key: cord-0831718-byw8uhbr
authors: Ahmad, Mohd Faizal Bin; Das, Srijit
title: Placental histopathological changes in COVID-19 in term patients admitted to labor and delivery
date: 2021-05-29
journal: Am J Obstet Gynecol
DOI: 10.1016/j.ajog.2021.05.040
sha: f9bc3df8ed9b6e09d942abc56d9bcf4b9e8e58de
doc_id: 831718
cord_uid: byw8uhbr

nan

Placental histopathological changes in COVID-19 in term patients admitted to labor and delivery TO THE EDITORS: We read with much interest the published article "Coronavirus disease 2019 infection and placental histopathology in women delivering at term" by Patberg et al. 1 We wish to share our scientific views on this article.

It was a comprehensive case-control study with a good sample size. Multivariable analysis was used to exclude the confounding bias. In addition, inclusion of other reports helped provide solid evidence for comparison in the study.

However, there are a few issues that may be highlighted. Irrespective of symptoms, only women with a positive COVID-19 test result were considered for compulsory screening. Clinically, we cannot differentiate an asymptomatic "carrier" from a healthy person with a false-positive result given that both are asymptomatic. Thus, not surprisingly, in the published paper, only 10% of women experienced symptoms. Most studies reported similar screening tests. Thus, we feel that this study could have repeated the screening after 48e72 hours to confirm the validity of the positive test result or repeated it at term before the delivery to correlate the COVID-19 infection with placenta morphology. 2 The risk of meconium aspiration syndrome (MAS) was found to be higher in the COVID-19 cohort. However, the incidence of MAS is multifactorial compared with COVID-19 alone. As this is just an observation, we believe that this warrants a detailed discussion, with more emphasis on the multifactorial causes. 3 Vasculitis of unknown origin or chronic intervillositis was also one of the findings in the COVID-19 cohort. However, it was also considered multifactorial because all COVID-19 cohorts in this study were tested only once. A higher correlation can be assumed if the COVID-19 test is positive within 72 hours before delivery. This is because of the nonspecific changes of placental histology, which can be caused by inflammation or the intrapartum event itself in an otherwise normal pregnancy. 4 It would be interesting to observe the long-term maternal and fetal follow-up to this study. We applaud the work by the authors and thank the editor for publishing such an interesting article.

Coronavirus disease 2019 infection and placental histopathology in women delivering at term

Mass population screening for SARS-CoV-2 and false positives-why Liverpool shows we have a problem

Point-of-care lung ultrasound in three neonates with COVID-19

The frequency and type of placental histologic lesions in term pregnancies with normal outcome

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The authors report no conflict of interest.The authors did not receive any funding for the study.