Case report: Tissue positivity for SARS-CoV-2 in a preterm born infant death of thrombosis: possible intrauterine transmission

Abstract

Intrauterine transmission of SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona Virus 2) is still matter of debate among scientists and there is limited information concerning this aspect of research. This could lead to severe complications of the growing fetus and, theoretically, of the newborn as well. We report the case of a male infant of 1,100 grams, born at 27th week of gestation to a SARS-CoV-2 mother, tested negative for viral detection at delivery. He was immediately admitted to neonatal Intensive Care Unit (ICU) for severe complications, where he died after 37 days by pulmonary embolism and thrombosis of the superior vena cava. After autopsy, SARS-CoV-2 N-protein and Spike RBD were detected in several tissues, particularly in the esophagus, stomach, spleen, and heart, with a significantly higher H-Score than the placenta. In conclusion, immunohistochemical analysis demonstrated SARS-CoV-2 NP and Spike RBD positivity in different tissues suggesting a possible intrauterine transmission. Newborn thrombo-embolism could be a complication of SARS-CoV-2 infection as observed in adult patients.

Maternal SARS‐CoV‐2 infection: The potential vertical transmission of SARS‐CoV‐2 and impact on neonates: A review

“…29 Recently, a case of newborn thrombo-embolism presents strong evidence of intrauterine transmission of SARS-CoV-2. 30 SARS-CoV-2 N-protein and Spike RBD were detected particularly in the esophagus, stomach, spleen, and heart, with a significantly higher H-Score than the placenta, suggesting a possible intrauterine transmission.…”

“…Even IgM is not transferred transplacentally in healthy pregnant women, it can be transferred through mother‐to‐child in severe inflammation of the birth canal or presence of viral cytotoxic effects 29 . Recently, a case of newborn thrombo‐embolism presents strong evidence of intrauterine transmission of SARS‐CoV‐2 30 . SARS‐CoV‐2 N‐protein and Spike RBD were detected particularly in the esophagus, stomach, spleen, and heart, with a significantly higher H‐Score than the placenta, suggesting a possible intrauterine transmission.…”

Gestational Viral Infections: Role of Host Immune System

“…However, a recent study reported a case of a 34-year-old woman admitted to the ICU due to severe COVID-19 infection whose newborn died by pulmonary embolism and thrombosis of the superior vena cava, in which immunohistochemical analysis demonstrated a SARS-CoV-2 NP presence in neonatal tissues [ 274 ].…”