Probable congenital SARS-CoV-2 infection in a neonate born to a woman with active SARS-CoV-2 infection

Kirtsman, Maksim; Diambomba, Yenge; Poutanen, Susan M.; Malinowski, Ann Kinga; Vlachodimitropoulou, Evangelia; Parks, W. Tony; Erdman, Laura K.; Morris, Shaun K.; Shah, Prakesh S.

doi:10.1503/cmaj.200821

Cited by 306 publications

(386 citation statements)

References 12 publications

(11 reference statements)

Supporting

Mentioning

319

Contrasting

Unclassified

Order By: Relevance

“…25 Transmission of SARS-CoV-2 via human milk is unlikely. Only three authors have reported SARS-CoV-2 in human milk, 19,25,26 while larger studies did not. [27][28][29] Viability of the SARS-CoV-2 in human milk has not been demonstrated.…”

Section: Biological Properties and Transmission Modes Of Sars-cov-2mentioning

confidence: 97%

Breastfeeding in COVID-19: A Pragmatic Approach

Low

Goh

et al. 2020

Am J Perinatol

View full text Add to dashboard Cite

The novel coronavirus disease 2019 (COVID-19) pandemic has resulted in changes to perinatal and neonatal care, concentrating on minimizing risks of transmission to the newborn and health care staff while ensuring medical care is not compromised for both mother and infant. Current recommendations on infant care and feeding when mother has COVID-19 ranges from mother–infant separation and avoidance of human milk feeding, to initiation of early skin-to-skin contact and direct breastfeeding. Health care providers fearing risks of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) maternal–infant transmission may veer toward restricted breastfeeding practices. We reviewed guidelines and published literature and propose three options for infant feeding depending on various scenarios. Option A involves direct breastfeeding with the infant being cared for by the mother or caregiver. In option B, the infant is cared for by another caregiver and receives mother's expressed milk. In the third option, the infant is not breastfed directly and does not receive mother's expressed milk. We recommend joint decision making by parents and the health care team. This decision is also flexible as situation changes. We also provide a framework for counseling mothers on these options using a visual aid and a corresponding structured training program for health care providers. Future research questions are also proposed. We conclude that evidence and knowledge about COVID-19 and breastfeeding are still evolving. Our options can provide a quick and flexible reference guide that can be adapted to local needs. Key Points

show abstract

Section: Biological Properties and Transmission Modes Of Sars-cov-2mentioning

confidence: 97%

Breastfeeding in COVID-19: A Pragmatic Approach

Low

Goh

et al. 2020

Am J Perinatol

View full text Add to dashboard Cite

show abstract

“…SARS-CoV-2 virus has not been detected in human milk samples in most reports-thus excluding the transmission by this route 23,24 -with the exception of scattered reports describing SARS-CoV-2 RNA detection in maternal milk samples. 6,[25][26][27] Notably, the same authors stated that the risk of the milk contamination by maternal respiratory secretions could not be ruled out. 25 Costa et al reported that the excretion of the virus in breastmilk was intermittent: only three of the six analyzed breast-milk samples (50%) were positive for SARS-CoV-2 RNA.…”

Section: Breastfeedingmentioning

confidence: 99%

“…6,[25][26][27] Notably, the same authors stated that the risk of the milk contamination by maternal respiratory secretions could not be ruled out. 25 Costa et al reported that the excretion of the virus in breastmilk was intermittent: only three of the six analyzed breast-milk samples (50%) were positive for SARS-CoV-2 RNA. 6 In the light of the available evidence, the Italian Society of Neonatology recommends commencement of breastfeeding in all women with suspected or confirmed SARS-CoV-2 infection if they are in good clinical conditions.…”

Section: Breastfeedingmentioning

confidence: 99%

Vertical Transmission of SARS-CoV-2 (COVID-19): Are Hypotheses More than Evidences?

et al. 2020

View full text Add to dashboard Cite

In spite of the increasing, accumulating knowledge on the novel pandemic coronavirus severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), questions on the coronavirus disease-2019 (COVID-19) infection transmission from mothers to fetuses or neonates during pregnancy and peripartum period remain pending and have not been addressed so far. SARS-CoV-2, a RNA single-stranded virus, has been detected in the amniotic fluid, in the cord blood and in the placentas of the infected women. In the light of these findings, the theoretical risk of intrauterine infection for fetuses, or of peripartum infection occurring during delivery for neonates, has a biological plausibility. The extent of this putative risk might, however, vary during the different stages of pregnancy, owing to several variables (physiological modifications of the placenta, virus receptors' expression, or delivery route). This brief review provides an overview of the current evidence in this area. Further data, based on national and international multicenter registries, are needed not only to clearly assess the extent of the risk for vertical transmission, but also to ultimately establish solid guidelines and consistent recommendations. Key Points

show abstract

“…The global spread of severe acute respiratory virus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID- 19), has led to concerns over mother-to-child transmission, including via breastfeeding. Several studies have reported the presence of SARS-CoV-2 RNA in human milk, [1][2][3][4] whereas others have not [5][6][7][8][9] (Table S1). Most previous studies are limited because they followed only a few participants, were cross-sectional, and/or failed to report how milk was collected and/or analyzed.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 and human milk: SARS-CoV-2, antibodies, and neutralizing capacity

Pace

Williams

Järvinen

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: It is not known whether SARS-CoV-2 can be transmitted from mother to infant during breastfeeding, and if so whether the benefits of breastfeeding outweigh this risk. This study was designed to evaluate 1) if SARS-CoV-2 RNA can be detected in milk and on the breast of infected women, 2) concentrations of milk-borne anti-SARS-CoV-2 antibodies, and 3) the capacity of milk to neutralize SARS-CoV-2 infectivity. Methods: We collected 37 milk samples and 70 breast swabs (before and after breast washing) from 18 women recently diagnosed with COVID-19. Samples were analyzed for SARS-CoV-2 RNA using RT-qPCR. Milk was also analyzed for IgA and IgG specific for the nucleocapsid protein, receptor binding domain (RBD), S2 subunit of the spike protein of SARS-CoV-2, as well as 2 seasonal coronaviruses using ELISA; and for its ability to neutralize SARS-CoV-2. Results: We did not detect SARS-CoV-2 RNA in any milk sample. In contrast, SARS-CoV-2 RNA was detected on several breast swabs, although only one was considered conclusive. All milk contained SARS-CoV-2-specific IgA and IgG, and levels of anti-RBD IgA correlated with SARS-CoV-2 neutralization. Strong correlations between levels of IgA and IgG to SARS-CoV-2 and seasonal coronaviruses were noted. Conclusions: Our data do not support maternal-to-child transmission of SARS-CoV-2 via milk; however, risk of transmission via breast skin should be further evaluated. Importantly, milk produced by infected mothers is a source of anti-SARS-CoV-2 IgA and IgG and neutralizes SARS-CoV-2 activity. These results support recommendations to continue breastfeeding during mild-to-moderate maternal COVID-19 illness.

show abstract

Probable congenital SARS-CoV-2 infection in a neonate born to a woman with active SARS-CoV-2 infection

Cited by 306 publications

References 12 publications

Breastfeeding in COVID-19: A Pragmatic Approach

Breastfeeding in COVID-19: A Pragmatic Approach

Vertical Transmission of SARS-CoV-2 (COVID-19): Are Hypotheses More than Evidences?

COVID-19 and human milk: SARS-CoV-2, antibodies, and neutralizing capacity

Contact Info

Product

Resources

About