key: cord-0982562-nnt4ptqz
authors: Algarroba, Gabriela N.; Hanna, Nazeeh N.; Rekawek, Patricia; Vahanian, Sevan A.; Khullar, Poonam; Palaia, Thomas; Peltier, Morgan R.; Chavez, Martin R.; Vintzileos, Anthony M.
title: Confirmatory evidence of visualization of SARS-CoV-2 virus invading the human placenta using electron microscopy
date: 2020-08-28
journal: Am J Obstet Gynecol
DOI: 10.1016/j.ajog.2020.08.106
sha: 5cab44648d2faea0a6645c1619ca33978cbc4001
doc_id: 982562
cord_uid: nnt4ptqz

nan

In May 2020, we published in the American Journal of Obstetrics and Gynecology, early on line, the first case of visualization of the SARS-CoV-2 virus invading the human placenta using electron microscopy. 1 In a subsequent Reply to Letter to the Editor, we outlined further evidence that our original paper represented SARS-CoV-2 virions. 2 The evidence we have With the current letter, we would like to add information regarding the detection of the virus in our placenta sample. A fresh piece of the placenta from our case was tested by RT-PCR by our neonatal research team, led by Dr. Nazeeh Hanna, which is also conducting Covid-19

research. Fresh placental tissues were collected immediately after birth. Total RNA was isolated with miRNeasy mini kit (Qiagen Sciences Inc., Germantown, MD). SARS-Cov-2 gene N1 and N2

were assayed by two step RT-PCR. Reverse transcription was carried out using the High-Capacity cDNA Reverse Transcription Kit with N1, N2, and RNase P gene specific primer. 5 Viral RNA was assayed using 2019-nCoV RUO Kit (Integrated DNA Technologies, Coralville, IA) and sample with cycle threshold (Ct) values less than 40 was considered positive. The results were positive for viral RNA in the placenta of our case report. 1 In conclusion, we want to emphasize that literature published after our case report 1 has unequivocally showed that there is scientific and clinical evidence that placental invasion J o u r n a l P r e -p r o o f by the SARS-CoV-2 virus is real. 3,6-8 As a matter of fact, when vertical trasplacental transmission occurs the viral load in the placenta is several fold higher than the other maternal and fetal compartments. 8 For all the reasons outlined in this letter, we are convinced that we have reported the first case of SARS-CoV-2 visualization in the human placenta. 1 

Visualization of severe acute respiratory syndrome coronavirus 2 invading the human placenta using electron microscopy

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