Placental vascular remodeling in pregnant women with COVID-19

  1. Sergiy G. Gychka
  2. Tinatin I. Brelidze
  3. Iurii L. Kuchyn
  4. Tetyana V. Savchuk
  5. Sofia I. Nikolaienko
  6. Volodymyr M. Zhezhera
  7. Ihor I. Chermak
  8. Yuichiro J. Suzuki

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

Severe acute respiratory syndrome coronavirus 2 has been causing the pandemic of coronavirus disease 2019 (COVID-19) that has so far resulted in over 450 million infections and six million deaths. This respiratory virus uses angiotensin-converting enzyme 2 as a receptor to enter host cells and affects various tissues in addition to the lungs. The present study reports that the placental arteries of women who gave birth to live full-term newborns while developing COVID-19 during pregnancy exhibit severe vascular wall thickening and the occlusion of the vascular lumen. A morphometric analysis of the placental arteries stained with hematoxylin and eosin suggests a 2-fold increase in wall thickness and a 5-fold decrease in the lumen area. Placental vascular remodeling was found to occur in all of SARS-CoV-2-positive mothers as defined by RT-PCR. Immunohistochemistry with α-smooth muscle actin and the Kv11.1 channel as well as Masson’s trichrome staining showed that such placental vascular remodeling in COVID-19 is associated with smooth muscle proliferation and fibrosis. Placental vascular remodeling may represent a response mechanism to the clinical problems associated with childbirth in COVID-19 patients.

Article activity feed

  1. Version published to 10.1371/journal.pone.0268591
  2. ScreenIT

    SciScore for 10.1101/2021.07.01.21259860: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsConsent: All the patients provided written informed consent.
    Sex as a biological variableFor comparison purposes, we used placental tissues from 28 women who underwent live childbirth without contracting SARS-CoV-2 as determined by a PCR test.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    The sections were stained with hematoxylin and eosin (H&E) and Masson’s trichrome, and immunohistochemistry using the antibody against α-smooth muscle actin was carried out.
    α-smooth muscle actin
    suggested: None
    Software and Algorithms
    SentencesResources
    Morphometric investigations included the assessment of placental arterial wall thickness and the placental arterial lumen index (the ratio of the internal vessel area to the external vessel area) using the ImageJ software.
    ImageJ
    suggested: (ImageJ, RRID:SCR_003070)
    Statistical analysis: For the morphometric analysis, IBM SPSS Statistics software version 22.0 was used for the statistical calculations.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.07.01.21259860v1 on medRxiv