Maternal-fetal immune responses in pregnant women infected with SARS-CoV-2
Valeria Garcia‐Flores, Roberto Romero, Yi Xu, Kevin R. Theis, Marcia Arenas‐Hernandez, Derek Miller, Azam Peyvandipour, Gaurav Bhatti, José Galaz, Meyer Gershater, Dustyn Levenson, Errile Pusod, Tao Li, David J. Kracht, Violetta Florova, Yaozhu Leng, Kenichiro Motomura, Robert Para, Megan Faucett, Chaur‐Dong Hsu, Gary Zhang, Adi L. Tarca, Roger Piqué-Regi, Nardhy Gomez‐Lopez
Abstract
Pregnant women represent a high-risk population for severe/critical COVID-19 and mortality. However, the maternal-fetal immune responses initiated by SARS-CoV-2 infection, and whether this virus is detectable in the placenta, are still under investigation. Here we show that SARS-CoV-2 infection during pregnancy primarily induces unique inflammatory responses at the maternal-fetal interface, which are largely governed by maternal T cells and fetal stromal cells. SARS-CoV-2 infection during pregnancy is also associated with humoral and cellular immune responses in the maternal blood, as well as with a mild cytokine response in the neonatal circulation (i.e., umbilical cord blood), without compromising the T-cell repertoire or initiating IgM responses. Importantly, SARS-CoV-2 is not detected in the placental tissues, nor is the sterility of the placenta compromised by maternal viral infection. This study provides insight into the maternal-fetal immune responses triggered by SARS-CoV-2 and emphasizes the rarity of placental infection.