Evidence map›Paper›PMID 34735736›Full record

ArticleBJOG : an international journal of obstetrics and gynaecology2022

COVID-19 and vertical transmission: assessing the expression of ACE2/TMPRSS2 in the human fetus and placenta to assess the risk of SARS-CoV-2 infection.

M A Beesley, J R Davidson, F Panariello, S Shibuya, D Scaglioni, B C Jones, K Maksym, O Ogunbiyi, N J Sebire, D Cacchiarelli and 3 more

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In one paragraph

Article in BJOG : an international journal of obstetrics and gynaecology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
4.6field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.

  1. Pooled it
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  11. SARS-CoV-2 Infection in Pregnancy: Clues and Proof of Adverse Outcomes.International journal of environmental research and public health · 2023
    Observational
  12. Single-Cell Immunobiology of the Maternal-Fetal Interface.Journal of immunology (Baltimore, Md. : 1950) · 2022
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 2 countries.

M A BeesleyGreat Ormond Street Institute of Child Health, University College London, UK.ORCID 0000-0002-9662-6889
J R DavidsonGreat Ormond Street Institute of Child Health, University College London, UK.ORCID 0000-0002-3303-6320
F PanarielloTelethon Institute of Genetics and Medicine (TIGEM), Armenise/Harvard Laboratory of Integrative Genomics, Pozzuoli, Italy.
S ShibuyaGreat Ormond Street Institute of Child Health, University College London, UK.ORCID 0000-0002-4274-1312
D ScaglioniGreat Ormond Street Institute of Child Health, University College London, UK.ORCID 0000-0002-0441-2198
B C JonesGreat Ormond Street Institute of Child Health, University College London, UK.ORCID 0000-0002-2637-8859
K MaksymEGA Institute for Women's Health, University College London, UK.
O OgunbiyiNIHR Great Ormond Street Biomedical Research Centre, London, UK.
N J SebireGreat Ormond Street Institute of Child Health, University College London, UK.
D CacchiarelliTelethon Institute of Genetics and Medicine (TIGEM), Armenise/Harvard Laboratory of Integrative Genomics, Pozzuoli, Italy.
A L DavidEGA Institute for Women's Health, University College London, UK.ORCID 0000-0002-0199-6140
P De CoppiGreat Ormond Street Institute of Child Health, University College London, UK.ORCID 0000-0002-1659-0207
Mfm GerliGreat Ormond Street Institute of Child Health, University College London, UK.ORCID 0000-0002-9331-7394
Great Ormond Street Hospital · GBFederico II University Hospital · ITTelethon Institute Of Genetics And Medicine · ITUniversity College London · GBUniversity College London Hospitals NHS Foundation Trust · GB

Funding

European Research Council 759154Medical Research Council MR/R006237/1Medical Research Council MR/V006797/1Medical Research Council MR/V028480/1
6 · The paper itself

Abstract

backgroundPregnant women have been identified as a potentially at-risk group concerning COVID-19 infection, but little is known regarding the susceptibility of the fetus to infection. Co-expression of ACE2 and TMPRSS2 has been identified as a prerequisite for infection, and expression across different tissues is known to vary between children and adults. However, the expression of these proteins in the fetus is unknown.

methodsWe performed a retrospective analysis of a single cell data repository. The data were then validated at both gene and protein level by performing RT-qPCR and two-colour immunohistochemistry on a library of second-trimester human fetal tissues.

findingsTMPRSS2 is present at both gene and protein level in the predominantly epithelial fetal tissues analysed. ACE2 is present at significant levels only in the fetal intestine and kidney, and is not expressed in the fetal lung. The placenta also does not co-express the two proteins across the second trimester or at term.

interpretationThis dataset indicates that the lungs are unlikely to be a viable route of SARS-CoV2 fetal infection. The fetal kidney, despite presenting both the proteins required for the infection, is anatomically protected from the exposure to the virus. However, the gastrointestinal tract is likely to be susceptible to infection due to its high co-expression of both proteins, as well as its exposure to potentially infected amniotic fluid. TWEETABLE ABSTRACT: This work provides detailed mechanistic insight into the relative protection & vulnerabilities of the fetus & placenta to SARS-CoV-2 infection by scRNAseq & protein expression analysis for ACE2 & TMPRSS2. The findings help to explain the low rate of vertical transmission.

Indexed as

COVID-19Gene Expression ProfilingAdultAngiotensin-Converting Enzyme 2Databases, Nucleic AcidDisease SusceptibilityFemaleFetal ResearchGenetic TestingGestational AgeHumansImmunohistochemistryInfectious Disease Transmission, VerticalPlacentaPregnancyProtective FactorsACE2 protein, humanAngiotensin-Converting Enzyme 2Ribonucleoproteins, Small CytoplasmicSerine EndopeptidasesTMPRSS2 protein, humanACE2COVID-19fetal infectionSARS-CoV2TMPRSS2vertical transmission

Identifiers

PMID34735736
PMCPMC8652560
OpenAlexW3208274090

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.