Maternal-fetal immune responses in pregnant women infected with SARS-CoV-2

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.

Valeria Garcia-Flores, Roberto Romero, Yi Xu, Kevin R. Theis, Marcia Arenas-Hernandez, Derek Miller, Azam Peyvandipour, Gaurav Bhatti, Jose Galaz, Meyer Gershater, Dustyn Levenson, Errile Pusod, Li Tao, David Kracht, Violetta Florova, Yaozhu Leng, Kenichiro Motomura, Robert Para, Megan Faucett, Chaur-Dong Hsu, Gary Zhang, Adi L. Tarca, Roger Pique-Regi, Nardhy Gomez-Lopez