SARS-CoV-2 Placentitis

Welcome back to the wonderful world of Covid. Sigh.

The rate of stillbirths and deaths within a month of birth (neonatal) is low in the US relative to Latin America, Africa, the MIddle East and southern Asia.

  • The rate of neonatal deaths in the US was approximately 3.4 in every 1,000 births in 2019, the year before the pandemic. (1)
  • The rate of stillbirths in the US was 5.89 per thousand births (2016). (2)

These are low numbers, but that doesn’t reflect the trauma of the parents and grandparents who lose a baby before or shortly after birth. I’m one of those grandparents.

Covid-19 is a game changer. The incidence of fetal and neonatal death appears to be almost double among pregnant women known to be infected with this virus. New research has produced an explanation for why this is happening.

When most virus infect a pregnant woman, they pass through the blood stream directly into the fetus, and damage the organs of the fetus.

Covid-19, as usual, is different. While autopsies of fetuses show the presence of the SARS virus in some, Covid works by attacking the placenta, the organ that transmits oxygen and nutrients to the fetus. There are two separate paths through which damage occurs:

  1. Direct placenta cell death.
  2. An immune response that jettisons ACE2 receptors. These receptors are essential to many body functions, but Covid leverages these contact points to attack cells in the body. (4)

Destruction of placenta cells reduces blood flow to the fetus, eventually killing it. Simple and deadly.

ACE2 is an enzyme that exists on the surface of many cells. Covid latches onto that enzyme and uses that attachment point to attack the host cell. Covid uses the reproductive engine in the target cell to produce copies of the virus, which leave to attack other cells as the host cell self-destructs.

Why are ACE2 receptors so vital?

ACE2 is a vital element in a biochemical pathway that is critical to regulating processes such as blood pressure, wound healing and inflammation, called the renin-angiotensin-aldosterone system (RAAS) pathway. (3)

ACE2 receptors exist throughout the human body, which at least partially explains the “roulette wheel” effect by which the SARS-Cov-2 virus can affect so many different organs as well as the blood vessels connecting them.

Since we have no reliable way to identify who is carrying the virus, this adds stress to what otherwise could be a joyous experience. The mother-to-be needs to be in very close contact with her OB/GYN doctor, and that doctor needs to be well versed in the risks Covid represents.

Sources:

  1. https://data.unicef.org/topic/child-survival/neonatal-mortality/
  2. https://www.cdc.gov/ncbddd/stillbirth/data.html
  3. https://www.asbmb.org/asbmb-today/science/051620/what-is-the-ace2-receptor
  4. https://www.medicalnewstoday.com/articles/covid-19-during-pregnancy-how-the-placenta-is-involved?utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=MNT%20Daily%20News&utm_content=2022-02-22&apid=32823411&rvid=1d7fc4fbc41da35ed0d96c59f74ddf89434ecc148ef542006495aeba1450e27c#Studying-placentas
  5. https://www.cdc.gov/nchs/nvss/linked-birth.htm
Very sad and very true; source — found online

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