ABSTRACT
The COVID-19 pandemic underlined the need to focus on women’s health, particularly during pregnancy. Recent studies have shown that maternal SARS-CoV-2 infection during pregnancy may increase obstetrical risks. However, intraamniotic SARS-CoV-2 infection has been understudied. Here, we conduct inclusive autopsies on 18 fetuses following maternal SARS-CoV-2 infection to determine whether and which fetal organs can be infected by SARS-CoV-2 in utero. We analyze a total of 538 samples from 32 tissue types to comprehensively map and quantify the distribution and replication patterns of SARS-CoV-2 across fetal organs. Our observations reveal that SARS-CoV-2 can be widely distributed in fetal organs through vertical transmission. As the length of time from SARS-CoV-2 infection to termination of pregnancy increases, the prevalence of infection in fetal organs decrease. Further, proteomic profiling reveals DNA damage and immune imbalance in infected organs.