학술논문
Hofbauer Cells and COVID-19 in Pregnancy: Molecular Pathology Analysis of Villous Macrophages, Endothelial Cells, and Placental Findings From 22 Placentas Infected by SARS-CoV-2 With and Without Fetal Transmission.
Document Type
Article
Author
Schwartz, David A.; Baldewijns, Marcella; Benachi, Alexandra; Bugatti, Mattia; Bulfamante, Gaetano; Ke Cheng; Collins, Rebecca R. J.; Debelenko, Larisa; De Luca, Danièle; Facchetti, Fabio; Fitzgerald, Brendan; Levitan, Daniel; Linn, Rebecca L.; Marcelis, Lukas; Morotti, Denise; Morotti, Raffaella; Patanè, Luisa; Prevot, Sophie; Pulinx, Bianca; Saad, Ali G.
Source
Subject
*BLASTOCYST
*COVID-19
*SARS-CoV-2
*MATERNAL-fetal exchange
*ENDOTHELIUM
*MACROPHAGES
*RETROSPECTIVE studies
*MOLECULAR pathology
*VERTICAL transmission (Communicable diseases)
*PREGNANCY
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Language
ISSN
0003-9985
Abstract
* Context.--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 intervillositis together with necrosis and positivity of syncytiotrophoblast for SARS-CoV-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 is 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 were present in all 22 placentas (100%). SARS-CoV-2 was identified in Hofbauer cells from 4 of 22 placentas (18.2%). Villous capillary endothelial staining was positive in 2 of 22 cases (9.1%), both of which also had viral positivity in Hofbauer cells. Syncytiotrophoblast staining occurred in 21 of 22 placentas (95.5%). Hofbauer cell hyperplasia was present in 3 of 22 placentas (13.6%). In the 7 cases having documented transplacental infection of the fetus, 2 (28.6%) 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. [ABSTRACT FROM AUTHOR]