First case of placental infection with SARS-CoV-2

Hosier, H.; Farhadian, S.; Morotti, R.; Deshmukh, U.; Lu-Culligans, A.; Campbell, K.; Yasumoto, Y.; Vogels, C.; Casanovas-Massana, A.; Vijayakumar, P.; Geng, B.; Odio, C.; Fournier, J.; Brito, A.; Fauver, J.; Liu, F.; Alpert, T.; Tal, R.; Szigeti-Buck, K.; Perincheri, S.; Larsen, C.; Gariepy, A.; Aguilar, G.; Fardelmann, K.; Harigopal, M.; Taylor, H.; Pettker, C.; Wyllie, A.; Dela Cruz, C.; Ring, A.; Grubaugh, N.; Ko, A.; Horvath, T.; Iwasaki, A.; Reddy, U.; Lipkind, H.

Background: The effects of Covid-19 in pregnancy remain relatively unknown. We present a case of second trimester pregnancy with symptomatic Covid-19 complicated by severe preeclampsia and placental abruption. Methods: We analyzed placenta for the presence of SARS-CoV-2 through molecular and immunohistochemical assays and by and electron microscopy, and we measured the maternal antibody response in blood to this infection. Results: SARS-CoV-2 localized predominantly to syncytiotrophoblast cells at the maternal-fetal interface of the placenta. Histological examination of the placenta revealed a dense macrophage infiltrate, but no evidence for vasculopathy typically associated with preeclampsia. Conclusion: This case demonstrates, for the first time, SARS-CoV-2 invasion of the placenta, highlighting the potential for severe morbidity among pregnant women with Covid-19.