Postmortem Documentation of SARS-CoV-2 in Utero and Postpartum Transmission, through Amniotic Fluid, Placental, and Pulmonary Tissue RT-PCR

Enache, Alexandra; Ciocan, Veronica; Muresan, Camelia Oana; Cut, Talida Georgiana; Novacescu, Dorin; Paul, Corina; Andreescu, Nicoleta; Mihailescu, Alexandra; Raica, Marius; Dumache, Raluca

doi:10.3390/app11209505

Open AccessArticle

Postmortem Documentation of SARS-CoV-2 in Utero and Postpartum Transmission, through Amniotic Fluid, Placental, and Pulmonary Tissue RT-PCR

by

Alexandra Enache

^1,2,

Veronica Ciocan

^1,2,†,

Camelia Oana Muresan

^1,2,†,

Talida Georgiana Cut

^2,3,4,*

,

Dorin Novacescu

^4,*

,

Corina Paul

^5,†

,

Nicoleta Andreescu

⁶

,

Alexandra Mihailescu

⁶,

Marius Raica

^7,8,† and

Raluca Dumache

^1,2

¹

Department VIII, Discipline of Forensic Medicine, Bioethics, Deontology and Medical Law, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania

²

Center for Ethics in Human Genetic Identifications, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania

³

Department XIII, Discipline of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania

⁴

Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania

⁵

Department XI, Discipline of Pediatrics, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania

⁶

Department II, Discipline of Genetics, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania

⁷

Department II, Discipline of Histology, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania

⁸

Angiogenesis Research Center, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania

^*

Authors to whom correspondence should be addressed.

^†

The authors have equal contribution.

Appl. Sci. 2021, 11(20), 9505; https://doi.org/10.3390/app11209505

Submission received: 21 September 2021 / Revised: 7 October 2021 / Accepted: 11 October 2021 / Published: 13 October 2021

(This article belongs to the Special Issue Updates in Forensic Medicine: New Tools Applied in Forensic Science)

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Abstract

The physiopathology of SARS-CoV-2 infection, during pregnancy and in early childhood, is poorly understood. Unfavorable maternal outcomes, the risk of vertical/postpartum transmission, and severe, multisystem involvement in infants and children highlight the importance of developing a cohesive treatment and nuanced prophylaxis strategy. In this study, we evaluate autopsy reports, pathological findings, and SARS-CoV-2 genome expression in three distinct clinical scenarios: maternal death due to severe COVID-19 with in utero fetal demise (27 weeks); mother with moderate COVID-19 and in utero fetal demise (29 weeks); and 2-month-old infant death with confirmed COVID-19 caregivers. We report the presence of the SARS-CoV-2 genome in amniotic fluid and placental tissue in the context of in utero transmission of SARS-CoV-2, but also in postmortem infant pulmonary tissue samples in a case of late postpartum SARS-CoV-2 transmission with asymptomatic, rapidly progressive disease, resulting in infant death. Key pathological findings offer a descriptive portrayal of maternal, in utero, and infantile COVID-19 pathogenesis. Further investigations are necessary to fully comprehend the clinical implications of SARS-CoV-2 infection during pregnancy, a prerequisite for adequate therapeutic management and harm reduction.

Keywords: SARS-CoV-2; pregnancy; vertical transmission; postpartum transmission; autopsy; fetal demise; amniotic fluid RT-PCR; placenta RT-PCR; pulmonary tissue RT-PCR; multisystem inflammatory syndrome in children (MIS-C)

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MDPI and ACS Style

Enache, A.; Ciocan, V.; Muresan, C.O.; Cut, T.G.; Novacescu, D.; Paul, C.; Andreescu, N.; Mihailescu, A.; Raica, M.; Dumache, R. Postmortem Documentation of SARS-CoV-2 in Utero and Postpartum Transmission, through Amniotic Fluid, Placental, and Pulmonary Tissue RT-PCR. Appl. Sci. 2021, 11, 9505. https://doi.org/10.3390/app11209505

AMA Style

Enache A, Ciocan V, Muresan CO, Cut TG, Novacescu D, Paul C, Andreescu N, Mihailescu A, Raica M, Dumache R. Postmortem Documentation of SARS-CoV-2 in Utero and Postpartum Transmission, through Amniotic Fluid, Placental, and Pulmonary Tissue RT-PCR. Applied Sciences. 2021; 11(20):9505. https://doi.org/10.3390/app11209505

Chicago/Turabian Style

Enache, Alexandra, Veronica Ciocan, Camelia Oana Muresan, Talida Georgiana Cut, Dorin Novacescu, Corina Paul, Nicoleta Andreescu, Alexandra Mihailescu, Marius Raica, and Raluca Dumache. 2021. "Postmortem Documentation of SARS-CoV-2 in Utero and Postpartum Transmission, through Amniotic Fluid, Placental, and Pulmonary Tissue RT-PCR" Applied Sciences 11, no. 20: 9505. https://doi.org/10.3390/app11209505

APA Style

Enache, A., Ciocan, V., Muresan, C. O., Cut, T. G., Novacescu, D., Paul, C., Andreescu, N., Mihailescu, A., Raica, M., & Dumache, R. (2021). Postmortem Documentation of SARS-CoV-2 in Utero and Postpartum Transmission, through Amniotic Fluid, Placental, and Pulmonary Tissue RT-PCR. Applied Sciences, 11(20), 9505. https://doi.org/10.3390/app11209505

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Postmortem Documentation of SARS-CoV-2 in Utero and Postpartum Transmission, through Amniotic Fluid, Placental, and Pulmonary Tissue RT-PCR

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