Analysis of SARS-CoV-2 Vertical Transmission During Pregnancy

Overview

Journal Nat Commun

Specialty Biology

Date 2020 Oct 13

PMID 33046695

Citations 201

Authors

Claudio Fenizia

Mara Biasin

Irene Cetin

Patrizia Vergani

Davide Mileto

Arsenio Spinillo

Maria Rita Gismondo

Francesca Perotti

Clelia Callegari

Alessandro Mancon

Selene Cammarata

Ilaria Beretta

Manuela Nebuloni

Daria Trabattoni

Mario Clerici

Valeria Savasi

Affiliations

Soon will be listed here.

Abstract

The impact of SARS-CoV-2 infection during gestation remains unclear. Here, we analyse the viral genome on maternal and newborns nasopharyngeal swabs, vaginal swabs, maternal and umbilical cord plasma, placenta and umbilical cord biopsies, amniotic fluids and milk from 31 mothers with SARS-CoV-2 infection. In addition, we also test specific anti-SARS-CoV-2 antibodies and expression of genes involved in inflammatory responses in placentas, and in maternal and umbilical cord plasma. We detect SARS-CoV-2 genome in one umbilical cord blood and in two at-term placentas, in one vaginal mucosa and in one milk specimen. Furthermore, we report the presence of specific anti-SARS-CoV-2 IgM and IgG antibodies in one umbilical cord blood and in one milk specimen. Finally, in the three documented cases of vertical transmission, SARS-CoV-2 infection was accompanied by a strong inflammatory response. Together, these data support the hypothesis that in utero SARS-CoV-2 vertical transmission, while low, is possible. These results might help defining proper obstetric management of COVID-19 pregnant women, or putative indications for mode and timing of delivery.

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References

Shah P, Diambomba Y, Acharya G, Morris S, Bitnun A . Classification system and case definition for SARS-CoV-2 infection in pregnant women, fetuses, and neonates. Acta Obstet Gynecol Scand. 2020; 99(5):565-568. PMC: 7262318. DOI: 10.1111/aogs.13870. View

Smithgall M, Liu-Jarin X, Hamele-Bena D, Cimic A, Mourad M, Debelenko L . Third-trimester placentas of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive women: histomorphology, including viral immunohistochemistry and in-situ hybridization. Histopathology. 2020; 77(6):994-999. PMC: 7405484. DOI: 10.1111/his.14215. View

Richtmann R, Torloni M, Otani A, Levi J, Tobara M, Silva C . Fetal deaths in pregnancies with SARS-CoV-2 infection in Brazil: A case series. Case Rep Womens Health. 2020; 27:e00243. PMC: 7354271. DOI: 10.1016/j.crwh.2020.e00243. View

Parazzini F, Bortolus R, Mauri P, Favilli A, Gerli S, Ferrazzi E . Delivery in pregnant women infected with SARS-CoV-2: A fast review. Int J Gynaecol Obstet. 2020; 150(1):41-46. PMC: 9087752. DOI: 10.1002/ijgo.13166. View

Tay M, Poh C, Renia L, Macary P, Ng L . The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol. 2020; 20(6):363-374. PMC: 7187672. DOI: 10.1038/s41577-020-0311-8. View

Dixon D . The Role of Human Milk Immunomodulators in Protecting Against Viral Bronchiolitis and Development of Chronic Wheezing Illness. Children (Basel). 2016; 2(3):289-304. PMC: 4928768. DOI: 10.3390/children2030289. View

Li M, Chen L, Zhang J, Xiong C, Li X . The SARS-CoV-2 receptor ACE2 expression of maternal-fetal interface and fetal organs by single-cell transcriptome study. PLoS One. 2020; 15(4):e0230295. PMC: 7161957. DOI: 10.1371/journal.pone.0230295. View

Ferraiolo A, Barra F, Kratochwila C, Paudice M, Vellone V, Godano E . Report of Positive Placental Swabs for SARS-CoV-2 in an Asymptomatic Pregnant Woman with COVID-19. Medicina (Kaunas). 2020; 56(6). PMC: 7353888. DOI: 10.3390/medicina56060306. View

Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A . Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020; 323(16):1574-1581. PMC: 7136855. DOI: 10.1001/jama.2020.5394. View

10.

Wong S, Chow K, Leung T, Ng W, Ng T, Shek C . Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol. 2004; 191(1):292-7. PMC: 7137614. DOI: 10.1016/j.ajog.2003.11.019. View

11.

Fu Y, Cheng Y, Wu Y . Understanding SARS-CoV-2-Mediated Inflammatory Responses: From Mechanisms to Potential Therapeutic Tools. Virol Sin. 2020; 35(3):266-271. PMC: 7090474. DOI: 10.1007/s12250-020-00207-4. View

12.

Barroso Dos Reis H, Boldrini N, Caldas J, Paz A, Ferrugini C, Miranda A . Severe coronavirus infection in pregnancy: challenging cases report. Rev Inst Med Trop Sao Paulo. 2020; 62:e49. PMC: 7359721. DOI: 10.1590/s1678-9946202062049. View

13.

Zhang L, Jiang Y, Wei M, Cheng B, Zhou X, Li J . [Analysis of the pregnancy outcomes in pregnant women with COVID-19 in Hubei Province]. Zhonghua Fu Chan Ke Za Zhi. 2020; 55(3):166-171. DOI: 10.3760/cma.j.cn112141-20200218-00111. View

14.

Simoes E Silva A, Leal C . Is SARS-CoV-2 Vertically Transmitted?. Front Pediatr. 2020; 8:276. PMC: 7243472. DOI: 10.3389/fped.2020.00276. View

15.

Ferrazzi E, Frigerio L, Savasi V, Vergani P, Prefumo F, Barresi S . Vaginal delivery in SARS-CoV-2-infected pregnant women in Northern Italy: a retrospective analysis. BJOG. 2020; 127(9):1116-1121. PMC: 7267664. DOI: 10.1111/1471-0528.16278. View

16.

Heerema-McKenney A . Defense and infection of the human placenta. APMIS. 2018; 126(7):570-588. DOI: 10.1111/apm.12847. View

17.

Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y . Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020; 71(15):762-768. PMC: 7108125. DOI: 10.1093/cid/ciaa248. View

18.

Algarroba G, Rekawek P, Vahanian S, Khullar P, Palaia T, Peltier M . Visualization of severe acute respiratory syndrome coronavirus 2 invading the human placenta using electron microscopy. Am J Obstet Gynecol. 2020; 223(2):275-278. PMC: 7219376. DOI: 10.1016/j.ajog.2020.05.023. View

19.

Long Q, Liu B, Deng H, Wu G, Deng K, Chen Y . Antibody responses to SARS-CoV-2 in patients with COVID-19. Nat Med. 2020; 26(6):845-848. DOI: 10.1038/s41591-020-0897-1. View

20.

Gross R, Conzelmann C, Muller J, Stenger S, Steinhart K, Kirchhoff F . Detection of SARS-CoV-2 in human breastmilk. Lancet. 2020; 395(10239):1757-1758. PMC: 7241971. DOI: 10.1016/S0140-6736(20)31181-8. View