Detection of SARS-CoV-2 in Neonatal Autopsy Tissues and Placenta

Emerg Infect Dis. 2022 Mar;28(3):510-517. doi: 10.3201/eid2803.211735. Epub 2022 Feb 9.


Severe coronavirus disease in neonates is rare. We analyzed clinical, laboratory, and autopsy findings from a neonate in the United States who was delivered at 25 weeks of gestation and died 4 days after birth; the mother had asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and preeclampsia. We observed severe diffuse alveolar damage and localized SARS-CoV-2 by immunohistochemistry, in situ hybridization, and electron microscopy of the lungs of the neonate. We localized SARS-CoV-2 RNA in neonatal heart and liver vascular endothelium by using in situ hybridization and detected SARS-CoV-2 RNA in neonatal and placental tissues by using reverse transcription PCR. Subgenomic reverse transcription PCR suggested viral replication in lung/airway, heart, and liver. These findings indicate that in utero SARS-CoV-2 transmission contributed to this neonatal death.

Keywords: 2019 novel coronavirus disease; COVID-19; SARS-CoV-2; autopsy; coronavirus disease; infant; newborn; pregnancy; respiratory infections; severe acute respiratory syndrome coronavirus 2; vertical transmission; viruses; zoonoses.

Publication types

  • Review

MeSH terms

  • Autopsy
  • COVID-19*
  • Female
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical
  • Lung
  • Placenta
  • Pregnancy
  • Pregnancy Complications, Infectious*
  • RNA, Viral / genetics
  • SARS-CoV-2


  • RNA, Viral