Vertical transmission and materno-fetal outcomes in 13 patients with coronavirus disease 2019

Masmejan, Sophie; Pomar, Léo; Favre, Guillaume; Panchaud, Alice; Giannoni, Éric; Greub, Gilbert

doi:10.1016/j.cmi.2020.06.035

Cited by 9 publications

(7 citation statements)

References 7 publications

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“…20,21 Severe neonatal COVID-19 is described and sporadic cases of vertical transmission were reported. [22][23][24][25][26] Assuming the critical nourishing and protecting functions of the placenta, it is crucial to evaluate in further detail the impact of SARS-CoV-2 infection during pregnancy. However, due to the high degree of interspecies placenta diversity, animal models of human placenta diseases are of limited relevance.…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 can infect and propagate in human placenta explants

Fahmi¹,

Brügger²,

Démoulins³

et al. 2021

Cell Reports Medicine

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Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 can infect and propagate in human placenta explants

Fahmi¹,

Brügger²,

Démoulins³

et al. 2021

Cell Reports Medicine

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“…Congenital infection of SARS-CoV-2 from feto-maternal interface is a matter of controversy. Some case series suggest that there is lack of vertical transmission of SARS-CoV-2 (Li et al, 2020b;Masmejan et al, 2020). However large-scale systematic reviews reveal that a proportion of babies born to mother with COVID-19 are positive for viral RNA (Allotey et al, 2020;Gajbhiye et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Persistence of SARS-CoV-2 in the first trimester placenta leading to transplacental transmission and fetal demise from an asymptomatic mother

et al. 2020

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Coronavirus disease 2019 (COVID-19) is caused by infection of the respiratory tract by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which survives in the tissues during the clinical course of infection but there is limited evidence on placental infection and vertical transmission of SARS-CoV-2. The impact of COVID-19 in first trimester pregnancy remains poorly understood. Moreover, how long SARS-CoV-2 can survive in placenta is unknown. Herein, we report a case of a pregnant woman in the first trimester who tested positive for SARS-CoV-2 at 8 weeks of gestation, although her clinical course was asymptomatic. At 13 weeks of gestation, her throat swab tested negative for SARS-CoV-2 but viral RNA was detected in the placenta, and the Spike (S) proteins (S1 and S2) were immunolocalized in cytotrophoblast and syncytiotrophoblast cells of the placental villi. Histologically, the villi were generally avascular with peri-villus fibrin deposition and in some areas the syncytiotrophoblast layer appeared lysed. The decidua also had fibrin deposition with extensive leukocyte infiltration suggestive of inflammation. The SARS-CoV-2 crossed the placental barrier, as the viral RNA was detected in the amniotic fluid and the S proteins were detected in the fetal membrane. Ultrasonography revealed extensively subcutaneous edema with pleural effusion suggestive of hydrops fetalis and the absence of cardiac activity indicated fetal demise. This is the first study to provide concrete evidence of persistent placental infection of SARS-CoV-2 and its congenital transmission is associated with hydrops fetalis and intrauterine fetal demise in early pregnancy.

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“…We included 34 primary studies that were not case reports. The primary studies included eight case series (Chaudhary S 2020, Liu W 2020, Masmejan S 2020, Olivini N 2020, Pereira A 2020, Pissarra S 2020, Zhang P 2020, 21 cohort studies (either prospective or retrospective) (Anand P 2020, Ayed A 2020 , Bachani S 2020, Barbero P 2020, Gale C 2020, Fenizia B 2020, He Z 2020, Hu X 2020, Luo Q 2020, Khan MA 2020, Nayak AH 2020, Ogamba I 2020, Oncel MY 2020, Maraschini A 2020, Popofsky S 2020, Smithgall MC 2020,Tang F 2020, Vinuela MC 2020, Vouga M 2020,Yang R 2020, 2 retrospective observational studies , Moreno SC 2020. and one quality improvement project (Cojocaru L 2020), one longitudinal surveillance study (Woodworth KR 2020), and one multi-centre retrospective chart review (Marin Gabriel MA 2020.…”

Section: Primary Studiesmentioning

confidence: 99%

“…The studies included symptomatic and asymptomatic women; however there did not seem to be a specific correlation between symptom status of the mothers and the likelihood of a positive test in the babies, with some studies reporting on women who had symptoms of COVID-19 either immediately prior to or during hospitalisation, some with severe symptoms, where none of the babies tested positive within 24h of birth (e.g. Liu W 2020, Luo Q 2020, Masmejan S 2020, Moreno SC 2020, Ogamba I 2020, Popofsky S 2020 (See Table 1a). Similarly, the mode of delivery (vaginal birth, caesarean section, emergency caesarean section) did not seem to be correlated to positivity rate amongst neonates; across the included cohort and case series studies, for the 6188 cases where mode of delivery was reported, 3939 were by vaginal delivery, 2122 by caesarean section, and 127 reported as emergency caesarean (Table 1b).…”

Section: Primary Studiesmentioning

confidence: 99%

“…Of the included studies, 25 studies reported assessment of the placenta, of these 18 were case studies (Alamar I 2020, Birindwa EK 2020, Ferraiolo A 2020, Grimminck K 2020, Kulkarni R 2020, Hsu AL 2020, Lv Y 2020, Palalioglu RM 2020, Pulinx B 2020, Rebello CM 2020, Shende P 2020, Sisman J 2020, Stonoga E 2020, Tang J 2020, Von Kohorn I 2020, Zaigham M 2020, 2 were retrospective case series (Liu W 2020, Masmejan S 2020, 3 were cohort studies (Fenizia B 2020, Ogamba I 2020, Oncel MY 2020 and 2 were a cohort and a case series specifically studying placental samples (Smithgall MC 2020, Zhang P 2020) (Supplementary file Table 4. Findings of studies reporting placenta analysis).…”

Section: Detection Of Virus In the Placenta Using Pcr And Immunostainingmentioning

confidence: 99%

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SARS-CoV-2 and the role of vertical transmission from infected pregnant women to their fetuses: systematic review.

Plüddemann

Spencer

Heneghan

et al. 2021

Preprint

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Background Vertical transmission of SARS-CoV-2 has been reported but does not appear to be common. This study aims to systematically review the evidence for vertical transmission of SARS-CoV-2. Methods This review is part of an Open Evidence Review on the transmission dynamics of SARS-CoV-2 and the role of intrauterine mother to fetus transmission. Literature searches were performed in the WHO Covid-19 Database, LitCovid, medRxiv, and Google Scholar for SARS-CoV-2 using keywords and associated synonyms, search date up to 20 December 2020, no language restrictions. Results We included 106 studies assessing vertical transmission of SARS-CoV-2 from pregnant women to their neonates: these studies comprised 40 reviews (21 fulfilled systematic review methodology, including risk of bias assessment of included studies) and 66 primary studies including 32 case reports (of up to two cases) and 34 prospective and retrospective cohort studies, prospective and retrospective case series, observational studies (including asymptomatic screening), database studies and a quality improvement project. Almost all were conducted in a hospital setting. The 32 case reports were considered to be at high risk of bias, due to the study design; across the 34 remaining primary studies, risk of bias was low to moderate. Sixteen case reports examined vertical transmission, which was not related to maternal symptomatology. For the cohort and case series studies, the percentage of positive neonates ranged from 0% to 22% across the studies. Twenty studies reported no positive vertical transmission. Three studies that reported the highest positivity rates of 11%, 15% and 22% had specifically selected neonates with a positive test (within up to 35 days) within the study population and were therefore more selective populations. Across the cohort and case series studies there were 65/2391 (2.7%) neonates born to mothers with a diagnosis of COVID-19 tested positive for SARS-CoV-2 within 24 hours of birth. No evidence correlated maternal symptomatology to vertical transmission. Mode of delivery did not correlate with rates of vertical transmission. Of 25 studies, 7 identified SARS-CoV-2 in placental tissue; some of these did not demonstrate vertical transmission to the neonate. No study reported the results of viral culture to detect SARS-CoV-2. Conclusions The results of these studies indicate that vertical transmission is possible, but is not frequent, and factors that influence when vertical transmission occurs are unknown. Further studies using standardised methods to establish viral infection are needed to establish vertical transmission rates and to assess clinical and other conditions affecting transmission.

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Vertical transmission and materno-fetal outcomes in 13 patients with coronavirus disease 2019

Cited by 9 publications

References 7 publications

SARS-CoV-2 can infect and propagate in human placenta explants

SARS-CoV-2 can infect and propagate in human placenta explants

Persistence of SARS-CoV-2 in the first trimester placenta leading to transplacental transmission and fetal demise from an asymptomatic mother

SARS-CoV-2 and the role of vertical transmission from infected pregnant women to their fetuses: systematic review.

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