SARS CoV-2 detected in neonatal stool remote from maternal COVID-19 during pregnancy

Abstract

BACKGROUND:In utero transmission of SARS coronavirus 2 (SARS-CoV-2) has not been fully investigated. We investigated whether newborns of mothers with COVID-19 during pregnancy might harbor SARS-CoV-2 in the gastrointestinal tract. METHODS: This cohort study investigated stool from 14 newborns born at 25-41 weeks admitted at delivery to our urban academic hospital whose mothers had COVID-19 during pregnancy. Eleven mothers had COVID-19 resolved more than 10 weeks before delivery. Newborn stool was evaluated for SARS-CoV-2 RNA, Spike protein, and induction of inflammatory cytokines interleukin-6 (IL-6) and interferon-γ (IFN-γ) in macrophages. RESULTS: Despite negative SARS CoV-2 nasal PCRs from all newborns, viral RNAs and Spike protein were detected in the stool of 11 out of 14 newborns as early as the first day of life and increased over time in 6. Stool homogenates from all 14 newborns elicited elevated inflammatory IL-6 and IFN-γ from macrophages. Most newborns were clinically well except for one death from gestational autoimmune liver disease and another who developed necrotizing enterocolitis. CONCLUSIONS: These findings suggest in utero transmission of SARS-CoV-2 and possible persistent intestinal viral reservoirs in the newborns. Further investigation is required to understand the mechanisms and their clinical implications.

SARS-CoV-2 and COVID-19: From Crisis to Solution

“…The brain injury caused by infection is associated with the development and acceleration of dementias 81,82 , cognitive decline 83,84,85,86 , hormonal disturbances 87 , depression, anxiety, behavioral changes and substance abuse which may be falsely attributed to other causes 88,89 . It threatens human fertility and sexuality in various ways, including by directly infecting the gonads 90,91 , increasing the risk of hypogonadism 92 and erectile dysfunction 93 , negatively affecting sperm quality parameters 94 , crossing the placental barrier, infecting and damaging the placenta 95 and the fetus potentially several months following birth 96,97 , and is associated with increased risk of preeclampsia, fetal loss, and preterm birth 98 . Infection can cause acceleration of biological aging and telomere shortening 99 , impair mitochondria 100 , damage DNA 101,102 and chromatin 103 .…”

Covid associated immune dysfunction (CAID) leading to increased pediatric hospitalizations

“…10 Several studies have also started to show viral persistence of SARS-CoV-2, with alterations in the gut barrier and host immune homeostasis, 11 and in utero vertical transmission of SARS-CoV-2. 12 The timeline of the majority of pediatric COVID-19 cases, an association with states without NPIs, and increasing evidence of immune dysfunction related to SARS-CoV-2 indicate that the current "unprecedented" levels of pediatric hospitalization are related to SARS-CoV-2. "Immunity Debt" is likely not due to lack of RSV and similar infections in children but rather to immune system damage from SARS-CoV-2 infections.…”

Characterization of T Helper 1 and 2 Cytokine Profiles in Newborns of Mothers with COVID-19

“…Given the prevalence of SARS-CoV-2 in pediatric patients, doubts have arisen about the effects of infection in pregnant patients, particularly whether pregnancy would endanger the pregnant woman’s life or whether the infection would affect the fetus and even cause the birth of neonates with SARS-CoV-2 [ 10 ]. On that topic, viral SARS-CoV-2 particles have been detected in placentas and amniotic fluid, which suggests contamination of the fetus during its development [ 11 , 12 , 13 , 14 ].…”