Abstract
SARS-CoV-2 infected pregnant women are at increased risk of severe COVID-19 than non-pregnant women and have a higher risk of adverse pregnancy outcomes like intrauterine/fetal distress and preterm birth. However, little is known about the impact of SARS-CoV-2 infection on maternal and neonatal immunological profiles. In this study, we investigated the inflammatory and humoral responses to SARS-CoV-2 in maternal and cord blood paired samples. Thirty-six pregnant women were recruited at delivery at Hospital Sant Joan de Déu, Barcelona, Spain, between April-August 2020, before having COVID-19 available vaccines. Maternal and pregnancy variables, as well as perinatal outcomes, were recorded in questionnaires. Nasopharyngeal swabs and maternal and cord blood samples were collected for SARS-CoV-2 detection by rRT-PCR and serology, respectively. We measured IgM, IgG and IgA levels to 6 SARS-CoV-2 antigens (spike [S], S1, S2, receptor-binding domain [RBD], nucleocapsid [N] full-length and C-terminus), IgG to N from 4 human coronaviruses (OC43, HKU1, 229E and NL63), and the concentrations of 30 cytokines, chemokines and growth factors by Luminex. Mothers were classified as infected or non-infected based on the rRT-PCR and serology results. Sixty-four % of pregnant women were infected with SARS-CoV-2 (positive by rRT-PCR during the third trimester and/or serology just after delivery). None of the newborns tested positive for rRT-PCR. SARS-CoV-2 infected mothers had increased levels of virus-specific antibodies and several cytokines. Those with symptoms had higher cytokine levels. IFN-α was increased in cord blood from infected mothers, and in cord blood of symptomatic mothers, EGF, FGF, IL-17 and IL-15 were increased, whereas RANTES was decreased. Maternal IgG and cytokine levels showed positive correlations with their counterparts in cord blood. rRT-PCR positive mothers showed lower transfer of SARS-CoV-2-specific IgGs, with a stronger effect when infection was closer to delivery. SARS-CoV-2 infected mothers carrying a male fetus had higher antibody levels and higher EGF, IL-15 and IL-7 concentrations. Our results show that SARS-CoV-2 infection during the third trimester of pregnancy induces a robust antibody and cytokine response at delivery and causes a significant reduction of the SARS-CoV-2-specific IgGs transplacental transfer, with a stronger negative effect when the infection is closer to delivery.
Keywords: SARS-CoV-2; antibodies; cytokines; maternal and neonatal immunity; transplacental transfer.
【저자키워드】 antibodies, SARS-CoV-2, Cytokines, transplacental transfer., maternal and neonatal immunity, 【초록키워드】 COVID-19, IgG, IgM, severe COVID-19, Vaccines, serology, antibody, SARS-COV-2 infection, Infection, Symptom, outcome, chemokine, pregnant women, outcomes, SARS-CoV-2 detection, rRT-PCR, Newborn, Maternal, Pregnancy, Preterm birth, Humoral response, nucleocapsid, symptomatic, male, Spain, NL63, Swab, women, SARS-CoV-2 antigen, cytokine levels, OC43, HKU1, Blood, mother, 229E, IL-7, IL-15, Concentration, Inflammatory, cytokine response, distress, Barcelona, Neonatal, IFN-α, IL-17, reduction, Questionnaires, higher risk, increased risk, positive correlation, domain, blood sample, profiles, transfer, SARS-CoV-2-specific IgG, growth factor, positive, C-terminus, full-length, RANTES, immunological, concentrations, EGF, SARS-CoV-2-specific IgGs, non-infected, robust, human coronavirus, tested, were infected, collected, recruited, investigated, induce, cause, IgA level, were recorded, cytokine level, FGF, positive for rRT-PCR, variables, was increased, 【제목키워드】 IgG, immune response, Maternal, cytokine profile, Neonatal, transfer,