Pregnant Women Develop a Specific Immunological Long-Lived Memory Against SARS-COV-2

Abstract

It is well established that pregnancy induces deep changes in the immune system. This is part of the physiological adaptation of the female organism to the pregnancy and the immunological tolerance toward the fetus. Indeed, over the three trimesters, the suppressive T regulatory lymphocytes are progressively more represented, while the expression of co-stimulatory molecules decreases overtime. Such adaptations relate to an increased risk of infections and progression to severe disease in pregnant women, potentially resulting in an altered generation of long-lived specific immunological memory of infection contracted during pregnancy. How potent is the immune response against SARS-CoV-2 in infected pregnant women and how long the specific SARS-CoV-2 immunity might last need to be urgently addressed, especially considering the current vaccinal campaign. To address these questions, we analyzed the long-term immunological response upon SARS-CoV-2 infection in pregnant women from delivery to a six-months follow-up. In particular, we investigated the specific antibody production, T cell memory subsets, and inflammation profile. Results show that 80% developed an anti-SARS-CoV-2-specific IgG response, comparable with the general population. While IgG were present only in 50% of the asymptomatic subjects, the antibody production was elicited by infection in all the mild-to-critical patients. The specific T-cell memory subsets rebalanced over-time, and the pro-inflammatory profile triggered by specific SARS-CoV-2 stimulation faded away. These results shed light on SARS-CoV-2-specific immunity in pregnant women; understanding the immunological dynamics of the immune system in response to SARS-CoV-2 is essential for defining proper obstetric management of pregnant women and fine tune gender-specific vaccinal plans.

Future trajectory of SARS-CoV-2: Constant spillover back and forth between humans and animals

“…Notably, most of the findings of published research on COVID-19 are in pregnancy and infants ( Llorca et al., 2021 ). Through investigation, most scientists largely agree that pregnancy was developing a specific immunological long-lived memory against SARS-CoV-2 since 14 of the 1167 women recruited tested positive for SARS-CoV-2 RNA on the day of delivery, and subsequently, all 14 children born from these women diagnosed were negative for SARS-CoV-2 RNA ( Fenizia et al., 2022 ). In addition, people with other complications were more vulnerable to SARS-CoV-2 infection, depending on the individual's circumstances.…”

Updated Considerations for the Immunopharmacological Aspects of the “Talented mRNA Vaccines”

“…Also, once the SARS-CoV-2 neutralizing domain was identified, vaccines were designed to induce a high neutralizing antibody (nAb). Contrary to what has been observed for SARS-CoV-2-specific T lymphocytes, B cell response is waning overtime, decreasing the plasmatic titer of more than 60% in a 3–4 month span [ 79 , 80 ]. The low titer of neutralizing antibody correlates with a higher re-infection rate and vaccine breakthrough cases [ 81 , 82 ].…”

“…), neurological disorders, immunological disorders, or even in the particular setting of pregnancy. Understanding the vaccine-elicited immune reactions would possibly be of paramount importance for clinical management of these cohorts and for defining appropriate public health guidelines for vulnerable populations, including dedicated fine-tuned specific vaccinal plans [ 80 , 157 , 158 , 159 , 160 ].…”

Boosting maternal and neonatal anti–SARS-CoV-2 humoral immunity using a third mRNA vaccine dose

“…Increased risk for severe illness, mechanical ventilation, and death from COVID-19 has been reported in individuals who are pregnant compared with properly matched nonpregnant cohorts ( 7 – 19 ). Maternal COVID-19 morbidity and pregnancy-related complications also significantly affect fetal and neonatal health ( 20 – 22 ).…”