Dados do Trabalho

Título

SARS-CoV-2 can be detected in brain sample of fetal tissue, a case report

Apresentação do caso

A 36-year-old pregnant woman, in her first pregnancy, presented for prenatal care at a high-risk pregnancy service due to subclinical hypothyroidism and the presence of a PAI-1 4G/5G polymorphism. During her prenatal care, there were no maternal or fetal complications.
At the 39th week of gestation, she presented with spontaneous rupture of the membranes before labor with meconium amniotic fluid, and she started contractions of the active phase afterward.
A newborn male, hypotonic, weighing 2,600 g, was extracted. He was referred immediately to the neonatal intensive care unit. Death occurred after 4 days.
There was an extensive placental lesion that severely compromised the fetal perfusion. Considering the unfavorable outcome of the case and taking into account the context of the current pandemic and the recent evidence correlating SARS-COV-2 infection to placental injury, at 10 days after the delivery, the patient’s serology was evaluated and positive IgG, was detected by the immunofluorescence method, so it was decided to test the fetus and placenta as well.
RNA was extracted from paraffin-embedded samples of the placenta, lung, liver, heart, kidney, and brain of the fetus using a ReliaPrep™ FFPE Total RNA Miniprep System kit according to the manufacturer’s recommendations. The RNA control was extracted from nasopharyngeal and oropharyngeal (throat) specimens collected by a healthcare professional following the Centers for Disease Control and Prevention (CDC) instruction guidelines using an SV-Total RNA kit. Here we present the brain findings.
It was possible to detect the presence of SARS-CoV-2 through a nested RT-PCR assay in the brain samples. The sequencing of the generated amplicons showed a high sequence identity for different strains of SARS-CoV-2. The brain demonstrated a sequence identity of 100% with a query cover of 45%.

Discussão

The possibility of vertical transmission and abortion or newborn death related to Sars-Cov-2 has yet not been well documented, but we hereby present an evidence of such occurrence. The virus was able to migrate for brain of newborn during the pregnancy and this neurotropism need be considered in neuropathologies associated of Sars-CoV-2 infection.

Comentários finais

Although it is now certain that Sars-cov-2 can be vertically transmitted, new studies are necessary to evaluate the probability and risk of such finding on a larger population.

Palavras-Chave

Sars-CoV-2, Pregnancy, Vertical Transmission