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Case Report

Vertical Transmission of SARS-CoV-2 Infection and Miscarriage in the Second Trimester: Report of an Immunohistochemically Proven Case

1
Department of Clinical Pathology, Nadezhda Women’s Health Hospital, 1373 Sofia, Bulgaria
2
Neuropathological Laboratory, University Hospital “Saint Ivan Rilski”, 1431 Sofia, Bulgaria
3
Department of Research, Nadezhda Women’s Health Hospital, 1373 Sofia, Bulgaria
4
Department of Obstetrics & Gynaecology, Nadezhda Women’s Health Hospital, 1373 Sofia, Bulgaria
*
Authors to whom correspondence should be addressed.
Academic Editor: Anna Capasso
Clin. Pract. 2022, 12(4), 579-590; https://doi.org/10.3390/clinpract12040061
Received: 27 May 2022 / Revised: 19 July 2022 / Accepted: 21 July 2022 / Published: 26 July 2022
It is an acknowledged fact that SARS-CoV-2 exhibits tropism for the human placenta. A possible mechanism of SARS-CoV-2 entry into host cells is via angiotensin-converting enzyme 2 (ACE2) receptors, which are expressed in trophoblasts, endothelial cells, and macrophages. The present study describes a case of spontaneous miscarriage in the 20th gestational week after maternal SARS-CoV-2 infection. The placenta and various fetal organs were examined for structural alterations and expression of the viral nucleocapsid protein and several immune cell markers via immunohistochemistry (IHC). Histopathological examination of the placenta revealed acute chorioamnionitis, acute subamnionic placentitis, multiple intervillous thrombi, increased fibrinoid deposition, and necrotic changes of the chorionic villi. Immunohistochemistry confirmed the presence of SARS-CoV-2 nucleocapsid protein regions predominantly in the syncytiotrophoblast. Staining of the placental tissue for different markers helped elucidate the distribution of immune cells. Pathomorphological examination of the fetal organs demonstrated changes in microcirculation with the presence of sludge phenomenon and diapedesis haemorrhages, mostly in the lungs, brain, and myocardium. IHC staining of fetal organs revealed expression of SARS-CoV-2 nucleocapsid protein, which was detected to the highest extent in the brain, lungs, and liver. The findings of the present report support the hypothesis of possible vertical transmission of SARS-CoV-2 from mother to fetus. View Full-Text
Keywords: SARS-CoV-2; placental tropism; vertical transmission; nucleocapsid protein SARS-CoV-2; placental tropism; vertical transmission; nucleocapsid protein
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MDPI and ACS Style

Metodiev, D.; Ruseva, M.; Parvanov, D.; Ganeva, R.; Handzhiyska, M.; Vidolova, N.; Stamenov, G. Vertical Transmission of SARS-CoV-2 Infection and Miscarriage in the Second Trimester: Report of an Immunohistochemically Proven Case. Clin. Pract. 2022, 12, 579-590. https://doi.org/10.3390/clinpract12040061

AMA Style

Metodiev D, Ruseva M, Parvanov D, Ganeva R, Handzhiyska M, Vidolova N, Stamenov G. Vertical Transmission of SARS-CoV-2 Infection and Miscarriage in the Second Trimester: Report of an Immunohistochemically Proven Case. Clinics and Practice. 2022; 12(4):579-590. https://doi.org/10.3390/clinpract12040061

Chicago/Turabian Style

Metodiev, Dimitar, Margarita Ruseva, Dimitar Parvanov, Rumiana Ganeva, Maria Handzhiyska, Nina Vidolova, and Georgi Stamenov. 2022. "Vertical Transmission of SARS-CoV-2 Infection and Miscarriage in the Second Trimester: Report of an Immunohistochemically Proven Case" Clinics and Practice 12, no. 4: 579-590. https://doi.org/10.3390/clinpract12040061

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