Hofbauer cells and coronavirus disease 2019 (COVID-19) in pregnancy : Molecular pathology analysis of villous macrophages, endothelial cells, and placental findings from 22 placentas infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with and without fetal transmission
(2021) In Archives of pathology & laboratory medicine 145(11). p.1328-1340- Abstract
CONTEXT: - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can undergo maternal-fetal transmission, heightening interest in the placental pathology findings from this infection. Transplacental SARS-CoV-2 transmission is typically accompanied by chronic histiocytic intervillosaaitis together with necrosis and positivity of syncytiotrophoblast for SARSCoV-2. Hofbauer cells are placental macrophages that have been involved in viral diseases including HIV and Zika virus, but their involvement in SARS-CoV-2 in unknown.
OBJECTIVE: - To determine whether SARS-CoV-2 can extend beyond the syncytiotrophoblast to enter Hofbauer cells, endothelium and other villous stromal cells in infected placentas of liveborn and stillborn... (More)
CONTEXT: - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can undergo maternal-fetal transmission, heightening interest in the placental pathology findings from this infection. Transplacental SARS-CoV-2 transmission is typically accompanied by chronic histiocytic intervillosaaitis together with necrosis and positivity of syncytiotrophoblast for SARSCoV-2. Hofbauer cells are placental macrophages that have been involved in viral diseases including HIV and Zika virus, but their involvement in SARS-CoV-2 in unknown.
OBJECTIVE: - To determine whether SARS-CoV-2 can extend beyond the syncytiotrophoblast to enter Hofbauer cells, endothelium and other villous stromal cells in infected placentas of liveborn and stillborn infants.
DESIGN: - Case-based retrospective analysis by 29 perinatal and molecular pathology specialists of placental findings from a preselected cohort of 22 SARS-CoV-2-infected placentas delivered to pregnant women testing positive for SARS-CoV-2 from 7 countries. Molecular pathology methods were used to investigate viral involvement of Hofbauer cells, villous capillary endothelium, syncytiotrophoblast and other fetal-derived cells.
RESULTS: - Chronic histiocytic intervillositis and trophoblast necrosis was present in all 22 placentas (100%). SARS-CoV-2 was identified in Hofbauer cells from 4/22 placentas (18%). Villous capillary endothelial staining was positive in 2/22 cases (9%), both of which also had viral positivity in Hofbauer cells. Syncytiotrophoblast staining occurred in 21/22 placentas (95%). Hofbauer cell hyperplasia was present in 3/22 placentas (14%). In the 7 cases having documented transplacental infection of the fetus, 2 occurred in placentas with Hofbauer cell staining positive for SARS-CoV-2.
CONCLUSIONS: - SARS-CoV-2 can extend beyond the trophoblast into the villous stroma, involving Hofbauer cells and capillary endothelial cells, in a small number of infected placentas. Most cases of SARS-CoV-2 transplacental fetal infection occur without Hofbauer cell involvement.
(Less)
- author
- organization
- publishing date
- 2021-07-23
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Archives of pathology & laboratory medicine
- volume
- 145
- issue
- 11
- pages
- 1328 - 1340
- publisher
- College of American Pathologists
- external identifiers
-
- pmid:34297794
- scopus:85113770626
- ISSN
- 0003-9985
- DOI
- 10.5858/arpa.2021-0296-SA
- language
- English
- LU publication?
- yes
- id
- 794aef4f-20b5-4198-a429-55e63b36fb2d
- date added to LUP
- 2021-07-30 22:23:13
- date last changed
- 2024-11-17 06:33:46
@article{794aef4f-20b5-4198-a429-55e63b36fb2d, abstract = {{<p>CONTEXT: - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can undergo maternal-fetal transmission, heightening interest in the placental pathology findings from this infection. Transplacental SARS-CoV-2 transmission is typically accompanied by chronic histiocytic intervillosaaitis together with necrosis and positivity of syncytiotrophoblast for SARSCoV-2. Hofbauer cells are placental macrophages that have been involved in viral diseases including HIV and Zika virus, but their involvement in SARS-CoV-2 in unknown.</p><p>OBJECTIVE: - To determine whether SARS-CoV-2 can extend beyond the syncytiotrophoblast to enter Hofbauer cells, endothelium and other villous stromal cells in infected placentas of liveborn and stillborn infants.</p><p>DESIGN: - Case-based retrospective analysis by 29 perinatal and molecular pathology specialists of placental findings from a preselected cohort of 22 SARS-CoV-2-infected placentas delivered to pregnant women testing positive for SARS-CoV-2 from 7 countries. Molecular pathology methods were used to investigate viral involvement of Hofbauer cells, villous capillary endothelium, syncytiotrophoblast and other fetal-derived cells.</p><p>RESULTS: - Chronic histiocytic intervillositis and trophoblast necrosis was present in all 22 placentas (100%). SARS-CoV-2 was identified in Hofbauer cells from 4/22 placentas (18%). Villous capillary endothelial staining was positive in 2/22 cases (9%), both of which also had viral positivity in Hofbauer cells. Syncytiotrophoblast staining occurred in 21/22 placentas (95%). Hofbauer cell hyperplasia was present in 3/22 placentas (14%). In the 7 cases having documented transplacental infection of the fetus, 2 occurred in placentas with Hofbauer cell staining positive for SARS-CoV-2.</p><p>CONCLUSIONS: - SARS-CoV-2 can extend beyond the trophoblast into the villous stroma, involving Hofbauer cells and capillary endothelial cells, in a small number of infected placentas. Most cases of SARS-CoV-2 transplacental fetal infection occur without Hofbauer cell involvement.</p>}}, author = {{Schwartz, David A and Baldewijns, Marcella and Benachi, Alexandra and Bugatti, Mattia and Bulfamante, Gaetano and Cheng, Ke and Collins, Rebecca R J and Debelenko, Larisa and De Luca, Danièle and Facchetti, Fabio and Fitzgerald, Brendan and Levitan, Daniel and Linn, Rebecca L and Marcelis, Lukas and Morotti, Denise and Morotti, Raffaella and Patanè, Luisa and Prevot, Sophie and Pulinx, Bianca and Saad, Ali G and Schoenmakers, Sam and Strybol, David and Thomas, Kristen and Tosi, Delfina and Toto, Valentina and van der Meeren, Lotte E and Verdijk, Robert M and Vivanti, Alexandre J and Zaigham, Mehreen}}, issn = {{0003-9985}}, language = {{eng}}, month = {{07}}, number = {{11}}, pages = {{1328--1340}}, publisher = {{College of American Pathologists}}, series = {{Archives of pathology & laboratory medicine}}, title = {{Hofbauer cells and coronavirus disease 2019 (COVID-19) in pregnancy : Molecular pathology analysis of villous macrophages, endothelial cells, and placental findings from 22 placentas infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with and without fetal transmission}}, url = {{http://dx.doi.org/10.5858/arpa.2021-0296-SA}}, doi = {{10.5858/arpa.2021-0296-SA}}, volume = {{145}}, year = {{2021}}, }