02 Dec 2022
30 Nov 2022
Covid-19 infection in pregnancy is thought to cause vertical transmission. SARS-CoV-2 can bind directly to the ACE-2 receptor of placental macrophages which results in infection of the placenta. CD68 is a protein that is highly expressed on the surface of cells derived from monocytes and macrophages, including placental macrophages. This study aimed to analyze CD68 expression in the placenta of pregnant women with Covid-19 as a marker of vertical transmission. This case-control study was conducted on 66 pregnant women consisting of 33 pregnant women with positive PCR results for Covid-19 and 33 pregnant women with negative Covid-19 at Dr. Moewardi General Hospital Surakarta, Central Java, Indonesia from May to November 2021. Placental CD68 expression was examined by immunohistochemical method. Data were analyzed using Mann-Whitney test, Two Way ANOVA test, and ROC. The mean placental CD68 expression of pregnant women with Covid-19 was higher than those without Covid-19 (17.52±16.23 and 9.25±5.08, respectively, with p=0.021). The mean placental CD68 expression in Covid-19 pregnant women with Covid-19 positive neonates was higher than those with Covid-19 negative neonates from both groups (34.83±34.02, 11.24±9.98, and 9.25±5.08, respectively, with p<0.001). ROC analysis showed that the cut-off of placental CD68 expression as a vertical transmission marker in pregnant women with Covid-19 was 19.8 with a sensitivity of 70.4% and a specificity of 73.1% (AUC=0.786). Placental CD68 expression of pregnant women with Covid-19 is a marker of vertical transmission.