Clinical and immunologic features among COVID-19–affected mother–infant pairs: antibodies to SARS-CoV-2 detected in breast milk

Gao, Xuan; Wang, Shaoshuai; Zeng, Wanjiang; Chen, Suhua; Wu, Jiankang; Lin, Xingguang; Liu, Yanyan; Sun, Ziyong; Li, Feng

doi:10.1016/j.nmni.2020.100752

Cited by 60 publications

(68 citation statements)

References 17 publications

(15 reference statements)

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“…These results are supported by another study in China in 14 women in whom no SARS-CoV-2 RNA was found in breast milk, but in this study, SARS-CoV-2 antibodies (IgM or IgG) were found in only 3 samples (110). Both studies recommended that breastfeeding should continue with care in women infected with SARS-CoV-2 (109,110). Another study in China investigated the presence of SARS-CoV-2 antibodies in 64 infants, of whom 24 were born to mothers with confirmed COVID-19.…”

Section: Immunity In Special Populationssupporting

confidence: 88%

Immunity to SARS-CoV-2: Lessons Learned

Fergie

Srivastava

2021

Front. Immunol.

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In the year since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and with understanding of the etiology of the coronavirus disease 2019 (COVID-19) pandemic, it has become clear that most infected individuals achieve some form of immunity against the virus with relatively few reported reinfections. A number of vaccines have already achieved emergency use authorization based on data from large phase 3 field efficacy clinical trials. However, our knowledge about the extent and durability of this immunity, and the breadth of vaccine coverage against SARS-CoV-2 variants is still evolving. In this narrative review, we summarize the latest and rapidly developing understanding of immunity to SARS-CoV-2 infection, including what we have learned about the key antigens of SARS-CoV-2 (i.e., the spike protein and its receptor-binding domain), their importance in vaccine development, the immediate immune response to SARS-CoV-2, breadth of coverage of emerging SARS-CoV-2 variants, contributions of preexisting immunity to related coronaviruses, and duration of immunity. We also discuss lessons from newer approaches, such as systems serology, that provide insights into molecular and cellular immune responses elicited and how they relate to the trajectory of infection, and potentially inform immune correlates of protection. We also briefly examine the limited research literature on immune responses in special populations, such as pregnant women and children.

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Section: Immunity In Special Populationssupporting

confidence: 88%

Immunity to SARS-CoV-2: Lessons Learned

Fergie

Srivastava

2021

Front. Immunol.

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“…Common symptoms during pregnancy related to COVID-19 were fever, cough, sore throat, and headache. 22 Another study also observed that headache, cough, muscle aches, fever, sore throat, chills, and fatigue were the symptoms often reported during SARS-CoV-2 infection in pregnant and nonpregnant women aged between 18 and 44 years. 24 The symptoms experienced by the women who donated human milk or blood samples are likely related to mild COVID-19 infection.…”

Section: Discussionmentioning

confidence: 91%

“…17 Most studies on SARS-CoV-2 RBD-specific antibodies involve samples obtained from symptomatic patients with severe illness and hospitalization. [20][21][22] However, investigation of mild infection by SARS-CoV-2, especially breastfeeding mothers, is essential to understand their antibodies secreted in human milk. Worldwide, fever is the most frequent symptom (69.4%), followed by cough (35%), in mothers diagnosed with COVID-19 by reverse transcriptionpolymerase chain reaction (RT-PCR), whereas 13.4% of mothers with SARS-CoV-2 infection were asymptomatic.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Severe Acute Respiratory Syndrome Coronavirus 2-Specific Antibodies' Binding Capacity Between Human Milk and Serum from Coronavirus Disease 2019-Recovered Women

Demers‐Mathieu

DaPra

Medo

2021

Breastfeeding Medicine

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Background: Human milk from coronavirus disease 2019 (COVID-19)-recovered women may be useful as oral antibody therapy to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and provide long-term immunity to neonates and young children. As convalescent plasma is already used as antibody therapy, this study aimed to compare the binding capacity of antibodies specific to the receptorbinding domain (RBD) of SARS-CoV-2 between human milk and serum from COVID-19-recovered women. Materials and Methods: The areas under the curve (AUCs) for IgA, IgM, and IgG specific to the SARS-CoV-2 RBD in human milk and serum samples were measured using enzyme-linked immunosorbent assay. Milk samples were collected from 12 COVID-19-recovered women, while serum samples were from 10 COVID-19recovered women. The antibody concentrations were also determined. Results: Our study reveals that SARS-CoV-2 RBD-specific antibody titers differed between human milk and serum samples from COVID-19-recovered women. When the AUCs were not divided by the antibody concentration, SARS-CoV-2 RBD-specific IgA, IgM, and IgG levels were higher in the serum sample group than the human milk group ( p < 0.001). However, the titers of SARS-CoV-2 RBD-specific IgM (AUC/lg of IgM) and IgG (AUC/lg of IgG) were higher in human milk samples than serum samples ( p < 0.05). The titer of SARS-CoV-2 RBD-specific IgA (AUC/mg of IgA) was higher in the serum sample group than the human milk group ( p < 0.01). Conclusions: Human milk antibodies specific to the RBD of SARS-CoV-2 must be purified to obtain comparable binding capacity observed with SARS-CoV-2 RBD-specific serum antibodies.

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“…For SARS-CoV-2 the detection of viral RNA in human milk from infected women appears to be uncommon and transmission via human milk has not been recorded. Furthermore, the detection of viral RNA has only been found sporadically in samples of human milk from women infected with SARS-CoV-2 ( 14 – 20 ); with no milk samples showing active, replication-competent virus ( 18 ), as such, in no study has infectious virus been isolated from milk.…”

Section: Sars-cov-2 and Human Milkmentioning

confidence: 99%

Promoting and Protecting Human Milk and Breastfeeding in a COVID-19 World

Spatz

Davanzo

Müller³

et al. 2021

Front. Pediatr.

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The global COVID-19 pandemic has put enormous stress on healthcare systems and hospital staffing. However, through all this, families will continue to become pregnant, give birth, and breastfeed. Unfortunately, care of the childbearing family has been de-prioritized during the pandemic. Additionally, many healthcare practices during the pandemic have not been positive for the childbearing family or breastfeeding. Despite recommendations from the World Health Organization to promote early, direct breastfeeding and skin to skin contact, these and other recommendations are not being followed in the clinical setting. For example, some mothers have been forced to go through labor and birth alone in some institutions whilst some hospitals have limited or no parental visitation to infants in the NICU. Furthermore, hospitals are discharging mothers and their newborns early, limiting the amount of time that families receive expert lactation care, education, and technical assistance. In addition, some hospitals have furloughed staff or transferred them to COVID-19 wards, further negatively impacting direct care for families and their newborns. We are concerned that these massive changes in the care of childbearing families will be permanently adopted. Instead, we must use the pandemic to underscore the importance of human milk and breastfeeding as lifesaving medical interventions. We challenge healthcare professionals to change the current prenatal and post-birth practice paradigms to protect lactation physiology and to ensure that all families in need receive equal access to evidence-based lactation education, care and technical assistance.

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Clinical and immunologic features among COVID-19–affected mother–infant pairs: antibodies to SARS-CoV-2 detected in breast milk

Cited by 60 publications

References 17 publications

Immunity to SARS-CoV-2: Lessons Learned

Immunity to SARS-CoV-2: Lessons Learned

Comparison of Severe Acute Respiratory Syndrome Coronavirus 2-Specific Antibodies' Binding Capacity Between Human Milk and Serum from Coronavirus Disease 2019-Recovered Women

Promoting and Protecting Human Milk and Breastfeeding in a COVID-19 World

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