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              <text>SARS-CoV-2 Footprints in the Placenta: What We Know after Three Years of the Pandemic</text>
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              <text>COVID-19; entry factors; obstetric outcomes; perinatal outcomes; placental pathology; SARS-CoV-2; vertical transmission</text>
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              <text>As the COVID-19 pandemic continues into its third year, there is accumulating evidence on the consequences of maternal infection. Emerging data indicate increased obstetrics risks, including maternal complications, preterm births, impaired intrauterine fetal growth, hypertensive disorders, stillbirth, gestational diabetes, and a risk of developmental defects in neonates. Overall, controversial concerns still exist regarding the potential for vertical transmission. Histopathological examination of the placenta can represent a useful instrument for investigation and can contribute significant information regarding the possible immunohistopathological mechanisms involved in developing unfavorable perinatal outcomes. Based on current evidence, SARS-CoV-2 infection can affect placental tissue by inducing several specific changes. The level of placental involvement is considered one of the determining factors for unfavorable outcomes during pregnancy due to inflammation and vascular injuries contributing to complex cascade immunological and biological events; however, available evidence does not indicate a strong and absolute correlation between maternal infection, placental lesions, and obstetric outcomes. As existing studies are still limited, we further explore the placenta at three different levels, using histology, immunohistochemistry, and molecular genetics to understand the epidemiological and virological changes observed in the ongoing pandemic.  2023 by the authors.</text>
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              <text>Tosto V.; Meyyazhagan A.; Alqasem M.; Tsibizova V.; Di Renzo G.C.</text>
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              <text>Journal of Personalized Medicine, Vol-13, No. 4</text>
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              <text>2023-01-01</text>
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              <text>&lt;a href="https://doi.org/10.3390/jpm13040699" target="_blank" rel="noreferrer noopener"&gt;https://doi.org/10.3390/jpm13040699&lt;/a&gt;
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              <text>All Open Access; Gold Open Access; Green Open Access</text>
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              <text>ISSN: 20754426</text>
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              <text>Tosto V., Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, 06121, Italy; Meyyazhagan A., Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, 06121, Italy, Perinatology Research Branch, Wayne State University, Detroit, 48202, MI, United States, Department of Life Sciences, CHRIST (Deemed to be University), Bengaluru, 560029, India; Alqasem M., Department of Obstetrics and Gynecology, Faculty of Medicine, Mutah University, Al-Karak, 61710, Jordan; Tsibizova V., PREIS International School, Firenze, 50122, Italy; Di Renzo G.C., Centre of Perinatal and Reproductive Medicine, University of Perugia, Perugia, 06121, Italy, PREIS International School, Firenze, 50122, Italy, Department of Obstetrics and Gynecology, IM Sechenov First State University, 19c1, Moscow, 119991, Russian Federation, Almazov National Medical Research Centre, St Petersburg, 197341, Russian Federation</text>
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