Evidence of mother-to-newborn infection with COVID-19

Sun, Menghong; Xu, Guoting; Yang, Yong; Tao, Yuan; Pian-Smith, May C. M.; Madhavan, Vandana; Xie, Zhongcong; Zhang, Jiaqiang

doi:10.1016/j.bja.2020.04.066

Cited by 35 publications

(75 citation statements)

References 8 publications

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“…It was found that, 6.3% of infants born to COVID-19 mothers were infected. The transmission was reported both in preterm 13,[22][23][24][25] and full-term born infants 23,26 and even where the infection prevention and control measures were in place 13,22,25 . Furthermore, the vertical transmission was reported regardless of the mode of delivery, vaginal 22,27 or cesarean route 13,[23][24][25][26] .…”

Section: Discussionmentioning

confidence: 99%

A systematic review of vertical transmission and antibodies against SARS-CoV-2 among infants born to mothers with COVID-19

Bwire¹,

Njiro²,

Mwakawanga³

et al. 2020

Preprint

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Amidst the Coronavirus Disease 2019 (COVID-19) pandemic, evidence on vertical transmission and natural passive immunity among the newborns exposed to COVID-19 is scanty and varies. This pose a challenge on preventive interventions for the newborns. We conducted a systematic review to first, determine the likelihood of vertical transmission among COVID-19 exposed infants and second, determine whether antibodies against Severe Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)/ COVID-19 virus exist among COVID-19 vertically exposed but negative infants. This review registered in PROSPERO searched evidence from PubMed/ MEDLINE and Google Scholar, among others. About 517 studies were retrieved, where only 33 articles (5.8%) qualified for final analysis. A total of 205 infants born to SARS-CoV-2 positive mothers were pooled from 33 eligible studies. Overall, 6.3% (13/205; 95%CI: 3.0%-9.7%) of the infants tested positive for COVID-19 virus at birth. Of 33 eligible studies, 6 studies (18.8%) reported about IgG/IgM against SARS-CoV-2. Anti-SARS-CoV-2 IgG/IgM were detected in 90% (10/11; 95%CI: 73.9%-107.9%) of infants who had no COVID-19 but vertically exposed. In conclusion, the current evidence revealed a low possibility of vertical transmission of COVID-19 while antibodies against SARS-CoV-2 were detected in most of the infants who had no COVID-19. Further studies on perinatal outcomes and the magnitude of natural passive immunity in infants born to mothers with COVID-19 are warranted.

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Section: Discussionmentioning

confidence: 99%

A systematic review of vertical transmission and antibodies against SARS-CoV-2 among infants born to mothers with COVID-19

Bwire¹,

Njiro²,

Mwakawanga³

et al. 2020

Preprint

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“…19,22e24,28,30,35,37 Three of these studies reported level 3 PPE, 22,30,37 one reported biosafety level 3, 19 and four studies described PPE in detail including N95 masks, eye goggles, face shields, and surgical gowns. 23,24,28,35 However, we can only make tentative recommendations on the use of PPE as it was not clearly reported how long PPE was worn before, during, and/or after the surgery, and whether any changes were made to the level of PPE worn at any stage (e.g. after intubation/extubation of the patient).…”

Section: Hcw Outcomesmentioning

confidence: 99%

“…Ten reported procedures (53 Caesarean sections, 17 orthopaedic) using neuraxial anaesthesia only 17,22,26,28,30,31,34,36,37,41 and three reported procedures (five aortic dissections and one Caesarean section) using general anaesthesia only, 16,24,27 whereas six reported a mix of surgeries performed using either general or neuraxial anaesthesia. 19,20,32,33,35,40 When reported, spinal, epidural, or a combination of the two methods were used. Exact details of which anaesthetics and analgesics were used were only reported in five of the 26 studies.…”

Section: Covid-19 Statusmentioning

confidence: 99%

“…Patient use of PPE was poorly reported, with only nine studies stating that patients wore any protection. 19,21e23,28,29,35,38,39 Six of these reported the use of surgical masks only, 19,21,22,28,35,38 with N95 mask respirators specifically mentioned in three studies. 21,22,28 HCW use of PPE was more comprehensively reported, with 16 studies describing perioperative use.…”

Section: Use Of Ppe and Infection Reduction Strategiesmentioning

confidence: 99%

“…Nine of the studies in our review reported using operating rooms with negative pressure. 19,21,22,24,28,29,35,36,38 Only one of these studies also described the postoperative care of a patient in a negative pressure ICU, 24 although two studies described sending neonates to negative-pressure wards immediately after birth. 29,31 However, details on other elements of ventilation such as air changes per hour, direction, and filtration were lacking.…”

Section: Use Of Ppe and Infection Reduction Strategiesmentioning

confidence: 99%

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Perioperative management of patients with suspected or confirmed COVID-19: review and recommendations for perioperative management from a retrospective cohort study

Zheng

Hébert

Chatziperi

et al. 2020

British Journal of Anaesthesia

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Background: Current guidelines for perioperative management of coronavirus disease 19 (COVID-19) are mainly based on extrapolated evidence or expert opinion. We aimed to systematically investigate how COVID-19 affects perioperative management and clinical outcomes, to develop evidence-based guidelines. Methods: First, we conducted a rapid literature review in EMBASE, MEDLINE, PubMed, Scopus, and Web of Science (January 1 to July 1, 2020), using a predefined protocol. Second, we performed a retrospective cohort analysis of 166 women undergoing Caesarean section at Tongji Hospital, Wuhan during the COVID-19 pandemic. Demographic, imaging, laboratory, and clinical data were obtained from electronic medical records. Results: The review identified 26 studies, mainly case reports/series. One large cohort reported greater mortality in elective surgery patients diagnosed after, rather than before surgery. Higher 30 day mortality was associated with emergency surgery, major surgery, poorer preoperative condition and surgery for malignancy. Regional anaesthesia was favoured in most studies and personal protective equipment (PPE) was generally used by healthcare workers (HCWs), but its use was poorly described for patients. In the retrospective cohort study, duration of surgery, oxygen therapy and hospital stay were longer in suspected or confirmed patients than negative patients, but there were no differences in neonatal outcomes. None of the 262 participating HCWs was infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) when using level 3 PPE perioperatively. Conclusions: When COVID-19 is suspected, testing should be considered before non-urgent surgery. Until further evidence is available, HCWs should use level 3 PPE perioperatively for suspected or confirmed patients, but research is needed on its timing and specifications. Further research must examine longer-term outcomes. Clinical trial registration: CRD42020182891 (PROSPERO).

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Possible vertical transmission and antibodies against SARS‐CoV‐2 among infants born to mothers with COVID‐19: A living systematic review

Bwire

Njiro

Mwakawanga

et al. 2020

Journal of Medical Virology

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Current evidence suggests that coronavirus disease 2019 (COVID‐19), caused by severe respiratory syndrome coronavirus 2 (SARS‐CoV‐2), is predominantly transmitted from human‐to‐human. However, evidence on vertical transmission and natural passive immunity among the newborns exposed to COVID‐19 is scanty and varies. This poses a challenge on preventive interventions for the newborns. We conducted a systematic review to first, determine the likelihood of vertical transmission among COVID‐19 exposed infants and second, determine whether antibodies against SARS‐CoV‐2 were generated among COVID‐19 vertically exposed but negative infants. This review registered in PROSPERO searched evidence from PubMed/MEDLINE and Google Scholar, among others. About 517 studies were pooled, where 33 articles (5.8%) met the inclusion criteria such as infection prevention and control measures at birth. A total of 205 infants born to COVID‐19 positive mothers were studied. Overall, 6.3% (13/205; 95% CI: 3.0%–9.7%) of the infants tested positive for COVID‐19 virus at birth. Of 33 eligible studies, six studies (18.8%) reported about immunoglobulin G/M (IgG/IgM) against SARS‐CoV‐2. IgG/IgM were detected in 90% infants (10/11; 95% CI: 73.9%–107.9%) who tested negative for COVID‐19 virus. The median antibody levels detected were 75.49 AU/ml (range, 7.25–140.32 AU/ml) and 3.79 AU/ml (range, 0.16–45.83 AU/ml), p = .0041 for IgG and IgM, respectively. In conclusion, the current evidence revealed a low possibility of vertical transmission of COVID‐19 and antibodies against SARS‐CoV‐2 were detected among vertically exposed but negative infants. Further studies on transplacental transmission and the magnitude of natural passive immunity in infants born to mothers with COVID‐19 are warranted.

show abstract

Evidence of mother-to-newborn infection with COVID-19

Cited by 35 publications

References 8 publications

A systematic review of vertical transmission and antibodies against SARS-CoV-2 among infants born to mothers with COVID-19

A systematic review of vertical transmission and antibodies against SARS-CoV-2 among infants born to mothers with COVID-19

Perioperative management of patients with suspected or confirmed COVID-19: review and recommendations for perioperative management from a retrospective cohort study

Possible vertical transmission and antibodies against SARS‐CoV‐2 among infants born to mothers with COVID‐19: A living systematic review

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