Analysis of SARS-CoV-2 vertical transmission during pregnancy

  1. Claudio Fenizia
  2. Mara Biasin
  3. Irene Cetin
  4. Patrizia Vergani
  5. Davide Mileto
  6. Arsenio Spinillo
  7. Maria Rita Gismondo
  8. Francesca Perotti
  9. Clelia Callegari
  10. Alessandro Mancon
  11. Selene Cammarata
  12. Ilaria Beretta
  13. Manuela Nebuloni
  14. Daria Trabattoni
  15. Mario Clerici
  16. Valeria Savasi

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Abstract

The impact of SARS-CoV-2 infection during gestation remains unclear. Here, we analyse the viral genome on maternal and newborns nasopharyngeal swabs, vaginal swabs, maternal and umbilical cord plasma, placenta and umbilical cord biopsies, amniotic fluids and milk from 31 mothers with SARS-CoV-2 infection. In addition, we also test specific anti-SARS-CoV-2 antibodies and expression of genes involved in inflammatory responses in placentas, and in maternal and umbilical cord plasma. We detect SARS-CoV-2 genome in one umbilical cord blood and in two at-term placentas, in one vaginal mucosa and in one milk specimen. Furthermore, we report the presence of specific anti-SARS-CoV-2 IgM and IgG antibodies in one umbilical cord blood and in one milk specimen. Finally, in the three documented cases of vertical transmission, SARS-CoV-2 infection was accompanied by a strong inflammatory response. Together, these data support the hypothesis that in utero SARS-CoV-2 vertical transmission, while low, is possible. These results might help defining proper obstetric management of COVID-19 pregnant women, or putative indications for mode and timing of delivery.

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  1. Version published to 10.1038/s41467-020-18933-4
  2. Version published to 10.21203/rs.3.rs-45729/v1 on Research Square
  3. ScreenIT

    SciScore for 10.1101/2020.07.09.20149591: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The protocol was approved by the local Medical Ethical and Institutional Review Board.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableAll women underwent clinical evaluation of vital signs and symptoms, laboratory analysis and radiological chest assessment at admission at discretion of physicians.

    Table 2: Resources

    Antibodies
    SentencesResources
    The presence of SARS-CoV-2 specific antibodies was investigated using SARS-CoV-2 IgG and IgM chemiluminescence immunoassay (CLIA) kits on fully automated iFlash1800 analyzer (Shenzen YHLO Biotech Co., Ltd., Shenzen, China): the assay uses Nucleocapsid (N) and Spike (S) viral proteins as magnetic beads coating antigens.
    SARS-CoV-2 IgG
    suggested: None
    Software and Algorithms
    SentencesResources
    The analyses were performed using SPSS Statistics, Version 26.0 (IBM Corp. Armonk, NY) together with GraphPad Prism 8.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)
    GraphPad Prism
    suggested: (GraphPad Prism, RRID:SCR_002798)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2020.07.09.20149591v1 on medRxiv