APlacentaPneumonia, ViralPregnancyPregnancy Complications, InfectiousSARS-CoV-2Trophoblasts

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32755724

Citation

Komine-Aizawa, Shihoko, et al. "Placental Barrier Against COVID-19." Placenta, vol. 99, 2020, pp. 45-49.
Komine-Aizawa S, Takada K, Hayakawa S. Placental barrier against COVID-19. Placenta. 2020;99:45-49.
Komine-Aizawa, S., Takada, K., & Hayakawa, S. (2020). Placental barrier against COVID-19. Placenta, 99, 45-49. https://doi.org/10.1016/j.placenta.2020.07.022
Komine-Aizawa S, Takada K, Hayakawa S. Placental Barrier Against COVID-19. Placenta. 2020 09 15;99:45-49. PubMed PMID: 32755724.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Placental barrier against COVID-19. AU - Komine-Aizawa,Shihoko, AU - Takada,Kazuhide, AU - Hayakawa,Satoshi, Y1 - 2020/07/25/ PY - 2020/06/08/received PY - 2020/06/23/revised PY - 2020/07/21/accepted PY - 2020/8/7/pubmed PY - 2020/10/8/medline PY - 2020/8/7/entrez KW - COVID-19 KW - Placental barrier KW - Pregnancy KW - SARS-CoV-2 SP - 45 EP - 49 JF - Placenta JO - Placenta VL - 99 N2 - Vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and possible induction of pregnancy complications, including miscarriage, fetal malformations, fetal growth restriction and/or stillbirth, are serious concerns for pregnant individuals with COVID-19. According to clinical information, the incidence of vertical transmission of SARS-CoV-2 is limited to date. However, even if a neonate tests negative for SARS-CoV-2, frequent abnormal findings, including fetal and maternal vascular malperfusion, have been reported in cases of COVID-19-positive mothers. Primary receptor of SARS-CoV-2 is estimated as angiotensin-converting enzyme 2 (ACE2). It is highly expressed in maternal-fetal interface cells, such as syncytiotrophoblasts, cytotrophoblasts, endothelial cells, and the vascular smooth muscle cells of primary and secondary villi. However other route of transplacental infection cannot be ruled out. Pathological examinations have demonstrated that syncytiotrophoblasts are often infected with SARS-CoV-2, but fetuses are not always infected. These findings suggest the presence of a placental barrier, even if it is not completely effective. As the frequency and molecular mechanisms of intrauterine vertical transmission of SARS-CoV-2 have not been determined to date, intensive clinical examinations by repeated ultrasound and fetal heart rate monitoring are strongly recommended for pregnant women infected with COVID-19. In addition, careful investigation of placental samples after delivery by both morphological and molecular methods is also strongly recommended. SN - 1532-3102 UR - https://www.unboundmedicine.com/medline/citation/32755724/Placental_barrier_against_COVID_19_ DB - PRIME DP - Unbound Medicine ER -