A systematic review on the levels of antibodies in COVID-19 virus exposed but negative newborns: a possible vertical transmission of IgG/ IgM

  1. George M. Bwire
  2. Belinda J. Njiro

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Abstract

Background

Currently, there is no doubt on human-to-human transmission of Coronavirus Disease 2019 (COVID-19). Now, the debates remain on whether, vertical transmission of Severe Respiratory Syndrome Virus 2 (SARS-CoV-2) and antibodies against the virus do exist. We therefore, conducted a systematic review to determine the immunoglobulin G and M (IgG/IgM) levels among infants born to mothers with COVID-19.

Methods

The systematic search was done using PubMed/MEDLINE and Google Scholar database. The research included studies on IgG/ IgM against SARS-CoV-2 among infants born to mother with COVID-19 published in English from December 1, 2019 onwards. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-P) guidelines. We synthesized a narrative from eligible studies and performed two tailed non-parametric Mann-Whitney test to determine and compare the median IgG/IgM levels.

Results

In total, 486 abstracts were screened and 63 full-text articles were assessed. Of 63 articles, 6 met the inclusion criteria for qualitative analysis. Two articles were included in quantitative analysis of anti-SARS-CoV-2 IgG/ IgM levels. The median antibody levels was 75.49AU/mL (range: 7.25AU/mL-140.32AU/mL) and for 3.79AU/mL (range: 0.16AU/mL-45.83AU/mL) (P = 0.0041) for anti-SARS-CoV-2 IgG and IgM, respectively.

Conclusion

There were high levels of IgG but low IgM against SARS-CoV-2 (using <10 AU/mL as a reference range) among COVID-19 virus exposed but negative newborns. This review suggest a possible natural passive immunity (IgG/ IgM) against COVID-19 virus.

Impact

A systematic review of infants born to mothers with COVID-19 was conducted to characterize the magnitude of antibodies generated against SARS-CoV-2 among infants who were vertically exposed to the virus. These findings were necessary to inform the ongoing vaccine development and research on the background natural passive immunity among COVID-19 exposed newborns. Furthermore, evidence are revealing the possibility of vertical transmission of anti-SARS-CoV-2 IgG/ IgM among the exposed newborns who tested negative for the virus.

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  1. ScreenIT

    SciScore for 10.1101/2020.06.09.20127118: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Search strategy: Articles were systematically searched from PubMed/MEDLINE and Google scholar.
    PubMed/MEDLINE
    suggested: None
    Google scholar
    suggested: (Google Scholar, RRID:SCR_008878)
    Similarly, a grey literature search (e.g. pre-prints) was done with help of Google.
    Google
    suggested: (Google, RRID:SCR_017097)
    The strategy was developed for PubMed/MEDLINE (Additional file 1) using keywords and MeSH (MEDLINE).
    MeSH
    suggested: (MeSH, RRID:SCR_004750)
    Data Management: All article citations pooled from database searches were exported into EndNote software version
    EndNote
    suggested: (EndNote, RRID:SCR_014001)
    Data extraction was done using Excel spreadsheet 2010
    Excel
    suggested: None
    We performed two tailed non-parametric Mann-Whitney test to determine and compared the median antibody levels (Prism 7 software; GraphPad Software, USA).
    GraphPad
    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.

  2. Version published to 10.1101/2020.06.09.20127118v1 on medRxiv