COVID-19-associated placental damage

Pilkevich N.B., Markovskaya V.A., Khabibullin R.R., Yavorskaya O.V., Smirnova A.P.

1) Belgorod State National Research University, Belgorod, Russia; 2) Belgorod Pathological Anatomy Bureau, Belgorod, Russia

Modern society has faced the coronavirus disease (COVID-19), which has become a serious global threat to public health. This infection had a significant impact on the healthcare systems around the world. The article analyzes the literature sources on the pathogenesis of placentitis in COVID-19.
During the COVID-19 pandemic, the World Health Organization (WHO) identified pregnant women as a vulnerable group in terms of morbidity, and pregnancy was recognized as a risk factor for the severity of the infection.
SARS-CoV-2 placentitis is a severe and rare damage to the placenta, which is due to the infectious and immunological factors. They can cause severe and diffuse placental parenchymal destruction that can affect >75% of the placenta.
Viral particles attach to the villous trophoblast and destroy it. There is a complement activation, which contributes to the activation of hemostasis and leads to coagulopathy, as well as microvascular damage. The infected syncytiotrophoblast is damaged through complete or incomplete apoptosis. The persistent high level of the virus in the syncytiotrophoblast can lead to prolonged generation of complement fragments, cytokines of inflammatory origin and other chemotactic factors; it may cause a monocyte-macrophage inflammatory reaction, which further exacer-bates placental dysfunction.
Conclusion: COVID-19 infection can lead to the development of placental damage, pregnancy complications, including premature birth, preeclampsia, miscarriages, fetal growth retardation and stillbirth. 
SARS-CoV-2 placentitis occurs due to direct cytotoxicity after virus replication in the syncytiotrophoblast and manifests in three ways: histiocytic intervillositis, perivillous fibrin deposition and trophoblast necrosis.

Authors’ contributions: Pilkevich N.B., Markovskaya V.A., Khabibullin R.R., Yavorskaya O.V., Smirnova A.P. – developing the concept and design of the study, collecting publications, processing and analyzing material on the topic, writing the text of the article, editing the article.
Conflicts of interest: Authors declare lack of the possible conflicts of interests.
Funding: The study was conducted without sponsorship.
For citation: Pilkevich N.B., Markovskaya V.A., Khabibullin R.R., Yavorskaya O.V., Smirnova A.P. COVID-19-associated placental damage.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (3): 13-19 (in Russian)




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Received 28.01.2024

Accepted 04.03.2024

About the Authors

Natalya B. Pilkevich, Dr. Sci. (Med), Professor of the Department of Pathology, Belgorod State National Research University, 308015, Russia, Belgorod, Victory, str., 85,
+7(980)388-30-62,,, SPIN: 5422-3042, Author ID: 1191419.
Vera A. Markovskaya, PhD (Bio), Head of the Department of Pathology, Belgorod State National Research University, 308015, Russia, Belgorod, Victory, str., 85,
Ruslan R. Khabibullin, Senior Lecturer of the Department of Human Anatomy and Histology, Belgorod State National Research University, 308015, Russia, Belgorod,
Victory, str., 85; Head of the Pathological Anatomy Department of Immunohistochemistry, pathologist, Belgorod Pathological Anatomy Bureau,,
Olga V. Yavorskaya, teacher of the Medical College, Belgorod State National Research University, 308015, Russia, Belgorod, Victory, str., 85, yavorskaya
Anastasia P. Smirnova, student of the Medical Institute, Belgorod State National Research University, 308015, Russia, Belgorod, Victory, str., 85,,
Corresponding author: Natalya B. Pilkevich,

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