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Figures & Tables

Fig 1.

SARS-CoV-2 cell entry via ACE2 and NRP-1 receptors. ACE2, angiotensin-converting enzyme 2; NRP-1, neuropilin-1; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; TMPRSS2, transmembrane protease serine 2.
SARS-CoV-2 cell entry via ACE2 and NRP-1 receptors. ACE2, angiotensin-converting enzyme 2; NRP-1, neuropilin-1; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; TMPRSS2, transmembrane protease serine 2.

Fig 2.

The role of macrophages in SARS-CoV-2 vertical transmission. ACE2, angiotensin-converting enzyme 2; FVM, fetal vascular malperfusion; IL, interleukin; INF-γ, interferon-γ; MVM, maternal vascular malperfusion; NRP-1, neuropilin-1; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; TMPRSS2, transmembrane protease serine 2; TNF-α, tumor necrosis factor-α.
The role of macrophages in SARS-CoV-2 vertical transmission. ACE2, angiotensin-converting enzyme 2; FVM, fetal vascular malperfusion; IL, interleukin; INF-γ, interferon-γ; MVM, maternal vascular malperfusion; NRP-1, neuropilin-1; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; TMPRSS2, transmembrane protease serine 2; TNF-α, tumor necrosis factor-α.

The mechanisms and probability of SARS-CoV-2 transmission

MechanismLocation in the body or transmission routeTransmission probability
ACE2 and TMPRSS2 proteaseHeart, kidneys, tests, lungs, nasopharynx, smooth muscle cells, placentaThe risk of transmission is the highest during early pregnancy and decreases toward delivery
Perinatal transmissionHealthcare services and proceduresExtremely low risk of viral transmission
BreastfeedingBreast milkExtremely low risk of viral transmission
Sexual intercourseSemenVery low risk of viral transmission
NRP-1Hofbauer cells, endothelial cells, smooth muscle cells, adipocytes, Sertoli cells, placentaThis is the most likely route of SARS-CoV-2 transmission
Macrophages and monocytesVarious tissues – especially placental macrophagesVery high risk of viral transmission

Pathologies and clinical manifestations

Level of changesPathologyClinical manifestation
Placental
  • Venous thrombosis

  • Hemodynamic changes

  • Hypercoagulability

  • Chronic histiocytic intervillositis

  • Syncytiotrophoblast necrosis

  • Fetal and maternal VM

  • Massive perivillous fibrin deposition

  • Lymphoplasmacytic deciduous

  • Extravasation of erythrocytes

  • Thrombosis of placental vessels

  • Cholangitis

  • Miscarriage

  • Stillbirth

  • Fetal growth restriction

  • Early preeclampsia

  • Neurosensory development delay

  • CNS disorders

  • FIRS

Systemic
  • Cytokine storm

  • Venous thrombosis

  • Hemodynamic changes

  • Hypercoagulability

Language: English
Submitted on: Jun 30, 2023
Accepted on: Sep 7, 2023
Published on: Dec 26, 2023
Published by: Hirszfeld Institute of Immunology and Experimental Therapy
In partnership with: Paradigm Publishing Services
Publication frequency: 1 times per year

© 2023 Karol Gostomczyk, Jędrzej Borowczak, Marta Siekielska-Domanowska, Krzysztof Szczerbowski, Mateusz Maniewski, Mariusz Dubiel, Łukasz Szylberg, Magdalena Bodnar, published by Hirszfeld Institute of Immunology and Experimental Therapy
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.