Probable vertical transmission of Alpha variant of concern (B.1.1.7) with evidence of SARS-CoV-2 infection in the syncytiotrophoblast, a case report

• DOI: 10.3389/fmed.2022.1099408
• Publication Date: 2023-01-06T16:54:45Z
• Authors: Hannah A. Bullock; Erika Fuchs; Roosecelis B. Mar...; Mamie Lush; Brigid Bollweg; Alyssa Rutan; Amy Nelson; Mark Brisso; Albert Owusu-Ansah; Craig Sitzman; Laurie Ketterl; Tim Timmons; Patricia Lopez; Elizabeth Mitchell; Emily McCutchen; Jonathan Figliomeni; Peter Iwen; Timothy M. Uyeki; Sarah Reagan-Steiner; Matthew Donahue
• Keywords: Syncytiotrophoblasts; Chorionic villi; Immunostaining

Definitive vertical transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has been rarely reported. We present a case third trimester pregnancy with fetal distress necessitating cesarean section that demonstrated maternal, placental, and infant the SARS-CoV-2 Alpha variant/B.1.1.7.CDC's Influenza Multiplex RT-PCR Assay was used to test for in maternal NP swab, plasma, formalin-fixed paraffin-embedded (FFPE) placental tissue specimens. Whole genome sequencing (WGS) performed on infant, specimens determine genotype. Histopathological evaluation, immunohistochemistry testing (IHC), electron microscopy (EM) analysis were placenta, umbilical cord, membrane FFPE blocks.All tested positive by RT-PCR. WGS further revealed identical sequences from clade 20I/501Y.V1 (lineage Alpha/B.1.1.7) Histopathologic evaluation placenta showed histiocytic neutrophilic intervillositis fibrin deposition trophoblast necrosis immunostaining syncytiotrophoblast evidence coronavirus.These findings suggest SARS-CoV-2, supported clinical course timing, genotypes samples, IHC EM infection. However, determination timing or distinction between prepartum peripartum remains unclear.