SARS-CoV-2 Infection and Pregnancy: Maternal and Neonatal Outcomes and Placental Pathology Correlations
Michał Pomorski,
Martyna Trzeszcz,
Agnieszka Matera-Witkiewicz,
Magdalena Krupińska,
Tomasz Fuchs,
Mariusz Zimmer,
Aleksandra Zimmer-Stelmach,
Anna Rosner-Tenerowicz,
Joanna Budny-Wińska,
Anna Tarczyńska-Podraza,
Klaudia Radziejewska,
Barbara Królak-Olejnik,
Anna Szczygieł,
Hanna Augustyniak-Bartosik,
Magdalena Kuriata-Kordek,
Karolina Skalec,
Izabela Smoła,
Ewa Morgiel,
Jakub Gawryś,
Adrian Doroszko,
Piotr Rola,
Małgorzata Trocha,
Krzysztof Kujawa,
Barbara Adamik,
Krzysztof Kaliszewski,
Katarzyna Kiliś-Pstrusińska,
Marcin Protasiewicz,
Janusz Sokołowski,
Ewa A. Jankowska,
Katarzyna Madziarska
Affiliations
Michał Pomorski
Clinical Department of Gynecology and Obstetrics, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Martyna Trzeszcz
Division of Pathology and Clinical Cytology, University Hospital in Wroclaw, Borowska Street 213, 50-556 Wroclaw, Poland
Agnieszka Matera-Witkiewicz
Screening of Biological Activity Assays and Collection of Biological Material Laboratory, Wroclaw Medical University Biobank, Faculty of Pharmacy, Wroclaw Medical University, Borowska Street 211A, 50-556 Wroclaw, Poland
Magdalena Krupińska
Screening of Biological Activity Assays and Collection of Biological Material Laboratory, Wroclaw Medical University Biobank, Faculty of Pharmacy, Wroclaw Medical University, Borowska Street 211A, 50-556 Wroclaw, Poland
Tomasz Fuchs
Clinical Department of Gynecology and Obstetrics, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Mariusz Zimmer
Clinical Department of Gynecology and Obstetrics, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Aleksandra Zimmer-Stelmach
Clinical Department of Gynecology and Obstetrics, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Anna Rosner-Tenerowicz
Clinical Department of Gynecology and Obstetrics, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Joanna Budny-Wińska
Clinical Department of Gynecology and Obstetrics, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Anna Tarczyńska-Podraza
Clinical Department of Gynecology and Obstetrics, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Klaudia Radziejewska
Clinical Department of Gynecology and Obstetrics, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Barbara Królak-Olejnik
Department of Neonatology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Anna Szczygieł
Department of Neonatology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Hanna Augustyniak-Bartosik
Clinical Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Magdalena Kuriata-Kordek
Clinical Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Karolina Skalec
University Hospital in Wroclaw, Borowska Street 213, 50-556 Wroclaw, Poland
Izabela Smoła
Clinical Department of Gastroenterology and Hepatology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Ewa Morgiel
Clinical Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Jakub Gawryś
Clinical Department of Internal Medicine, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
Adrian Doroszko
Clinical Department of Internal Medicine, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
Piotr Rola
Department of Cardiology, Provincial Specialized Hospital, Iwaszkiewicza Street 5, 59-220 Legnica, Poland
Małgorzata Trocha
Department of Pharmacology, Wroclaw Medical University, Mikulicz-Radecki Street 2, 50-345 Wroclaw, Poland
Krzysztof Kujawa
Statistical Analysis Centre, Wroclaw Medical University, K. Marcinkowski Street 2-6, 50-368 Wroclaw, Poland
Barbara Adamik
Clinical Department of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Krzysztof Kaliszewski
Clinical Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Katarzyna Kiliś-Pstrusińska
Clinical Department of Paediatric Nephrology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Marcin Protasiewicz
Clinical Department and Clinic of Cardiology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Janusz Sokołowski
Department of Emergency Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
Ewa A. Jankowska
Institute of Heart Diseases, University Hospital, Borowska Street 213, 50-556 Wroclaw, Poland
Katarzyna Madziarska
Clinical Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
There is accumulating evidence on the perinatal aspects of COVID-19, but available data are still insufficient. The reports on perinatal aspects of COVID-19 have been published on a small group of patients. Vertical transmission has been noted. The SARS-CoV-2 genome can be detected in umbilical cord blood and at-term placenta, and the infants demonstrate elevated SARS-CoV-2-specific IgG and IgM antibody levels. In this work, the analysis of clinical characteristics of RT-PCR SARS-CoV-2-positive pregnant women and their infants, along with the placental pathology correlation results, including villous trophoblast immunoexpression status for SARS-CoV-2 antibody, is presented. RT-PCR SARS-CoV-2 amniotic fluid testing was performed. Neonatal surveillance of infection status comprised RT-PCR testing of a nasopharyngeal swab and the measuring of levels of anti-SARS-CoV-2 in blood serum. In the initial study group were 161 pregnant women with positive test results. From that group, women who delivered during the hospital stay were selected for further analysis. Clinical data, laboratory results, placental histomorphology results, and neonatal outcomes were compared in women with immunohistochemistry (IHC)-con SARS-CoV-2-positive and IHC SARS-CoV-2-negative placentas (26 cases). A positive placental immunoprofile was noted in 8% of cases (n = 2), whereas 92% of cases were negative (n = 24). Women with placental infection proven by IHC had significantly different pathological findings from those without. One infected neonate was noted (n = 1; 4%). Infection was confirmed in perinatal autopsy, as there was the intrauterine fetal demise. The potential course of the infection with the risk of vertical transmission and implications for fetal–neonatal condition is critical for proper clinical management, which will involve comprehensive, multidisciplinary perinatal care for SARS-CoV-2-positive patients.
