Perinatal COVID-19

Briana, Despina D.; Syridou, Garyffalia; Papaevangelou, Vassiliki

doi:10.1097/inf.0000000000003356

Cited by 8 publications

(3 citation statements)

References 10 publications

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“…Our data regarding intracranial blood flow analysis in both groups suggest a relevant trend of decrease in RI (resistance) and PI (pulsatility) indices in the SARS-CoV-2-exposed group when maternal infections occur in the last 14 days of gestation and critical cases. This fact is thought to be a consequence of systemic adaptation to the persistent inflammatory condition that may be present even after the first 14 days of acute viral symptoms ( 27 , 28 ). Cases of early maternal infection with SARS-CoV-2 during pregnancy, especially in the first and second trimesters, would allow sufficient time for arterial flow autoregulation to settle and the systemic inflammatory response to subside.…”

Section: Discussionmentioning

confidence: 99%

Neuroimaging assessment of pediatric cerebral changes associated with SARS-CoV-2 infection during pregnancy

et al. 2023

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BackgroundSARS-CoV-2 infection and perinatal neurologic outcomes are still not fully understood. However, there is recent evidence of white matter disease and impaired neurodevelopment in newborns following maternal SARS-CoV-2 infection. These appear to occur as a consequence of both direct viral effects and a systemic inflammatory response, with glial cell/myelin involvement and regional hypoxia/microvascular dysfunction. We sought to characterize the consequences of maternal and fetal inflammatory states in the central nervous system of newborns following maternal SARS-CoV-2 infection.MethodsWe conducted a longitudinal prospective cohort study from June 2020 to December 2021, with follow-up of newborns born to mothers exposed or not exposed to SARS-CoV-2 infection during pregnancy. Brain analysis included data from cranial ultrasound scans (CUS) with grayscale, Doppler studies (color and spectral), and ultrasound-based brain elastography (shear-wave mode) in specific regions of interest (ROIs): deep white matter, superficial white matter, corpus callosum, basal ganglia, and cortical gray matter. Brain elastography was used to estimate brain parenchymal stiffness, which is an indirect quantifier of cerebral myelin tissue content.ResultsA total of 219 single-pregnancy children were enrolled, including 201 born to mothers exposed to SARS-CoV-2 infection and 18 from unexposed controls. A neuroimaging evaluation was performed at 6 months of adjusted chronological age and revealed 18 grayscale and 21 Doppler abnormalities. Predominant findings were hyperechogenicity of deep brain white matter and basal ganglia (caudate nuclei/thalamus) and a reduction in the resistance and pulsatility indices of intracranial arterial flow. The anterior brain circulation (middle cerebral and pericallosal arteries) displayed a wider range of flow variation than the posterior circulation (basilar artery). Shear-wave US elastography analysis showed a reduction in stiffness values in the SARS-CoV-2 exposed group in all analyzed regions of interest, especially in the deep white matter elasticity coefficients (3.98 ± 0.62) compared to the control group (7.76 ± 0.77); p-value < 0.001.ConclusionThis study further characterizes pediatric structural encephalic changes associated with SARS-CoV-2 infection during pregnancy. The maternal infection has been shown to be related to cerebral deep white matter predominant involvement, with regional hyperechogenicity and reduction of elasticity coefficients, suggesting zonal impairment of myelin content. Morphologic findings may be subtle, and functional studies such as Doppler and elastography may be valuable tools to more accurately identify infants at risk of neurologic damage.

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Section: Discussionmentioning

confidence: 99%

Neuroimaging assessment of pediatric cerebral changes associated with SARS-CoV-2 infection during pregnancy

et al. 2023

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“…Despite the magnitude of COVID-19 and its impacts on health, few reports are available on the composition of colostrum after women were stricken with this disease during pregnancy, either with or without symptoms ( 31 , 32 ).…”

Section: Discussionmentioning

confidence: 99%

The impact on colostrum oxidative stress, cytokines, and immune cells composition after SARS-CoV-2 infection during pregnancy

Graciliano

Tenório²,

Fragoso³

et al. 2022

Front. Immunol.

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BackgroundLimited data are available regarding the differences between immunological, biochemical, and cellular contents of human colostrum following maternal infection during pregnancy with coronavirus 2 disease (COVID-19).ObjectiveTo investigate whether maternal COVID-19 infection may affect immunological, biochemical, and cellular contents of human colostrum.MethodsUsing a case-control study design, we collected colostrum from 14 lactating women with a previous diagnosis of COVID-19 during pregnancy and 12 without a clear diagnosis during September 2020 to May 2021. Colostrum samples were analysed for some enzymes and non-enzymatic oxidative stress markers (SOD, CAT, GPx, MDA, GSH, GSSG, H2O2, MPO) and for IL-1β, IL-6, tumour necrosis factor (TNF)-α, protein induced by interferon gamma (IP)-10, IL-8, IFN-λ1, IL12p70, IFN-α2, IFN-λ2/3, granulocyte macrophage colony stimulating factor (GM-CSF), IFN-β, IL-10 and IFN-γ, along with IgA and IgG for the SARS-CoV-2 S protein. We perform immunophenotyping to assess the frequency of different cell types in the colostrum.ResultsColostrum from the COVID-19 symptomatic group in pregnancy contained reduced levels of H2O2, IFN-α2, and GM-CSF. This group had higher levels of GSH, and both NK cell subtypes CD3-CD56brightCD16-CD27+IFN-γ+ and CD3-CD56dimCD16+CD27- were also increased.ConclusionThe present results reinforce the protective role of colostrum even in the case of mild SARS-Cov-2 infection, in addition to demonstrating how adaptive the composition of colostrum is after infections. It also supports the recommendation to encourage lactating women to continue breastfeeding after COVID-19 illness.

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“…Although most infected newborns are asymptomatic or mildly symptomatic, there are case reports of severe neonatal SARS-CoV-2 infection, including cardiorespiratory failure and death [9,10]. There is conflicting evidence regarding the intrapartum and postpartum factors that influence the infection risk to newborns, and little data on newborn infection risk after birth hospital discharge [11]. In this study, we sought to describe the relationship between perinatal COVID-19 and maternal and newborn health outcomes, and our local incidence of newborn SARS-CoV-2 infection during the delivery admission and within 1 month after birth, over a 13-month period at two urban, high-risk birth hospitals.…”

Section: Introductionmentioning

confidence: 99%

Perinatal COVID-19 maternal and neonatal outcomes at two academic birth hospitals

et al. 2022

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Describe 1-month outcomes among newborns of persons with perinatal COVID-19. STUDY DESIGN: Prospective observational study of pregnant persons who tested positive for SARS-CoV-2 between 14 days before and 3 days after delivery and their newborns, from 3/2020 to 3/2021 at two urban high-risk academic hospitals. Phone interviews were conducted to determine 1-month newborn outcomes. RESULTS: Among 9748 pregnant persons, 209 (2.1%) tested positive for perinatal SARS-CoV-2. Symptomatically infected persons were more likely to have a preterm delivery due to worsening maternal condition and their newborns were more likely to test positive for SARS-CoV-2 compared with asymptomatic persons. Six of 191 (3.1%) infants tested were positive for SARS-CoV-2; none had attributable illness before discharge. Of 169 eligible families, 132 (78.1%) participated in post-discharge interviews; none reported their newborn tested positive for SARS-CoV-2 by 1 month of age. CONCLUSION: Symptomatic perinatal COVID-19 had a substantial effect on maternal health but no apparent short-term effect on newborns.

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Perinatal COVID-19

Abstract: The ESPID Reports and Reviews of Pediatric Infectious Diseases series topics, authors and contents are chosen and approved independently by the Editorial Board of ESPID.

Cited by 8 publications

References 10 publications

Neuroimaging assessment of pediatric cerebral changes associated with SARS-CoV-2 infection during pregnancy

Neuroimaging assessment of pediatric cerebral changes associated with SARS-CoV-2 infection during pregnancy

The impact on colostrum oxidative stress, cytokines, and immune cells composition after SARS-CoV-2 infection during pregnancy

Perinatal COVID-19 maternal and neonatal outcomes at two academic birth hospitals

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