A mechanistic analysis placental intravascular thrombus formation in COVID-19 patients
Identifieur interne : 000685 ( Pmc/Checkpoint ); précédent : 000684; suivant : 000686A mechanistic analysis placental intravascular thrombus formation in COVID-19 patients
Auteurs : J. Justin Mulvey [États-Unis] ; Cynthia M. Magro [États-Unis] ; Lucy X. Ma [États-Unis] ; Gerard J. Nuovo [États-Unis] ; Rebecca N. Baergen [États-Unis]Source :
- Annals of Diagnostic Pathology [ 1092-9134 ] ; 2020.
Abstract
COVID-19, the disease caused by the novel Coronavirus, SARS-CoV-2, is increasingly being recognized as a systemic thrombotic and microvascular injury syndrome that may have its roots in complement activation. We had the opportunity to study the placental pathology of five full-term births to COVID-19 patients, making up the entirety of such deliveries at our hospital. All five exhibited histology indicative of fetal vascular malperfusion characterized by very focal avascular villi and thrombi in larger fetal vessels. Vascular Complement deposition in the placentas was not abnormal, and staining for viral RNA and viral spike protein was negative. While all cases resulted in healthy, term deliveries, these findings indicate the systemic nature of COVID-19 infection. The finding of vascular thrombosis without complement deposition may reflect the systemic nature of COVID-19's procoagulant effects unrelated to systemic complement activation.
Url:
DOI: 10.1016/j.anndiagpath.2020.151530
PubMed: NONE
PubMed Central: 7182529
Affiliations:
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Magro</name><affiliation wicri:level="1"><nlm:aff id="af0010">Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology and Laboratory Medicine, Weill Cornell Medicine</wicri:regionArea><wicri:noRegion>Weill Cornell Medicine</wicri:noRegion></affiliation></author><author><name sortKey="Ma, Lucy X" sort="Ma, Lucy X" uniqKey="Ma L" first="Lucy X." last="Ma">Lucy X. Ma</name><affiliation wicri:level="1"><nlm:aff id="af0010">Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology and Laboratory Medicine, Weill Cornell Medicine</wicri:regionArea><wicri:noRegion>Weill Cornell Medicine</wicri:noRegion></affiliation></author><author><name sortKey="Nuovo, Gerard J" sort="Nuovo, Gerard J" uniqKey="Nuovo G" first="Gerard J." last="Nuovo">Gerard J. Nuovo</name><affiliation wicri:level="2"><nlm:aff id="af0015">The Ohio State University Comprehensive Cancer Center, Columbus, OH, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>The Ohio State University Comprehensive Cancer Center, Columbus, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="af0020">Discovery Life Sciences, Powell, OH, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Discovery Life Sciences, Powell, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Baergen, Rebecca N" sort="Baergen, Rebecca N" uniqKey="Baergen R" first="Rebecca N." last="Baergen">Rebecca N. 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Justin" last="Mulvey">J. Justin Mulvey</name><affiliation wicri:level="1"><nlm:aff id="af0005">Department of Laboratory Medicine, Memorial Sloan-Kettering Cancer Center, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Laboratory Medicine, Memorial Sloan-Kettering Cancer Center</wicri:regionArea><wicri:noRegion>Memorial Sloan-Kettering Cancer Center</wicri:noRegion></affiliation></author><author><name sortKey="Magro, Cynthia M" sort="Magro, Cynthia M" uniqKey="Magro C" first="Cynthia M." last="Magro">Cynthia M. Magro</name><affiliation wicri:level="1"><nlm:aff id="af0010">Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology and Laboratory Medicine, Weill Cornell Medicine</wicri:regionArea><wicri:noRegion>Weill Cornell Medicine</wicri:noRegion></affiliation></author><author><name sortKey="Ma, Lucy X" sort="Ma, Lucy X" uniqKey="Ma L" first="Lucy X." last="Ma">Lucy X. Ma</name><affiliation wicri:level="1"><nlm:aff id="af0010">Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology and Laboratory Medicine, Weill Cornell Medicine</wicri:regionArea><wicri:noRegion>Weill Cornell Medicine</wicri:noRegion></affiliation></author><author><name sortKey="Nuovo, Gerard J" sort="Nuovo, Gerard J" uniqKey="Nuovo G" first="Gerard J." last="Nuovo">Gerard J. Nuovo</name><affiliation wicri:level="2"><nlm:aff id="af0015">The Ohio State University Comprehensive Cancer Center, Columbus, OH, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>The Ohio State University Comprehensive Cancer Center, Columbus, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="af0020">Discovery Life Sciences, Powell, OH, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Discovery Life Sciences, Powell, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Baergen, Rebecca N" sort="Baergen, Rebecca N" uniqKey="Baergen R" first="Rebecca N." last="Baergen">Rebecca N. Baergen</name><affiliation wicri:level="1"><nlm:aff id="af0010">Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Pathology and Laboratory Medicine, Weill Cornell Medicine</wicri:regionArea><wicri:noRegion>Weill Cornell Medicine</wicri:noRegion></affiliation></author></analytic><series><title level="j">Annals of Diagnostic Pathology</title><idno type="ISSN">1092-9134</idno><idno type="eISSN">1532-8198</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>COVID-19, the disease caused by the novel Coronavirus, SARS-CoV-2, is increasingly being recognized as a systemic thrombotic and microvascular injury syndrome that may have its roots in complement activation. We had the opportunity to study the placental pathology of five full-term births to COVID-19 patients, making up the entirety of such deliveries at our hospital. All five exhibited histology indicative of fetal vascular malperfusion characterized by very focal avascular villi and thrombi in larger fetal vessels. Vascular Complement deposition in the placentas was not abnormal, and staining for viral RNA and viral spike protein was negative. While all cases resulted in healthy, term deliveries, these findings indicate the systemic nature of COVID-19 infection. The finding of vascular thrombosis without complement deposition may reflect the systemic nature of COVID-19's procoagulant effects unrelated to systemic complement activation.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Zhu, N" uniqKey="Zhu N">N. Zhu</name></author><author><name sortKey="Zhang, D" uniqKey="Zhang D">D. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann Diagn Pathol</journal-id><journal-id journal-id-type="iso-abbrev">Ann Diagn Pathol</journal-id><journal-title-group><journal-title>Annals of Diagnostic Pathology</journal-title></journal-title-group><issn pub-type="ppub">1092-9134</issn><issn pub-type="epub">1532-8198</issn><publisher><publisher-name>Published by Elsevier Inc.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmc">7182529</article-id><article-id pub-id-type="publisher-id">S1092-9134(20)30071-X</article-id><article-id pub-id-type="doi">10.1016/j.anndiagpath.2020.151530</article-id><article-id pub-id-type="publisher-id">151530</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>A mechanistic analysis placental intravascular thrombus formation in COVID-19 patients</article-title></title-group><contrib-group><contrib contrib-type="author" id="au0005"><name><surname>Mulvey</surname><given-names>J. Justin</given-names></name><xref rid="af0005" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="au0010"><name><surname>Magro</surname><given-names>Cynthia M.</given-names></name><xref rid="af0010" ref-type="aff">b</xref></contrib><contrib contrib-type="author" id="au0015"><name><surname>Ma</surname><given-names>Lucy X.</given-names></name><xref rid="af0010" ref-type="aff">b</xref></contrib><contrib contrib-type="author" id="au0020"><name><surname>Nuovo</surname><given-names>Gerard J.</given-names></name><xref rid="af0015" ref-type="aff">c</xref><xref rid="af0020" ref-type="aff">d</xref></contrib><contrib contrib-type="author" id="au0025"><name><surname>Baergen</surname><given-names>Rebecca N.</given-names></name><email>rbaergen@med.cornell.edu</email><xref rid="af0010" ref-type="aff">b</xref><xref rid="cr0005" ref-type="corresp">⁎</xref></contrib><aff id="af0005"><label>a</label>Department of Laboratory Medicine, Memorial Sloan-Kettering Cancer Center, United States of America</aff><aff id="af0010"><label>b</label>Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, United States of America</aff><aff id="af0015"><label>c</label>The Ohio State University Comprehensive Cancer Center, Columbus, OH, United States of America</aff><aff id="af0020"><label>d</label>Discovery Life Sciences, Powell, OH, United States of America</aff></contrib-group><author-notes><corresp id="cr0005"><label>⁎</label>Corresponding author at: Weill Cornell Medicine, Surgical Pathology, Starr-1002, 520 East 70<sup>th</sup> Street, United States of America. <email>rbaergen@med.cornell.edu</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>25</day><month>4</month><year>2020</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="epub"><day>25</day><month>4</month><year>2020</year></pub-date><elocation-id>151530</elocation-id><permissions><copyright-statement>© 2020 Published by Elsevier Inc.</copyright-statement><copyright-year>2020</copyright-year><copyright-holder></copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract id="ab0005"><p>COVID-19, the disease caused by the novel Coronavirus, SARS-CoV-2, is increasingly being recognized as a systemic thrombotic and microvascular injury syndrome that may have its roots in complement activation. We had the opportunity to study the placental pathology of five full-term births to COVID-19 patients, making up the entirety of such deliveries at our hospital. All five exhibited histology indicative of fetal vascular malperfusion characterized by very focal avascular villi and thrombi in larger fetal vessels. Vascular Complement deposition in the placentas was not abnormal, and staining for viral RNA and viral spike protein was negative. While all cases resulted in healthy, term deliveries, these findings indicate the systemic nature of COVID-19 infection. The finding of vascular thrombosis without complement deposition may reflect the systemic nature of COVID-19's procoagulant effects unrelated to systemic complement activation.</p></abstract><abstract abstract-type="author-highlights" id="ab0010"><title>Highlights</title><p><list list-type="simple" id="l0005"><list-item id="li0005"><label>•</label><p id="p0005">This paper explores thrombosis in the placentas COVID-19-positive patients at our hospital which at the time of publication made-up 100% of COVID-19-positive delivering patients.</p></list-item><list-item id="li0010"><label>•</label><p id="p0010">Potential prothrombotic mechanisms are explored.</p></list-item><list-item id="li0015"><label>•</label><p id="p0015">Direct infection of the placentas is ruled out as a cause.</p></list-item></list></p></abstract></article-meta></front></pmc><affiliations><list><country><li>États-Unis</li></country><region><li>Ohio</li></region></list><tree><country name="États-Unis"><noRegion><name sortKey="Mulvey, J Justin" sort="Mulvey, J Justin" uniqKey="Mulvey J" first="J. Justin" last="Mulvey">J. Justin Mulvey</name></noRegion><name sortKey="Baergen, Rebecca N" sort="Baergen, Rebecca N" uniqKey="Baergen R" first="Rebecca N." last="Baergen">Rebecca N. Baergen</name><name sortKey="Ma, Lucy X" sort="Ma, Lucy X" uniqKey="Ma L" first="Lucy X." last="Ma">Lucy X. Ma</name><name sortKey="Magro, Cynthia M" sort="Magro, Cynthia M" uniqKey="Magro C" first="Cynthia M." last="Magro">Cynthia M. Magro</name><name sortKey="Nuovo, Gerard J" sort="Nuovo, Gerard J" uniqKey="Nuovo G" first="Gerard J." last="Nuovo">Gerard J. Nuovo</name><name sortKey="Nuovo, Gerard J" sort="Nuovo, Gerard J" uniqKey="Nuovo G" first="Gerard J." last="Nuovo">Gerard J. Nuovo</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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