Placental Pathology in SARS-CoV-2 Infection During Second and Third Trimester: A Study in a Tertiary Care Center

Background: The pandemic caused by the novel coronavirus named SARS-CoV-2 (COVID-19) has affected millions. As of June 2024, the number of deaths has reached more than 7.1 million across the globe. The clinical spectrum ranges from mild respiratory tract infection to life-threatening complications and death. Pregnant women are a particular group, and pathological changes in the placentas of SARS-CoV-2 positive patients are needed to understand the effects and outcomes of pregnancy. This study was conducted to assess any specific placental histopathology related to COVID-19. Materials and Methods: We conducted a cross-sectional study on all placentas from women who were COVID-19 positive during the second and third trimesters of pregnancy in the Department of Pathology of a tertiary care center in Northeast India. Results: We encountered twelve (12) placentas from COVID-19 positive mothers. There were nine (75%) live births and three (25%) intrauterine fetal deaths. Features of maternal vascular malperfusion, such as increased perivillous and intervillous fibrin, were the most common findings. Chorangiosis and avascular villi were the most common features of fetal vascular malperfusion. Also observed were marked macrophage infiltration (CD 68 positive), chorioamnionitis, and calcification. Conclusion: Infection with COVID-19 has adverse clinical outcomes and significant placental histopathological and immunohistochemistry findings.