SARS-CoV-2 infection of the placenta.

Hosier, Hillary; Farhadian, Shelli F; Morotti, Raffaella A; Deshmukh, Uma; Lu-Culligan, Alice; Campbell, Katherine H; Yasumoto, Yuki; Vogels, Chantal Bf; Casanovas-Massana, Arnau; Vijayakumar, Pavithra; Geng, Bertie; Odio, Camila D; Fournier, John; Brito, Anderson F; Fauver, Joseph R; Liu, Feimei; Alpert, Tara; Tal, Reshef; Szigeti-Buck, Klara; Perincheri, Sudhir; Larsen, Christopher P; Gariepy, Aileen M; Aguilar, Gabriela; Fardelmann, Kristen L; Harigopal, Malini; Taylor, Hugh S; Pettker, Christian M; Wyllie, Anne L; Dela Cruz, Charles S; Ring, Aaron M; Grubaugh, Nathan D; Ko, Albert I; Horvath, Tamas L; Iwasaki, Akiko; Reddy, Uma M; Lipkind, Heather S

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 SARS-CoV-2 invasion of the placenta, highlighting the potential for severe morbidity among pregnant women with Covid-19.