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. 2021 Apr 13;2(5):575–590.e5. doi: 10.1016/j.medj.2021.04.009

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SARS-CoV-2 infection in pregnant women is associated with changes in RAS components

(A–F) Immunohistochemical (IHC) staining for (A) ACE2 in BP, (B) VT (STBs and HC; inset), and (C) FM in uninfected and (D) BP, (E) VT (STBs and HC; inset), and (F) FM in SARS-CoV-2-infected placenta. Arrows indicate expression of ACE2. Scale bar represents 20 μm.

(G) Semiquantitative analysis of ACE2 expression in uninfected and SARS-CoV-2-infected placenta.

(H) Densitometric analysis of ACE2 protein expression in term (left panel) and preterm (right panel) placenta of SARS-CoV-2-negative and positive pregnant women. Absolute quantification was performed after normalization with β-actin. The respective blots of ACE2 expression and loading control β-actin are shown.

(I and J) Pre-delivery soluble fms-like tyrosine kinase 1 (sFlt1) and angiotensin II type 1-receptor autoantibody (AT1-AA) levels in sera of uninfected and SARS-CoV-2-infected pregnant women.

P1–P3, SARS-CoV-2-negative placenta; P4, SARS-CoV-2-negative preterm placenta; S1–S3, SARS-CoV-2-positive placenta; S4, SARS-CoV-2-positive preterm placenta. Values are expressed as mean ± SEM. ∗p < 0.05, ∗∗p < 0.01, ∗∗∗p < 0.001, and ∗∗∗∗p < 0.0001.