Author | Schwartz, David A. | |
Author | Avvad-Portari, Elyzabeth | |
Author | Babál, Pavel | |
Author | Baldewijns, Marcella | |
Author | Blomberg, Marie | |
Author | Bouachba, Amine | |
Author | Camacho, Jessica | |
Author | Collardeau-Frachon, Sophie | |
Author | Colson, Arthur | |
Author | Dehaene, Isabelle | |
Author | Ferreres, Joan Carles | |
Author | Fitzgerald, Brendan | |
Author | Garrido-Pontnou, Marta | |
Author | Gergis, Hazem | |
Author | Hargitai, Beata | |
Author | Helguera-Repetto, A. Cecilia | |
Author | Holmström, Sandra | |
Author | Irles, Claudine Liliane | |
Author | Leijonhfvud, Åsa | |
Author | Libbrecht, Sasha | |
Author | Marton, Tamás | |
Author | McEntagart, Noel | |
Author | Molina, James T. | |
Author | Morotti, Raffaella | |
Author | Nadal, Alfons | |
Author | Navarro, Alexandra | |
Author | Nelander, Maria | |
Author | Oviedo, Angelica | |
Author | Otani, Andre Ricardo Oyamada | |
Author | Papadogiannakis, Nikos | |
Author | Petersen, Astrid C. | |
Author | Roberts, Drucilla J. | |
Author | Saad, Ali G. | |
Author | Sand, Anna | |
Author | Schoenmakers, Sam | |
Author | Sehn, Jennifer K. | |
Author | Simpson, Preston R. | |
Author | Thomas, Kristen | |
Author | Valdespino-Vázquez, M. Yolotzin | |
Author | Van Der Meeren, Lotte E. | |
Author | Van Dorpe, Jo | |
Author | Verdijk, Robert M. | |
Author | Watkins, Jaclyn C. | |
Author | Zaigham, Mehreen | |
Access date | 2022-10-06T17:44:37Z | |
Available date | 2022-10-06T17:44:37Z | |
Document date | 2022 | |
Citation | SCHWARTZ, David A. et al. Placental tissue destruction and insufficiency from COVID-19 causes stillbirth and neonatal death from hypoxic-ischemic injury: a study of 68 cases with SARS-CoV-2 placentitis from 12 countries. Archives of Pathology & Laboratory Medicine, v. 146, n. 6, p. 660-676, June 2022. | en_US |
ISSN | 0003-9985 | en_US |
URI | https://www.arca.fiocruz.br/handle/icict/55029 | |
Language | eng | en_US |
Publisher | College of American Pathologists | en_US |
Rights | open access | en_US |
Title | Placental tissue destruction and insufficiency from COVID-19 causes stillbirth and neonatal death from hypoxic-ischemic injury: a study of 68 cases with SARS-CoV-2 placentitis from 12 countries | en_US |
Type | Article | en_US |
DOI | 10.5858/arpa.2022-0029-SA | |
Abstract | Context.—Perinatal death is an increasingly important problem as the coronavirus disease 2019 (COVID-19) pandemic continues, but the mechanism of death has been unclear. Objective.—To evaluate the role of the placenta in causing stillbirth and neonatal death following maternal infection with COVID-19 and confirmed placental positivity for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Design.—Case-based retrospective clinicopathologic analysis by a multinational group of 44 perinatal specialists from 12 countries of placental and autopsy pathology findings from 64 stillborns and 4 neonatal deaths having placentas testing positive for SARS-CoV-2 following delivery to mothers with COVID-19. Results.—Of the 3 findings constituting SARS-CoV-2 placentitis, all 68 placentas had increased fibrin deposition and villous trophoblast necrosis and 66 had chronic histiocytic intervillositis. Sixty-three placentas had massive perivillous fibrin deposition. Severe destructive placental disease from SARS-CoV-2 placentitis averaged 77.7% tissue involvement. Other findings included multiple intervillous thrombi (37%; 25 of 68) and chronic villitis (32%; 22 of 68). The majority (19; 63%) of the 30 autopsies revealed no significant fetal abnormalities except for intrauterine hypoxia and asphyxia. Among all 68 cases, SARS-CoV-2 was detected from a body specimen in 16 of 28 cases tested, most frequently from nasopharyngeal swabs. Four autopsied stillborns had SARS-CoV-2 identified in internal organs. Conclusions.—The pathology abnormalities composing SARS-CoV-2 placentitis cause widespread and severe placental destruction resulting in placental malperfusion and insufficiency. In these cases, intrauterine and perinatal death likely results directly from placental insufficiency and fetal hypoxic-ischemic injury. There was no evidence that SARS-CoV-2 involvement of the fetus had a role in causing these deaths. | en_US |
Affilliation | Sem afiliação. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Departamento de Patologia. Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | Comenius University. Faculty of Medicine. Department of Pathology. Bratislava, Slovakia. | en_US |
Affilliation | University Hospitals Leuven. Department of Pathology. Leuven, Belgium. | en_US |
Affilliation | Linköping University. Department of Obstetrics and Gynecology. Linköping, Sweden / Linköping University. Department of Biomedical and Clinical Sciences. Linköping, Sweden. | en_US |
Affilliation | Hospices Civils de Lyon. Institut de Pathologie Multisite. Lyon, France / SOFFOET–Société Française de Fœtopathologie, Paris, France. | en_US |
Affilliation | Hospital Universitari Vall d'Hebron. Pathology Department. Barcelona, Spain. | en_US |
Affilliation | SOFFOET–Société Française de Fœtopathologie, Paris, France / Université Claude Bernard Lyon 1. Hospices Civils de Lyon. Hopital Femme-Mère Enfant. Department of Pathology. Bron, France. | en_US |
Affilliation | Université Catholique de Louvain. Institute of Experimental and Clinical Research. Department of Obstetrics. Brussels, Belgium. | en_US |
Affilliation | Ghent University Hospital. Department of Obstetrics and Gynaecology. Ghent, Belgium. | en_US |
Affilliation | Institut d'Investigació i Innovació Parc Taulí I3PT. Parc Taulí Hospital Universitari. Pathology Department. Barcelona, Spain / Universitat Autònoma de Barcelona. School of Medicine. Department of Morphological Sciences. Sabadell, Spain. | en_US |
Affilliation | Cork University Hospital. Department of Pathology. Wilton, Cork, Republic of Ireland. | en_US |
Affilliation | Hospital Universitari Vall d'Hebron. Pathology Department. Barcelona, Spain / Universitat Autònoma de Barcelona. School of Medicine. Department of Morphological Sciences. Barcelona, Spain. | en_US |
Affilliation | Women's Hospital. Doncaster and Bassetlaw NHS Teaching Hospitals. Department of Obstetrics and Gynaecology. Doncaster, United Kingdom. | en_US |
Affilliation | NHS Foundation Trust. Birmingham Women's and Children's Hospital. Department of Cellular Pathology. Division of Perinatal Pathology. Birmingham, United Kingdom. | en_US |
Affilliation | National Institute of Perinatology. Department of Immunobiochemistry. Mexico City, Mexico. | en_US |
Affilliation | Halland Hospital. Department of Obstetrics and Gynaecology. Varberg, Sweden. | en_US |
Affilliation | National Institute of Perinatology “Isidro Espinosa de los Reyes”. Department of Physiology and Cellular Development. Mexico City, Mexico. | en_US |
Affilliation | Helsingborg Hospital. Department of Obstetrics and Gynaecology. Helsingborg, Sweden / Lund University. Department of Clinical Science Helsingborg. Lund, Sweden. | en_US |
Affilliation | Antwerp University Hospital. Department of Pathological Anatomy. Edegem, Belgium. | en_US |
Affilliation | Birmingham Women's Hospital. Cellular Pathology Department. Birmingham, United Kingdom. | en_US |
Affilliation | Rotunda Hospital. Histopathology. Dublin, Republic of Ireland. | en_US |
Affilliation | Sem afiliação. | en_US |
Affilliation | Yale University School of Medicine. Autopsy Service. Department of Pathology and Pediatrics. New Haven, Connecticut. | en_US |
Affilliation | Hospital Clínic. Pathology Department. Barcelona, Spain / Universitat de Barcelona. School of Medicine. Department of Basic Clinical Practice. Barcelona, Spain / August Pi i Sunyer Biomedical Research Institute. Barcelona, Spain. | en_US |
Affilliation | Hospital Universitari Vall d'Hebron. Pathology Department. Barcelona, Spain. | en_US |
Affilliation | Uppsala University. Department of Women's and Children's Health. Uppsala, Sweden. | en_US |
Affilliation | Burrell College of Osteopathic Medicine. Department of Pathology and Laboratory Medicine. Las Cruces, New Mexico. | en_US |
Affilliation | Laboratório Ferdinando Costa. São Paulo, SP, Brasil. | en_US |
Affilliation | Karolinska University Hospital. Division of Pathology. Department of Laboratory Medicine. Stockholm, Sweden / Karolinska University Hospital. Departments of Pathology. Stockholm, Sweden. | en_US |
Affilliation | Aalborg University Hospital. Department of Pathology. Aalborg, Denmark. | en_US |
Affilliation | Harvard Medical School. Massachusetts General Hospital. Department of Pathology. Boston, Massachusetts. | en_US |
Affilliation | University of Miami Miller School of Medicine/Jackson Health System/Holtz Children's Hospital. Department of Pathology. Pediatric Pathology and Neuropathology. Miami, Florida. | en_US |
Affilliation | Karolinska Institute. Department of Women's and Children's Health. Stockholm, Sweden / Karolinska University Hospital. Department of Obstetrics and Gynaecology. Solna, Stockholm, Sweden. | en_US |
Affilliation | University Medical Center Rotterdam. Department of Obstetrics and Gynaecology. Rotterdam, the Netherlands. | en_US |
Affilliation | St. Louis University School of Medicine. Department of Pathology. St Louis, Missouri. | en_US |
Affilliation | CHRISTUS Hospital St Elizabeth. Department of Pathology. Beaumont, Texas. | en_US |
Affilliation | New York University School of Medicine. NYU Langone Health–Main Campus & Bellevue Hospital Center. Department of Pathology. New York, USA. | en_US |
Affilliation | National Institute of Perinatology. Department of Anatomical Pathology. Mexico City, Mexico. | en_US |
Affilliation | Leiden University Medical Center. Department of Pathology. Leiden, the Netherlands / University Medical Center Utrecht. Department of Pathology. Utrecht, the Netherlands. | en_US |
Affilliation | Ghent University Hospital. Department of Pathology. Ghent, Belgium. | en_US |
Affilliation | University Medical Center Rotterdam. Department of Obstetrics and Gynaecology. Rotterdam, the Netherlands. | en_US |
Affilliation | Harvard Medical School. Massachusetts General Hospital. Department of Pathology. Boston, Massachusetts. | en_US |
Affilliation | Lund University. Institution of Clinical Sciences Lund. Obstetrics & Gynecology. Lund, Sweden / Skåne University Hospital. Department of Obstetrics and Gynecology. Malmö and Lund, Sweden. | en_US |
Subject | SARS-CoV-2 placentitis | en_US |
Subject | Perinatal death | en_US |
Subject | COVID-19 | en_US |
Subject | SARS-CoV-2 | en_US |
e-ISSN | 1543-2165 | |