ACE2 Receptors Finding in Placenta with Intrauterine Fetal COVID-19 Infection: A Meta-Analysis

Tigor Peniel Simanjuntak (Department of Obstetrics and Gynecology Medicine Faculty of Universitas Kristen Indonesia)
Hanny Hadinata Wiranegara (Department of Obstetrics and Gynecology Medicine Faculty of Universitas Kristen Indonesia)
Temmy Hadinata Wiranegara (Department of Obstetrics and Gynecology Medicine Faculty of Universitas Kristen Indonesia)

Indonesian Journal of Obstetrics & Gynecology Science
Volume 5 Nomor 2 September 2022

Objective: Association between ACE2 receptors in the placenta and the incidence of intrauterine COVID-19 infection in pregnant women infected with COVID-19 Methods: Systematic review and meta-analysis of placenta in pregnant women with COVID-19 infection, ACE2 receptor in placenta, and RT-PCR of neonates from COVID-19 pregnant women. This study followed the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) protocol. Results: 6 journals meet the inclusion criteria. ACE2 receptors were found in syncytiotrophoblasts 72/72 (100%), cytotrophoblasts 41/72 (56.9%), extravillous trophoblasts 24/72 (33.3%), decidual cells 2/72 (2.7%), villous stromal cells 1/72 (1.3%), and 1/72 stromal cells (1.3%) with the incidence of neonates infected with SARS-CoV-2 from pregnant women with COVID-19 10.5%, odds ratio (OR) between ACE2 receptors and neonates infected with COVID-19 is 1.97 (95%CI 0.05–81.09), the pooled proportion of ACE2 receptor findings in 72 placentas in pregnant women with COVID-19 infection, syncytiotrophoblast 98.3 (95% CI 94.3–99.9), cytotrophoblast 40.3 (95% CI 2.3–88.9), and extravillous trophoblast 35.2 (95% CI 0.2–88.5). Conclusion: Expression of ACE2 receptors is always present in the placenta of pregnant women, and there is an association but non-significant between ACE2 receptors in the placenta and the incidence of COVID-19 intrauterine infection with an odds ratio of 1.97 (95%CI 0.05-81.09).Reseptor ACE2 Pada Plasenta dengan Kejadian Infeksi COVID-19 Intrauterine Pada Fetus: A Meta-AnalysisAbstrakTujuan: Hubungan antara reseptor ACE2 di plasenta dengan angka kejadian infeksi COVID-19 intrauterine pada ibu hamil yang terinfeksi COVID-19. Metode: Tinjauan sistematis dan meta-analisis plasenta pada ibu hamil COVID-19, reseptor ACE2 pada plasenta, dan hasil uji RT-PCR neonatus dari ibu hamil COVID-19. Penelitian ini mengikuti protokol Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). Hasil: 6 jurnal memenuhi kriteria. Reseptor ACE2 ditemukan di sinsitiotrofoblas 72/72 (100%), 41/72 sitotrofoblas (56.9%), trofoblas ekstravili 24/72 (33.3%), sel desidua 2/72 (2.7%), sel stroma vili 1/72 (1.3%), dan sel stroma 1/72 (1.3%) dengan insidensi neonatus yang terinfeksi SARS-CoV-2 dari ibu hamil dengan COVID-19 sebanyak 10.5%, odds ratio (OR) antara reseptor ACE2 dan neonatus terinfeksi COVID-19 adalah 1.97 (95%CI 0.05–81.09), proporsi gabungan penemuan reseptor ACE2 pada 72 plasenta ibu hamil COVID-19, sintiotrofoblas 98.3 (95%CI 94.3 – 99.9), sitotrofoblas 40.3 (95%CI 2.3 – 88.9), dan trofoblas ekstravili 35.2 (95%CI 0.2 – 88.5). Kesimpulan: Ekspresi reseptor ACE2 selalu ditemukan di plasenta ibu hamil, dan terdapat hubungan yang tidak bermakna antara reseptor ACE2 di plasenta dengan kejadian infeksi intrauterine COVID-19 yaitu odds ratio 1.97 (95%CI 0.05-81.09).Kata kunci : Infeksi COVID-19, Intrauterine, reseptor ACE2 plasenta.