Mechanisms associated with possible vertical transmission of SARS-CoV-2

Authors

DOI:

https://doi.org/10.33448/rsd-v12i1.39786

Keywords:

COVID-19; Vertical Transmission of Infectious Diseases; Pregnancy; COVID-19 vaccines.

Abstract

Pregnancy associated with SARS-CoV-2 infection can be lethal for both mother and fetus, and prematurity is more frequent in infected patients. However, possible vertical transmission is still a divergent issue in the scientific environment, where the veracity and possible mechanisms are not yet fully established. We conducted a systematic review, previously registered in OSF (https://osf.io/ybt8x/?view_only=b62dc26ca157432dabcc56d40f9cc32a), using DeCS/MeSH descriptors and Boolean operators, in Embase, PubMed and Web of Science databases, with selection by screening and reading the full text, aiming to assess the occurrence of vertical transmission, with a focus on the outcome. We found that the expression of angiotensin-converting enzyme receptor 2 (ACE2) at the maternal-fetal interface involving the placenta and decidua, even if minimal, exposes a situation in which SARS-CoV-2 can invade, damage, and increase placental permeability, resulting in infectious involvement of the fetus. Transmission, when present, is not directly dependent on the severity of disease progression, even though there is an association of anti-SARS-CoV-2 IgM positivity with placental abnormalities and the severity of maternal disease. We conclude that there is a possibility of vertical transmission, even though there is controversy among authors, and also highlight the potentiation of vaccine antibody responses, exposing positive results for pregnant women and even for the fetus.

Author Biography

Cleverson Rodrigues Fernandes, Universidade de Rio Verde

Fisioterapeuta, Mestre, Doutor e Pós-doutor em Ciências Médicas pelo Departamento de Patologia da Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo (FMRP- USP). Pós-doutor em Cardiologia pela Universidade de Harvard (Harvard Medical School / Brigham and Women´s Hospital). Especialista (aprimoramento) em Fisioterapia Cardiorrespiratória e Intensiva pelo Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HCFMRP-USP). Especialista em Fisioterapia Pneumológica pela Universidade de Franca (Unifran). Especialista em Acupuntura Auricular e Sistêmica pelo Instituto Paulista de Estudos Sistêmicos (IPES), Sociedade Brasileira de Fisioterapeutas Acupunturistas (SOBRAFISA). Associado e membro integrante do Comitê de Cursos e Eventos da Associação Brasileira de Medicina de Urgência e Emergência (ABRAMEDE). Foi Coordenador do Curso de Fisioterapia das Faculdades Integradas IESGO, supervisor de estágio em Fisioterapia na alta complexidade no Hospital Regional de Ceilândia pela UNIPLAN e coordenador da pós graduação em Fisioterapia intensiva UNIP/UNIPLAN DF. Atualmente é professor de Anatomia Humana, Neuroanatomia, Patologia I e II na Faculdade de Medicinada da Universidade Rio Verde, UniRV e supervisor de estágio em fisioterapia Neurofuncional pela Universidade do Distrito Federal (UDF).

References

Becker, R. C. (2020). COVID-19 update: Covid-19-associated coagulopathy. Journal of Thrombosis and Thrombolysis, 50(1): 54. https://doi.org/10.1007%2Fs11239-020-02134-3

Beesley, M. A., Davidson, J. R., Panariello, F., Shibuya, S., Scaglioni, D., Jones, B. C., Maksym, K., Ogunbiyi, O., Sebire, N. J., Cacchiarelli, D., David, A. L., De Coppi, P., & Gerli, M. (2022). COVID-19 and vertical transmission: assessing the expression of ACE2/TMPRSS2 in the human fetus and placenta to assess the risk of SARS-CoV-2 infection. BJOG: An International Journal of Obstetrics and Gynaecology, 129(2), 256–266. https://doi.org/10.1111/1471-0528.16974

Celik, E., Vatansever, C., Ozcan, G., Kapucuoglu, N., Alatas, C., Besli, Y., Palaoglu, E., Gursoy, T., Manici, M., Turgal, M., Dogan, O., Cekic, S. G., Duru, B., Ata, B., Ergonul, O., & Can, F. (2022). Placental deficiency during maternal SARS-CoV-2 infection. Placenta, 117, 47–56. https://doi.org/10.1016/j.placenta.2021.10.012

Dashraath, P., Wong, J. L. J., Lim, M. X. K., Lim, L. M., Li, S., Biswas, A., Choolani, M., Mattar, C., & Su, L. L. (2020). Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. American Journal of Obstetrics and Gynecology, 222(6), 521–531. https://doi.org/10.1016/j.ajog.2020.03.021

Faure‐Bardon, V., Isnard, P., Roux, N., Leruez‐Ville, M., Molina, T., Bessieres, B., & Ville, Y. (2021). Protein expression of angiotensin‐converting enzyme 2, a SARS‐CoV‐2‐specific receptor, in fetal and placental tissues throughout gestation: new insight for perinatal counseling. Ultrasound in Obstetrics & Gynecology, 57(2), 242–247. https://doi.org/10.1002/uog.22178.

Fenizia, C., Biasin, M., Cetin, I., Vergani, P., Mileto, D., Spinillo, A., Gismondo, M. R., Perotti, F., Callegari, C., Mancon, A., Cammarata, S., Beretta, I., Nebuloni, M., Trabattoni, D., Clerici, M., & Savasi, V. (2020). Analysis of SARS-CoV-2 vertical transmission during pregnancy. Nature Communications, 11(1), 5128. https://doi.org/10.1038/s41467-020-18933-4

Halici-Ozturk, F., Ocal, F. D., Aydin, S., Tanacan, A., Ayhan, S. G., Altinboga, O., Dinc, B., Moraloglu, Ö. T., & Sahin, D. (2021). Investigating the risk of maternal-fetal transmission of SARS-CoV-2 in early pregnancy. Placenta, 106, 25–29. https://doi.org/10.1016/j.placenta.2021.02.006

Jafari, M., Pormohammad, A., Sheikh Neshin, S. A., Ghorbani, S., Bose, D., Alimohammadi, S., Basirjafari, S., Mohammadi, M., Rasmussen‐Ivey, C., Razizadeh, M. H., Nouri‐Vaskeh, M., & Zarei, M. (2021). Clinical characteristics and outcomes of pregnant women with COVID‐19 and comparison with control patients: A systematic review and meta‐analysis. Reviews in Medical Virology, 31(5), 1–16. https://doi.org/10.1002/rmv.2208

Juan, J., Gil, M. M., Rong, Z., Zhang, Y., Yang, H., & Poon, L. C. (2020). Effect of coronavirus disease 2019 (COVID‐19) on maternal, perinatal and neonatal outcome: systematic review. Ultrasound in Obstetrics & Gynecology, 56(1), 15–27. https://doi.org/10.1002/uog.22088

Li, Y., Zhou, W., Yang, L., & You, R. (2020). Physiological and pathological regulation of ACE2, the SARS-CoV-2 receptor. Pharmacological Research, 157, 104833. https://doi.org/10.1016/j.phrs.2020.104833

Lye, P., Dunk, C. E., Zhang, J., Wei, Y., Nakpu, J., Hamada, H., Imperio, G. E., Bloise, E., Matthews, S. G., & Lye, S. J. (2021). ACE2 Is Expressed in Immune Cells That Infiltrate the Placenta in Infection-Associated Preterm Birth. Cells, 10(7), 1724. https://doi.org/10.3390/cells10071724

Pique-Regi, R., Romero, R., Tarca, A. L., Luca, F., Xu, Y., Alazizi, A., Leng, Y., Hsu, C.-D., & Gomez-Lopez, N. (2020). Does the human placenta express the canonical cell entry mediators for SARS-CoV-2? ELife, 9. https://doi.org/10.7554/elife.58716

Shook, L. L., Bordt, E. A., Meinsohn, M.-C., Pepin, D., De Guzman, R. M., Brigida, S., Yockey, L. J., James, K. E., Sullivan, M. W., Bebell, L. M., Roberts, D. J., Kaimal, A. J., Li, J. Z., Schust, D., Gray, K. J., & Edlow, A. G. (2021). Placental Expression of ACE2 and TMPRSS2 in Maternal Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Are Placental Defenses Mediated by Fetal Sex? The Journal of Infectious Diseases, 224(Supplement_6), S647–S659. https://doi.org/10.1093/infdis/jiab335

Sievers, B. L., Chakraborty, S., Xue, Y., Gelbart, T., Gonzalez, J. C., Cassidy, A. G., Golan, Y., Prahl, M., Gaw, S. L., Arunachalam, P. S., Blish, C. A., Boyd, S. D., Davis, M. M., Jagannathan, P., Nadeau, K. C., Pulendran, B., Singh, U., Scheuermann, R. H., Frieman, M. B., & Vashee, S. (2022). Antibodies elicited by SARS-CoV-2 infection or mRNA vaccines have reduced neutralizing activity against Beta and Omicron pseudoviruses. Science Translational Medicine, 14(634). https://doi.org/10.1126/scitranslmed.abn7842

Verma, S., Joshi, C. S., Silverstein, R. B., He, M., Carter, E. B., & Mysorekar, I. U. (2021). SARS-CoV-2 colonization of maternal and fetal cells of the human placenta promotes alteration of local renin-angiotensin system. Med, 2(5), 575-590.e5. https://doi.org/10.1016/j.medj.2021.04.009

Wastnedge, E. A. N., Reynolds, R. M., van Boeckel, S. R., Stock, S. J., Denison, F. C., Maybin, J. A., & Critchley, H. O. D. (2021). Pregnancy and COVID-19. Physiological Reviews, 101(1), 303–318. https://doi.org/10.1152/physrev.00024.2020

Zaigham, M., & Andersson, O. (2020). Maternal and perinatal outcomes with COVID‐19: A systematic review of 108 pregnancies. Acta Obstetricia et Gynecologica Scandinavica, 99(7), 823–829. https://doi.org/10.1111/aogs.13867

Published

12/01/2023

How to Cite

RODRIGUES, D. de S. .; FERNANDES, C. R. . Mechanisms associated with possible vertical transmission of SARS-CoV-2. Research, Society and Development, [S. l.], v. 12, n. 1, p. e29812139786, 2023. DOI: 10.33448/rsd-v12i1.39786. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/39786. Acesso em: 19 apr. 2024.

Issue

Section

Health Sciences