Center-Based Experiences Implementing Strategies to Reduce Risk of Horizontal Transmission of SARS-Cov-2: Potential for Compromise of Neonatal Microbiome Assemblage

Romano-Keeler, Joann; Fiszbein, Dana; Zhang, Jilei; Horowitz, Joseph; Hayani, Karen C.; Buhimschi, Irina; López, C Díaz; Kadhem, Zaynab; Berman, James; Rasamimari, Phornphat; Raghavan, Aarti; Pillers, De-Ann M.; Sun, Jun

doi:10.1101/2021.01.07.21249418

Cited by 4 publications

(7 citation statements)

References 31 publications

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“…The infection control measures we implemented resulted in no vertical transmission of SARS-CoV-2 and therefore findings of our study confirm previous reports. Similar approaches in the literature are likewise shown to have resulted in no perinatal transmission [38,39]. We believe that discussion about future directions for patient management to minimize perinatal viral transmission is still required and that adopting a strict policy even with asymptomatic patients may be essential due to new virus mutations [40].…”

Section: Discussionmentioning

confidence: 98%

COVID-19 in Pregnancy—Perinatal Outcomes and Vertical Transmission Preventative Strategies, When Considering More Transmissible SARS-CoV-2 Variants

Januszewski

Ziuzia-Januszewska

Santor-Zaczynska

et al. 2021

JCM

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The COVID-19 pandemic affected the physical and mental health of people around the world and left unprepared health care systems struggling to mount an adequate response. Understanding the impact of COVID-19 on pregnancy in terms of perinatal and fetal outcomes is essential to propose strategies for mminimising viral transmission. Overall, 91 pregnant women in labour, or with indication for induction of labour, with COVID-19 were admitted to hospital. On the day of admission, each pregnant woman underwent a nasopharyngeal swab to validate SARS-CoV-2 infection. Whenever delivery was by caesarean section, an amniotic fluid sample was collected after uterus incision. Neonates were tested twice: first by nasopharyngeal swab at birth and secondly either at 24 h after (when babies were isolated) or at discharge (when rooming-in). All samples underwent rRT-PCR testing for SARS-CoV-2. The SARS-CoV-2 RNA tests by nasopharyngeal swab of the pregnant women produced positive results in 47 patients. This cohort gave birth to 48 infants who were double tested by nasopharyngeal swab and included in the prospective observational study. Moreover, in this same cohort, 39 amniotic fluid samples were taken during caesarean section. All samples underwent rRT-PCR testing for SARS-CoV-2 and came back negative. The study results suggest a low risk of vertical transmission of COVID-19 and favourable perinatal outcomes due to adequate preventative strategies. This approach may prove to be more beneficial in the new SARS-CoV-2 variants era.

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Section: Discussionmentioning

confidence: 98%

COVID-19 in Pregnancy—Perinatal Outcomes and Vertical Transmission Preventative Strategies, When Considering More Transmissible SARS-CoV-2 Variants

Januszewski

Ziuzia-Januszewska

Santor-Zaczynska

et al. 2021

JCM

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“…A more recent metaanalysis reported a higher transmission rate of 12% in a study where 54 neonates were positive for SARS-CoV-2. Most of these studies reported that infants were placed 6 ft or 1.5 m from their mothers and offered intermittent SSC, but they did not report on the duration of SSC (7,(33)(34)(35)(36). A national study from India had 21 (1.43%) neonates who tested positive beyond 72 h and reported these as horizontal transmission and had a higher positivity rate in neonates rooming in with their mothers (22).…”

Section: Discussionmentioning

confidence: 99%

An outbreak of infection due to severe acute respiratory corona virus-2 in a neonatal unit from a low and middle income setting

et al. 2022

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IntroductionThe provision of kangaroo mother care (KMC) involving continuous skin-to-skin care (SSC) is an important intervention in neonatal care, which is recommended even when women are infected with severe acute respiratory syndrome coronavirus (SARS-CoV-2). We report on a nosocomial outbreak of SARS-CoV-2 infections in a KMC ward.MethodsContact tracing was conducted following the diagnosis of SARS-CoV-2 in a mother lodging in the KMC ward. All mother-newborn dyads in the KMC and healthcare workers (HCW) were tested for SARS-CoV-2 within 24–72 h of diagnosing the index case. Nasopharyngeal swab samples were obtained and tested from contacts, with a nucleic acid amplification test (NAAT) assay. Next-generation sequencing was done on positive samples. The secondary attack rate (SAR) was calculated assuming that the mother who presented with symptoms was the source of infection.ResultsTwelve (70.6%) of 17 mothers and 8 (42.1%) of 19 neonates who were in the KMC ward with the index case were found to be positive with SARS-CoV-2. Seven (87.5%) of the 8 neonates who tested positive had mothers who also tested positive. Seventy-five percent (9/12) of the mothers and 62.5% (5/8) of the neonates who tested positive were asymptomatic. Eight (27.6%) of 29 HCW were found to be positive and were all asymptomatic. One neonate died from Acinetobacter baumannii sepsis, and his post-mortem lung histopathology showed features compatible with SARS-CoV-2 pneumonia. The sequencing of 13 specimens, which included 1 mother-newborn dyad, indicated clustering to the same phylogenetic lineage with identical mutations. In assessing for factors contributing to this outbreak, it was found that spaces between beds were less than 1 m and mothers had their meals around the same table at the same time.ConclusionWe report on a nosocomial outbreak of SARS-CoV-2 in a KMC ward, affecting a high number of mothers and neonates, and to a lesser extent HCWs. Although it is difficult to point to the index case as the source of this outbreak, as asymptomatic individuals can spread infection, the inadequate adherence to non-pharmaceutical interventions was assessed to have contributed to the spread of infection. This highlights the need for awareness and adherence to mitigation strategies to avoid SARS-CoV-2 outbreaks.

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“…The impact of COVID-19 infection has been explored from the earliest ages[ 1 , 6 ] (Table 3 ). In a single-center observational cohort study, Romano-Keeler et al [ 44 ] examined 21 deliveries of COVID-19 positive mothers between March and August 2020. A higher rate of Caesarean section emerged in the study population compared to institutional (29% in 2019) and national rates (31.9% in 2018)[ 44 ].…”

Section: Infant Microbiota and Covid-19 Infectionmentioning

confidence: 99%

Gut microbiota and COVID-19: An intriguing pediatric perspective

Valentino¹,

Esposito²,

Colosimo³

et al. 2022

WJCC

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Gastrointestinal (GI) involvement has been reported in approximately 50% of patients with coronavirus disease 2019 (COVID-19), which is due to the pathogenic role of inflammation and the intestinal function of the angiotensin-converting enzyme 2 and its receptor. Accumulating adult data has pointed out that gut dysbiosis might occur in these patients with a potential impact on the severity of the disease, however the role of gut microbiota in susceptibility and severity of COVID-19 disease in children is still poorly known. During the last decades, the crosstalk between gut and lung has been largely recognized resulting in the concept of “gut-lung axis” as a central player in modulating the development of several diseases. Both organs are involved in the common mucosal immune system (including bronchus-associated and gut-associated lymphoid tissues) and their homeostasis is crucial for human health. In this framework, it has been found that the role of GI dysbiosis is affecting the homeostasis of the gut-liver axis. Of note, a gut microbiome imbalance has been linked to COVID-19 severity in adult subjects, but it remains to be clarified. Based on the increased risk of inflammatory diseases in children with COVID-19, the potential correlation between gut microbiota dysfunction and COVID-19 needs to be studied in this population. We aimed to summarize the most recent evidence on this striking aspect of COVID-19 in childhood.

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Center-Based Experiences Implementing Strategies to Reduce Risk of Horizontal Transmission of SARS-Cov-2: Potential for Compromise of Neonatal Microbiome Assemblage

Cited by 4 publications

References 31 publications

COVID-19 in Pregnancy—Perinatal Outcomes and Vertical Transmission Preventative Strategies, When Considering More Transmissible SARS-CoV-2 Variants

COVID-19 in Pregnancy—Perinatal Outcomes and Vertical Transmission Preventative Strategies, When Considering More Transmissible SARS-CoV-2 Variants

An outbreak of infection due to severe acute respiratory corona virus-2 in a neonatal unit from a low and middle income setting

Gut microbiota and COVID-19: An intriguing pediatric perspective

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