Placental Necrosis and Immaturity of Ischemic Origin and Syncytiotrophoblastic Knots as Possible Histopathological Findings Associated to COVID-19 Infection

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in 2019 in Wuhan, China, and since then a significant number of hospitalizations in intensive care units and consequently deaths have been reported. In Brazil, 616,018 deaths were reported until the end of 2021. Given the impact on global public health, studies are needed to evaluate the mechanisms of action of the virus, as well as its consequences.

Methods: Electronic medical record data on placental anatomopathological findings and clinical data were collected from 230 pregnant women attended in 2021, 115 of whom acquired coronavirus disease 2019 (COVID-19) during pregnancy and 115 of whom did not.

Results: The mean age of pregnant women who contracted COVID-19 was 27.9 years. Analysis of clinical data showed a positive association between COVID-19 infection and development of gestational hypertension (p = 0.005). Histopathological data indicated that COVID-19-infected patients had a higher rate of placental infarction (p = 0.008) and placentas from COVID-19-positive mothers were at a higher weight percentile than those from COVID-19-negative mothers.

Conclusion: SARS-CoV-2 triggered a serious global health crisis. This study aimed to analyze the role of SARS-CoV-2 in pregnant women treated at reference hospitals in Porto Alegre, Brazil, focusing on placental anatomopathological findings. New epidemiological studies may help to better understand the national scenario and guide the development of appropriate health care strategies.