Abstract
Background: The vertical transmission of severe acute respiratory coronavirus-2 (SARS-CoV-2) remains highly debated. Here, we evaluated SARS-CoV-2-transmission in newborns with intrauterine conditions.
Methods: This was a prospective, observational and multicentric study involving 13 Spanish hospitals included in the GEStational and NEOnatal-COVID cohort. Pregnant women with microbiologically confirmed SARS-CoV-2 infection during any trimester of pregnancy or delivery and their newborns were included from March to November 2020. Demographic, clinical and microbiological data were also obtained. Viral loads were analyzed in different maternal and newborn biological samples (placenta, breast milk and maternal blood; urine, meconium and newborn blood).
Results: A total of 177 newborns exposed to SARS-CoV-2 were included. Newborns were tested by reverse transcriptase-polymerase chain reaction using nasopharyngeal swabs within the first 24-48 hours of life and at 14 days of life. In total 5.1% were considered to have SARS-CoV-2 infection in the neonatal period, with 1.7% considered intrauterine and 3.4% intrapartum or early postnatal transmission cases. There were no differences in the demographic and clinical characteristics of the pregnant women and their newborns’ susceptibility to infections in their perinatal history or background.
Conclusions: Intrauterine transmission of SARS-CoV-2 is possible, although rare, with early postnatal transmission occurring more frequently. Most infected newborns remained asymptomatic or had mild symptoms that evolved well during follow-up. We did not find any maternal characteristics predisposing infants to neonatal infection. All infected newborn mothers had acute infection at delivery.Although there was no presence of SARS-CoV2 in cord blood or breast milk samples, SARS-CoV-2 viral load was detected in urine and meconium samples from infected newborns.
【초록키워드】 SARS-CoV-2, SARS-CoV2, Clinical characteristics, Placenta, SARS-COV-2 infection, susceptibility, hospital, Infection, Transmission, Infant, pregnant women, Nasopharyngeal swab, polymerase chain reaction, Infants, Cohort, Newborn, Cord blood, Pregnancy, Characteristics, Asymptomatic, Viral load, nasopharyngeal swabs, acute infection, breast milk, Urine, vertical transmission, Follow-up, women, demographic, mild symptoms, Blood, mother, Coronavirus-2, Neonatal infection, reverse transcriptase-polymerase chain reaction, Neonatal, life, reverse transcriptase, Chain Reaction, in urine, maternal blood, neonatal period, Mild symptom, no difference, SARS-CoV-2 viral load, severe acute respiratory coronavirus, viral loads, no differences, demographic and clinical characteristics, Severe acute respiratory coronavirus-2, MOST, transmission of SARS-CoV-2, Spanish, meconium, tested, analyzed, remained, evaluated, conditions, biological sample, microbiologically, 【제목키워드】 COVID-19, Impact, vertical,