JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

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Original Article
Can asymptomatic SARS-CoV-2 infection cause spontaneous abortion?
Abstract
Aims: The probability of spontaneous abortion is known to increase (15%) in the pregnant women who develop symptomatic and even “Severe Acute Respiratory Syndrome (SARS)” due to maternal infections. It is known that the SARS-CoV-2 virus, one of these infectious agents, enters host cells by binding to angiotensin-converting enzyme 2 (ACE2). New literature data have shown the increased ACE2 receptor in the endometrium during the decidualization phase and the ability of SARS-CoV-2 to enter endometrial stromal cells through ACE2 proteins. This shows that the COVID-19 infection can cause many pathologies such as early pregnancy loss. The aim of this study is to investigate the effects of SARS-CoV-2 virus which are positive in the uterine samples on pregnancy loss. Material and
Methods: 13 women who had first trimester pregnancy loss were included in this cross-sectional study. None of these pregnant women had any known symptoms of SARS-CoV-2 infection. SARS-CoV-2 infection was screened in uterus and naso-oropharynx samples by real-time polymerase chain reaction (RT-PCR) test in these pregnant women. Women with positive RT-PCR results will be evaluated for pneumonia by lung tomography. It is planned to evaluate the sample taken from the naso-oropharynx in the partners of these women for SARS-CoV-2 infection by RT-PCR. In addition, in positive cases, RT-PCR was planned from the uterus and naso-oropharynx samples at 7-day intervals until the case turned negative.
Results: RT-PCR test for SARS-CoV-2 was positive only in a sample taken from the uterus of one woman (7.6%). The naso-oropharyngeal sample of the same patient was negative, and the patient had no symptoms of COVID-19. No COVID-19-related lesion was observed in the lung tomography of this patient. The results of the RT-PCR test performed 7 days later with samples taken from the uterus and naso-pharynx were also negative. After the patient's positive RT-PCR result, a naso-oropharyngeal sample was taken from his partner. The RT-PCR test result for SARS-CoV-2 in the patient's partner was negative.
Conclusion: The fact that the SARS-CoV-2 virus was negative in the naso-oropharyngeal sample and positive in the uterine sample in a pregnant woman who had a miscarriage suggests that the endometrium may be an entry route for the virus. These data suggest that the virus can lead to adverse pregnancy outcomes, including early pregnancy loss, even without known symptoms. A large number of studies are needed to evaluate the effects of common viruses on pregnancy beyond the expected and defined symptoms.

Keywords : Pregnancy loss, SARS-CoV-2, abortion, intrauterine, COVID-19

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1. Goddijn M, Leschot NJ. Genetic aspects of miscarriage. BaillieresBest Pract Res Clin Obstet Gynaecol 2000; 14: 855-65.
2. Regan L, Rai R. Epidemiology and the medical causes ofmiscarriage. Baillieres Best Pract Res Clin Obstet Gynaecol 2000;14: 839-54.
3. Frazier T, Hogue CJR, Bonney EA, Yount KM, Pearce BD.Weathering the storm; a review of pre-pregnancy stress and riskof spontaneous abortion. Psychoneuroendocrinology 2018; 92:142-54.
4. Xiong YQ, Tan J, Liu YM, et al. The risk of maternal parvovirusB19 infection during pregnancy on fetal loss and fetal hydrops: Asystematic review and meta-analysis. J Clin Virol 2019; 114: 12-20.
5. Gomez GB, Kamb ML, Newman LM, Mark J, Broutet N,Hawkes SJ. Untreated maternal syphilis and adverse outcomesof pregnancy: a systematic review and meta-analysis. Bull WorldHealth Organ 2013; 91: 217-26.
6. Rasti S, Ghasemi FS, Abdoli A, Piroozmand A, Mousavi SG,Fakhrie-Kashan Z. ToRCH "co-infections" are associated withincreased risk of abortion in pregnant women. Congenit Anom(Kyoto) 2016; 56: 73-8.
7. Wedi CO, Kirtley S, Hopewell S, Corrigan R, Kennedy SH,Hemelaar J. Perinatal outcomes associated with maternal HIVinfection: a systematic review and meta-analysis. Lancet HIV2016; 3: e33-48.
8. Ghasemi FS, Rasti S, Piroozmand A, Bandehpour M, KazemiB, Mousavi SG, et al. Toxoplasmosis-associated abortion andstillbirth in Tehran, Iran. J Matern Fetal Neonatal Med 2016; 29:248-51.
9. Favre G, Pomar L, Musso D, Baud D 2019-nCoV epidemic: whatabout pregnancies? Lancet 2020; 395: e40.
10. Baud D, Greub G, Favre G, et al. Second-Trimester Miscarriagein a Pregnant Woman With SARS-CoV-2 Infection. JAMA 2020;323: 2198-2200.
11. Shanes ED, Mithal LB, Otero S, Azad HA, Miller ES, Goldstein JA.Placental Pathology in COVID-19. Am J Clin Pathol 2020; 154:23-32.
12. la Cour Freiesleben N, Egerup P, Hviid KVR, et al. SARS-CoV-2in first trimester pregnancy: a cohort study. Hum Reprod 2021;36: 40-7.
13. Penfield CA, Brubaker SG, Limaye MA, et al. Detection of severeacute respiratory syndrome coronavirus 2 in placental and fetalmembrane samples. Am J Obstet Gynecol MFM 2020; 2: 100133.
14. Hamming I, Timens W, Bulthuis ML, Lely AT, Navis G, van GoorH. Tissue distribution of ACE2 protein, the functional receptorfor SARS coronavirus. A first step in understanding SARSpathogenesis. J Pathol 2004; 203: 631-7.
15. Chadchan SB, Popli P, Maurya VK, Kommagani R. The SARS-CoV-2 receptor, angiotensin-converting enzyme 2, is requiredfor human endometrial stromal cell decidualizationdagger. BiolReprod 2021; 104: 336-43.
16. Chadchan SB, Maurya VK, Popli P, Kommagani R. The SARS-CoV-2 receptor, Angiotensin converting enzyme 2 (ACE2) isrequired for human endometrial stromal cell decidualization.Preprint. bioRxiv. 2020;2020.06.23.168252.
17. Bellos I, Pandita A, Panza R. Maternal and perinatal outcomes inpregnant women infected by SARS-CoV-2: A meta-analysis. Eur JObstet Gynecol Reprod Biol 2021; 256: 194-204.
18. Wei SQ, Bilodeau-Bertrand M, Liu S, Auger N. The impact ofCOVID-19 on pregnancy outcomes: a systematic review andmeta-analysis. CMAJ 2021; 193: E540-E8.
19. Schwartz DA, Dhaliwal A. Infections in pregnancy with covid-19and other respiratory rna virus diseases are rarely, if ever,transmitted to the fetus: experiences with coronaviruses, hpiv,hmpv rsv, and influenza. Arch Pathol Lab Med 2020;10.5858/arpa.2020-0211-SA.
20. Di Toro F, Gjoka M, Di Lorenzo G, et al. Impact of COVID-19 onmaternal and neonatal outcomes: a systematic review and meta-analysis. Clin Microbiol Infect 2021; 27: 36-46.
21. Wu D, Fang D, Wang R, Deng D, Liao S. Management of pregnancyduring the COVID-19 Pandemic. Glob Chall 2021; 5: 2000052.
22. Elshafeey F, Magdi R, Hindi N, et al. A systematic scoping reviewof COVID-19 during pregnancy and childbirth. Int J GynaecolObstet 2020; 150: 47-52.
Article available in :
Volume 6, Issue 2, 2023
Page : 385-388
https://doi.org/10.32322/jhsm.1216310
Article Information
Received : 16 Ara 2022
Accepted : 09 Şub 2023
Published : 27 Mar 2023
Corresponding Author :

Rukiye Ada Bender: Department of Obstetrics and Gynecology, School of Medicine, Biruni University, İstanbul, Turkey

[email protected]
Citation : Bender RA, Akbulak R, Şengül A. Can asymptomatic SARS-CoV-2 infection cause spontaneous abortion?. J Health Sci Med 2023; 6(2): 385-388.

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