Potential Risk of Brain Damage and Poor Developmental Outcomes in Children Prenatally Exposed to Sars-Cov-2: A Systematic Review

Abstract

Objective: To perform a systematic literature review to analyze existing data on the neurological effects of coronavirus on newborns. Data sources: We followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P), and searched the PubMed and Embase platforms for the keywords [brain damage OR pregnancy OR developmental outcomes] and [coronavirus OR SARS-CoV-2 OR SARS-CoV OR MERS-CoV] between January 1, 2000 and June 1, 2020. Data synthesis: Twenty-three reports described the course of pregnant women exposed to SARS-CoV-2, SARS-CoV, or MERS-CoV during the gestational period, eight to SARS-CoV-2, eight to SARS-CoV, and seven to MERS-CoV. No data were found on abnormalities in brain development or on a direct link between the virus and neurological abnormalities in the human embryo, fetus, or children. Spontaneous miscarriage, stillbirth, and termination of pregnancy were some complications connected with SARS/MERS-CoV infection. SARS-CoV-2 is not currently associated with complications in the gestational period. Conclusions: The literature has no data associating exposure to coronavirus during pregnancy with brain malformations and neurodevelopmental disorders. However, despite the lack of reports, monitoring the development of children exposed to SARS-CoV-2 is essential given the risk of complications in pregnant women and the potential neuroinvasive and neurotropic properties found in previous strains.

COVID-19 in pregnancy: implications for fetal brain development

“…Consistent with the observed low rate of placental infection and vertical transmission, data are now available from completed pregnancies exposed to SARS-CoV-2 during all developmental windows (first through third trimesters). To date, no characteristic congenital syndrome has emerged after prenatal SARS-CoV-2 exposure that would suggest direct fetal infection [122,123,130,131]. Prenatal neuroimaging studies in pregnant cohorts have similarly failed to identify evidence of grossly visible fetal intracranial pathology associated with maternal SARS-CoV-2 infection, though the small number of women included with severe or critical illness versus mild disease may limit generalizability of these findings [132,133].…”

Infants prenatally exposed to SARS-CoV-2 show the absence of fidgety movements and are at higher risk for neurological disorders: A comparative study

“…Although such disorders, which can manifest as a reduction in fetal movements [ 4 ], have been observed in conjunction with irritability, poor suction, axial hypertonia and opisthotonos in infants exposed to SARS-CoV-2 [ 5 ]; there are also studies in which neonates exposed prenatally to SARS-CoV-2 do not develop neurological alterations [ 6 ]. Therefore, to date, no definitive answers have been found that explain the broad spectrum of the effects of SARS-CoV-2 on the central nervous system (CNS) and, as with SARS-CoV and MERS, it is not yet known what their impact on long-term brain development is [ 7 , 8 ].…”

A propósito de la pandemia COVID-19: hablemos con los padres con respecto a los trastornos del desarrollo del lenguaje

“…En relación con el desarrollo prenatal aún no existe una asociación a la exposición del coronavirus durante el embarazo y la presencia de malformaciones cerebrales y trastornos del neurodesarrollo 14 . Sin embargo, se requiere de mayor tiempo de seguimiento para poder concluir de forma más contundente cuales fueron los efectos directos del virus como los relacionados al confinamiento.…”