Coronavirus Disease 2019 and the Placenta: A Literature Review
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Date
2022
Authors
Gesaka, Samwel R
Obimbo, Moses M
Wanyoro, Anthony
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Abstract
Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) virus has been implicated in the clinical pathology of multiple organs and organ systems. Due to the
novelty of the disease, there is a need to review emerging literature to understand the profile of SARS-CoV-2 in
the placenta. This review sought to evaluate the literature on the mediators, mechanism of entry, pathogenesis,
detection, and pathology of SARS-CoV-2 in the placenta. Systematic literature searches found 96 eligible studies.
Our review revealed that SARS-CoV-2 canonical mediators, angiotensin-converting enzyme-2 (ACE2), and
transmembrane serine protease-2 (TMPRSS2) are variably expressed in various placenta compartments,
including the villous cytotrophoblasts, syncytiotrophoblasts (STBs), and extravillous trophoblasts (EVTs)
throughout pregnancy. Placental SARS-CoV-2 and coronavirus-associated receptors and factors (SCARFs),
including basigin (BSG/CD147), dipeptidyl peptidase-4 (DPP4/CD26), cathepsin B/L (CTL B/L), furin,
interferon-induced transmembrane protein (IFITM1-3), and lymphocyte antigen 6E (LY6E) may increase or
reduce the permissiveness of the placenta to SARS-CoV-2. EVTs express genes that code for proteins that may
drive viral pathogenesis in the placenta. Viral RNA, proteins, and particles were detected primarily in the STBs by
in situ hybridization, immunohistochemistry, electron microscopy, and polymerase chain reaction. Placental
pathology in SARS-CoV-2-infected placentas included maternal and fetal vascular malperfusion and a generally
nonspecific inflammatory-immune response.
The localization of SARS-CoV-2 receptors, proteases, and genes involved in coding proteins that drive viral
pathogenesis in the placenta predisposes the placenta to SARS-CoV-2 infection variably in all pregnancy trimesters, with antecedent placental pathology. There is a need for further studies to explicate the mechanism of
entry and pathogenesis of SARS-CoV-2 in the placenta
Description
Article
Keywords
SARS-CoV-2, ACE2, Placental infection, Placental pathology, Single-cell analysis
Citation
Gesaka, S. R., Obimbo, M. M., & Wanyoro, A. (2022). Coronavirus disease 2019 and the placenta: A literature review. Placenta.