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BENDER RA, AKBULAK R, SENGUL A. Can asymptomatic SARS-CoV-2 infection cause spontaneous abortion? JOURNAL OF HEALTH SCIENCES AND MEDICINE 2023. [DOI: 10.32322/jhsm.1216310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Aim: The probability of spontaneous abortion is known to increase (15%) in the pregnant women who develop symptomatic and even “Severe Acute Respiratory Syndrome (SARS)” due to maternal infections. It is known that the SARS-CoV-2 virus, one of these infectious agents, enters host cells by binding to angiotensin-converting enzyme 2 (ACE2). New literature data have shown the increased ACE2 receptor in the endometrium during the decidualization phase and the ability of SARS-CoV-2 to enter endometrial stromal cells through ACE2 proteins. This shows that the COVID-19 infection can cause many pathologies such as early pregnancy loss. The aim of this study is to investigate the effects of SARS-CoV-2 virus which are positive in the uterine samples on pregnancy loss.
Material and Method: 13 women who had first trimester pregnancy loss were included in this cross-sectional study. None of these pregnant women had any known symptoms of SARS-CoV-2 infection. SARS-CoV-2 infection was screened in uterus and naso-oropharynx samples by real-time polymerase chain reaction (RT-PCR) test in these pregnant women. Women with positive RT-PCR results will be evaluated for pneumonia by lung tomography. It is planned to evaluate the sample taken from the naso-oropharynx in the partners of these women for SARS-CoV-2 infection by RT-PCR. In addition, in positive cases, RT-PCR was planned from the uterus and naso-oropharynx samples at 7-day intervals until the case turned negative.
Results: RT-PCR test for SARS-CoV-2 was positive only in a sample taken from the uterus of one woman (7.6%). The naso-oropharyngeal sample of the same patient was negative, and the patient had no symptoms of COVID-19. No COVID-19-related lesion was observed in the lung tomography of this patient. The results of the RT-PCR test performed 7 days later with samples taken from the uterus and naso-pharynx were also negative. After the patient's positive RT-PCR result, a naso-oropharyngeal sample was taken from his partner. The RT-PCR test result for SARS-CoV-2 in the patient's partner was negative.
Conclusion: The fact that the SARS-CoV-2 virus was negative in the naso-oropharyngeal sample and positive in the uterine sample in a pregnant woman who had a miscarriage suggests that the endometrium may be an entry route for the virus. These data suggest that the virus can lead to adverse pregnancy outcomes, including early pregnancy loss, even without known symptoms. A large number of studies are needed to evaluate the effects of common viruses on pregnancy beyond the expected and defined symptoms.
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Affiliation(s)
| | | | - Ali SENGUL
- Medicana International Istanbul Hospital
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Shi Q, Wu M, Chen P, Wei B, Tan H, Huang P, Chang S. Criminal of Adverse Pregnant Outcomes: A Perspective From Thyroid Hormone Disturbance Caused by SARS-CoV-2. Front Cell Infect Microbiol 2022; 11:791654. [PMID: 35047419 PMCID: PMC8761741 DOI: 10.3389/fcimb.2021.791654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/06/2021] [Indexed: 01/11/2023] Open
Abstract
Nowadays, emerging evidence has shown adverse pregnancy outcomes, including preterm birth, preeclampsia, cesarean, and perinatal death, occurring in pregnant women after getting infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the underlying mechanisms remain elusive. Thyroid hormone disturbance has been unveiled consistently in various studies. As commonly known, thyroid hormone is vital for promoting pregnancy and optimal fetal growth and development. Even mild thyroid dysfunction can cause adverse pregnancy outcomes. We explored and summarized possible mechanisms of thyroid hormone abnormality in pregnant women after coronavirus disease 2019 (COVID-19) infection and made a scientific thypothesis that adverse pregnancy outcomes can be the result of thyroid hormone disorder during COVID-19. In which case, we accentuate the importance of thyroid hormone surveillance for COVID-19-infected pregnant women.
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Affiliation(s)
- Qiman Shi
- Department of General Surgery, Xiangya Hospital Central South University, Changsha, China
| | - Min Wu
- Department of General Surgery, Xiangya Hospital Central South University, Changsha, China
| | - Pei Chen
- Department of General Surgery, Xiangya Hospital Central South University, Changsha, China
| | - Bo Wei
- Department of General Surgery, Xiangya Hospital Central South University, Changsha, China
| | - Hailong Tan
- Department of General Surgery, Xiangya Hospital Central South University, Changsha, China
| | - Peng Huang
- Department of General Surgery, Xiangya Hospital Central South University, Changsha, China
| | - Shi Chang
- Department of General Surgery, Xiangya Hospital Central South University, Changsha, China.,Clinical Research Center for Thyroid Disease in Hunan Province, Changsha, China.,Hunan Provincial Engineering Research Center for Thyroid and Related Diseases Treatment Technology, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
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Moazzami B, Chaichian S, Samie S, Zolbin MM, Jesmi F, Akhlaghdoust M, Pishkuhi MA, Mirshafiei ZS, Khalilzadeh F, Safari D. Does endometriosis increase susceptibility to COVID-19 infections? A case-control study in women of reproductive age. BMC Womens Health 2021; 21:119. [PMID: 33752656 PMCID: PMC7983080 DOI: 10.1186/s12905-021-01270-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 03/16/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In today's world, coronavirus disease 2019 (COVID-19) is the most critical health problem and research is continued on studying the associated factors. But it is not clear whether endometriosis increases the risk of COVID-19. METHODS Women who referred to the gynecology clinic were evaluated and 507 women with endometriosis (case group) were compared with 520 women without endometriosis (control group). COVID-19 infection, symptoms, exposure, hospitalization, isolation, H1N1 infection and vaccination, and past medical history of the participants were recorded and compared between the groups using IBM SPSS Statistics for Windows version 21. RESULTS Comparison between the groups represent COVID-19 infection in 3.2% of the case group and 3% of the control group (P = 0.942). The control group had a higher frequency of asymptomatic infection (95.7% vs. 94.5%; P < 0.001) and fever (1.6% vs. 0%; P = 0.004), while the frequency of rare symptoms was more common in the case group (P < 0.001). The average disease period was 14 days in both groups (P = 0.694). COVID-19 infection was correlated with close contact (r = 0.331; P < 0.001 in the case group and r = 0.244; P < 0.001 in the control group), but not with the history of thyroid disorders, H1N1 vaccination, traveling to high-risk areas, and social isolation (P > 0.05). CONCLUSION Endometriosis does not increase the susceptibility to COVID-19 infections, but alters the manifestation of the disease. The prevalence of the disease may depend on the interaction between the virus and the individual's immune system but further studies are required in this regard.
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Affiliation(s)
- Bahram Moazzami
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran
| | - Shahla Chaichian
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran.
| | - Saeed Samie
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran
| | - Masoumeh Majidi Zolbin
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Jesmi
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran
| | - Meisam Akhlaghdoust
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran
| | - Mahin Ahmadi Pishkuhi
- PhD Student in Epidemiology, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Sadat Mirshafiei
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran
| | - Fereshteh Khalilzadeh
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran
| | - Dorsa Safari
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran
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Carvalho BRD, Adami KDS, Gonçalves-Ferri WA, Samama M, Ferriani RA, Marcolin AC. COVID-19: Uncertainties from Conception to Birth. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2021; 43:54-60. [PMID: 33513637 PMCID: PMC10183911 DOI: 10.1055/s-0040-1721856] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Scientific information on the impact of the new coronavirus (SARS-CoV-2) on the health of pregnant women, fetuses and newborns is considered of limited confidence, lacking good-quality evidence, and drawing biased conclusions. As a matter of fact, the initial impressions that the evolution of COVID-19 was no different between pregnant and non-pregnant women, and that SARS-CoV-2 was not vertically transmitted, are confronted by the documentation of worsening of the disease during pregnancy, poor obstetric outcomes, and the possibility of vertical transmission. The present article aims to compile the data available on the association of COVID-19 and reproductive events, from conception to birth.
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Affiliation(s)
| | - Karina de Sá Adami
- Maternidade Climério de Oliveira, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Walusa Assad Gonçalves-Ferri
- Department of Pediatrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Marise Samama
- Department of Gynecology, Escola Paulista de Medicina, Universidade Federal de São Paulo, SP, Brazil
| | - Rui Alberto Ferriani
- Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Alessandra Cristina Marcolin
- Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Di Iorio R, Bianchi P, Bastianelli C, Brosens I, Benagiano G. Vertical transmission of SARS-CoV-2 infection in early pregnancy: what is the evidence? J Matern Fetal Neonatal Med 2020; 35:3512-3513. [PMID: 32967472 DOI: 10.1080/14767058.2020.1825671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Romolo Di Iorio
- Department of Medico-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza, University of Rome, Rome, Italy
| | - Paola Bianchi
- Department of Medico-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza, University of Rome, Rome, Italy
| | - Carlo Bastianelli
- Department of Maternal and Child Health, Gynecology and Urology, Policlinico Umberto I Hospital, Sapienza, University of Rome, Rome, Italy
| | - Ivo Brosens
- Department of Medico-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza, University of Rome, Rome, Italy
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Menter T, Mertz KD, Jiang S, Chen H, Monod C, Tzankov A, Waldvogel S, Schulzke SM, Hösli I, Bruder E. Placental Pathology Findings during and after SARS-CoV-2 Infection: Features of Villitis and Malperfusion. Pathobiology 2020; 88:69-77. [PMID: 32950981 PMCID: PMC7573905 DOI: 10.1159/000511324] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/31/2020] [Indexed: 11/19/2022] Open
Abstract
Since the outbreak of coronavirus disease 2019 (COVID-19), there has been a debate whether pregnant women are at a specific risk for COVID-19 and whether it might be vertically transmittable through the placenta. We present a series of five placentas of SARS coronavirus 2 (SARS-CoV-2)-positive women who had been diagnosed with mild symptoms of COVID-19 or had been asymptomatic before birth. We provide a detailed histopathologic description of morphological changes accompanied by an analysis of presence of SARS-CoV-2 in the placental tissue. All placentas were term deliveries (40th and 41st gestational weeks). One SARS-CoV-2-positive patient presented with cough and dyspnoea. This placenta showed prominent lymphohistiocytic villitis and intervillositis and signs of maternal and foetal malperfusion. Viral RNA was present in both placenta tissue and the umbilical cord and could be visualized by in situ hybridization in the decidua. SARS-CoV-2 tests were negative at the time of delivery of 3/5 women, and their placentas did not show increased inflammatory infiltrates. Signs of maternal and/or foetal malperfusion were present in 100% and 40% of cases, respectively. There was no transplacental transmission to the infants. In our cohort, we can document different time points regarding SARS-CoV-2 infection. In acute COVID-19, prominent lymphohistiocytic villitis may occur and might potentially be attributable to SARS-CoV-2 infection of the placenta. Furthermore, there are histopathological signs of maternal and foetal malperfusion, which might have a relationship to an altered coagulative or microangiopathic state induced by SARS-CoV-2, yet this cannot be proven considering a plethora of confounding factors.
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Affiliation(s)
- Thomas Menter
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Sizun Jiang
- Department of Pathology, Stanford University, Stanford, California, USA
| | - Han Chen
- Department of Pathology, Stanford University, Stanford, California, USA
| | - Cécile Monod
- Department of Obstetrics and Antenatal Care, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Alexandar Tzankov
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Salome Waldvogel
- Department of Neonatology, University Children's Hospital Basel UKBB, Basel, Switzerland
| | - Sven M. Schulzke
- Department of Neonatology, University Children's Hospital Basel UKBB, Basel, Switzerland
| | - Irene Hösli
- Department of Obstetrics and Antenatal Care, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Elisabeth Bruder
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
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