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CC BY 4.0 · Rev Bras Ginecol Obstet 2021; 43(05): 377-383
DOI: 10.1055/s-0041-1729146
Original Article
Covid-19

Placental Sampling for Understanding Viral Infections — A Simplified Protocol for the COVID-19 Pandemic

Coleta placentária para entender infecções virais – Um protocolo simplificado para a pandemia de COVID-19
Guilherme de Moraes Nobrega 
1   Universidade Estadual de Campinas, Campinas, SP, Brazil
,
José Paulo Siqueira Guida 
1   Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Rodolfo Rosa Japecanga 
1   Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Arthur Antolini-Tavares 
1   Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Indira Mysorekar 
2   Washington University School of Medicine, St. Louis, MO, United States of America
,
Maria Laura Costa 
1   Universidade Estadual de Campinas, Campinas, SP, Brazil
› Author Affiliations Funding G. M. N. is supported by Fundação de Amparo à Pesquisa do Estado de São Paulo – FAPESP (grant number 19/18720-6) and Coordenação de Aperfeiçoamento Pessoal de Nível Superior - CAPES (grant number 88887.600190/2021-00). I. M. is supported in part by a grant from the National Institutes of Health (grant number R01HD091218). M. L. C. has support from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) (grant number 409605/2016-6) and FAEPEX (grant number 2300/20). I. M. and M. L. C. have a McDonnell International Scholars Academy seed grant for research on infectious diseases and the impact of COVID-19. The funders had no role in the present study's design, data collection and analysis, decision to publish, or preparation of the manuscript. Figures were created with BioRender.com. We also acknowledge the medical team at the REBRACO institutions, especially all the medical residents involved, for the great help in sample collection during the childbirth of COVID-19 positive patients, proving that the implementation of a research protocol is possible, even facing a pandemic.
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Abstract

Objective The coronavirus disease 2019 (COVID-19) is a pandemic viral disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The impact of the disease among the obstetric population remains unclear, and the study of the placenta can provide valuable information. Adequate sampling of the placental tissue can help characterize the pathways of viral infections.

Methods A protocol of placental sampling is proposed, aiming at guaranteeing representativity of the placenta and describing the adequate conservation of samples and their integrity for future analysis. The protocol is presented in its complete and simplified versions, allowing its implementation in different complexity settings.

Results Sampling with the minimum possible interval from childbirth is the key for adequate sampling and storage. This protocol has already been implemented during the Zika virus outbreak.

Conclusion A protocol for adequate sampling and storage of placental tissue is fundamental for adequate evaluation of viral infections on the placenta. During the COVID-19 pandemic, implementation of this protocol may help to elucidate critical aspects of the SARS-CoV-2 infection.

Resumo

Objetivo A doença do novo coronavírus (COVID-19) é uma doença viral pandêmica causada pelo coronavírus da síndrome respiratória aguda 2 (SARS-CoV-2). O impacto da doença entre a população obstétrica ainda é incerto, e o estudo da placenta pode fornecer informações valiosas. Assim, a coleta adequada do tecido placentário pode ajudar a caracterizar algumas propriedades das infecções virais.

Métodos Um protocolo de coleta placentária é proposto, objetivando a garantia de representatividade da placenta, descrevendo a maneira de conservação adequada das amostras, e visando garantir sua integridade para análises futuras. O protocolo é apresentado em suas versões completa e simplificada, permitindo sua implementação em diferentes configurações de infraestrutura.

Resultados A amostragem com o intervalo mínimo possível do parto é essencial para coleta e armazenamento adequados. Esse protocolo já foi implementado durante a epidemia de vírus Zika.

Conclusão Um protocolo para coleta e armazenamento adequados de tecido placentário é fundamental para a avaliação adequada de infecções virais na placenta. Durante a pandemia de COVID-19, a implementação deste protocolo pode ajudar a elucidar aspectos críticos da infecção por SARS-CoV-2.

Keywords

COVID-19 - placenta - pregnancy - systematic sampling - viral infections

Palavras-chave

COVID-19 - placenta - gestação - coleta sistemática - infecções virais

Contributions

G. M. N. and M. L. C. structured the manuscript and did the majority of the writing, conception, and design. J. P. S. G., R. R. J., A. A. T. and I. U. M. were essential for developing the article and conducting a critical review of the intellectual content. All authors declare that they have seen and approved the final version of the manuscript.


Supplementary Material



Publication History

Received: 12 May 2020

Accepted: 04 February 2021

Article published online:
28 June 2021

© 2021. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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