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Principi N, Esposito S. Is the Immunization of Pregnant Women against COVID-19 Justified? Vaccines (Basel) 2021; 9:970. [PMID: 34579207 PMCID: PMC8473171 DOI: 10.3390/vaccines9090970] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 12/11/2022] Open
Abstract
Maternal immunization against some infectious diseases can offer significant advantages for women, preventing maternal morbidity and mortality, or for offspring, preventing fetal disease and conferring passive immunity to neonates. Recently, clinical trials specifically to evaluate the immunogenicity, safety, and tolerability of some of the available coronavirus disease 2019 (COVID-19) vaccines in pregnant and lactating women have been planned, initiated and, in some cases, completed. This paper discusses whether the immunization of pregnant women against COVID-19 is justified and presents knowledge about the immunogenicity and safety of mRNA COVID-19 vaccines for these subjects. The results of recent studies indicate that pregnant women are at increased risk of developing severe disease compared with nonpregnant women of the same age. Studies carried out with mRNA vaccines indicate that the immunogenicity, safety and tolerability of these preventive measures in pregnant women are not different from those in nonpregnant women of the same age. Moreover, antibodies are efficiently transferred through the placenta and can be detected in breastmilk, suggesting a potential prevention of infection in the child. All these findings authorize the use of mRNA vaccines in pregnant women to protect both the mother and the child. However, further studies with larger sample size and with follow-up of the pregnant women vaccinated during different periods of pregnancy and their children are needed to better characterize the immune response of pregnant women, to define when these vaccines should be administered to obtain the best protection, and to measure vaccine efficacy against virus variants in both mothers and infants. COVID-19 vaccines based on different technological platforms cannot presently be used, and their role in pregnant women should be clarified.
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Affiliation(s)
- Nicola Principi
- Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy;
| | - Susanna Esposito
- Pediatric Clinic, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126 Parma, Italy
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52
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Bovbjerg ML. Current Resources for Evidence-Based Practice, September 2021. J Obstet Gynecol Neonatal Nurs 2021; 50:642-654. [PMID: 34437841 DOI: 10.1016/j.jogn.2021.08.095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes an assessment of safety of birth centers in the United States and commentaries on reviews focused on aspirin prophylaxis in pregnancy and the new gestational weight gain evidence summary from the United States Preventive Services Task Force.
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53
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Shah MD, Saugstad OD. Newborns at risk of Covid-19 - lessons from the last year. J Perinat Med 2021; 49:643-649. [PMID: 34116585 DOI: 10.1515/jpm-2021-0258] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 05/27/2021] [Indexed: 12/23/2022]
Abstract
After more than 1 year of the SARS-CoV-2 pandemic, a great deal of knowledge on how this virus affects pregnant women, the fetus and the newborn has accumulated. The gap between different guidelines how to handle newborn infants during this pandemic has been minimized, and the American Academy of Pediatrics (AAP)'s recommendations are now more in accordance with those of the World Health Organization (WHO). In this article we summarize present knowledge regarding transmission from mother to the fetus/newborn. Although both vertical and horizontal transmission are rare, SARS-CoV-2 positivity is associated with an increased risk of premature delivery and higher neonatal mortality and morbidity. Mode of delivery and cord clamping routines should not be affected by the mother's SARS-CoV-2 status. Skin to skin contact, rooming in and breastfeeding are recommended with necessary hygiene precautions. Antibodies of infected or vaccinated women seem to cross both the placenta and into breast milk and likely provide protection for the newborn.
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Affiliation(s)
- Malika D Shah
- Prentice Newborn Nursery, Northwestern Memorial Hospital, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
- Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ola Didrik Saugstad
- Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pediatric Research, University of Oslo, Oslo, Norway
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54
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Ciapponi A, Bardach A, Comandé D, Berrueta M, Argento FJ, Rodriguez Cairoli F, Zamora N, Santa María V, Xiong X, Zaraa S, Mazzoni A, Buekens P. COVID-19 and pregnancy: An umbrella review of clinical presentation, vertical transmission, and maternal and perinatal outcomes. PLoS One 2021; 16:e0253974. [PMID: 34185807 PMCID: PMC8241118 DOI: 10.1371/journal.pone.0253974] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/16/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND We conducted an overview of systematic reviews (SRs) summarizing the best evidence regarding the effect of COVID-19 on maternal and child health following Cochrane methods and PRISMA statement for reporting (PROSPERO-CRD42020208783). METHODS We searched literature databases and COVID-19 research websites from January to October 2020. We selected relevant SRs reporting adequate search strategy, data synthesis, risk of bias assessment, and/or individual description of included studies describing COVID-19 and pregnancy outcomes. Pair of reviewers independently selected studies through COVIDENCE web-software, performed the data extraction, and assessed its quality through the AMSTAR-2 tool. Discrepancies were resolved by consensus. Each SR's results were synthesized and for the most recent, relevant, comprehensive, and with the highest quality, by predefined criteria, we presented GRADE evidence tables. RESULTS We included 66 SRs of observational studies out of 608 references retrieved and most (61/66) had "critically low" overall quality. We found a relatively low degree of primary study overlap across SRs. The most frequent COVID-19 clinical findings during pregnancy were fever (28-100%), mild respiratory symptoms (20-79%), raised C-reactive protein (28-96%), lymphopenia (34-80%), and pneumonia signs in diagnostic imaging (7-99%). The most frequent maternal outcomes were C-section (23-96%) and preterm delivery (14-64%). Most of their babies were asymptomatic (16-93%) or presented fever (0-50%), low birth weight (5-43%) or preterm delivery (2-69%). The odds ratio (OR) of receiving invasive ventilation for COVID-19 versus non-COVID-19 pregnant women was 1.88 (95% Confidence Interval [CI] 1.36-2.60) and the OR that their babies were admitted to neonatal intensive care unit was 3.13 (95%CI 2.05-4.78). The risk of congenital transmission or via breast milk was estimated to be low, but close contacts may carry risks. CONCLUSION This comprehensive overview supports that pregnant women with COVID-19 may be at increased risk of adverse pregnancy and birth outcomes and low risk of congenital transmission.
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Affiliation(s)
- Agustín Ciapponi
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Ariel Bardach
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Daniel Comandé
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Mabel Berrueta
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Fernando J. Argento
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | | | - Natalia Zamora
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Victoria Santa María
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Xu Xiong
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States of America
| | - Sabra Zaraa
- School of Pharmacy, University of Washington, Seattle, WA, United States of America
| | - Agustina Mazzoni
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Pierre Buekens
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States of America
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55
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Goenka A, Halliday A, Gregorova M, Milodowski E, Thomas A, Williamson MK, Baum H, Oliver E, Long AE, Knezevic L, Williams AJK, Lampasona V, Piemonti L, Gupta K, Di Bartolo N, Berger I, Toye AM, Vipond B, Muir P, Bernatoniene J, Bailey M, Gillespie KM, Davidson AD, Wooldridge L, Rivino L, Finn A. Young infants exhibit robust functional antibody responses and restrained IFN-γ production to SARS-CoV-2. CELL REPORTS MEDICINE 2021; 2:100327. [PMID: 34124701 PMCID: PMC8188298 DOI: 10.1016/j.xcrm.2021.100327] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/13/2021] [Accepted: 06/04/2021] [Indexed: 10/27/2022]
Abstract
Severe COVID-19 appears rare in children. This is unexpected, especially in young infants, who are vulnerable to severe disease caused by other respiratory viruses. We evaluate convalescent immune responses in 4 infants under 3 months old with confirmed COVID-19 who presented with mild febrile illness, alongside their parents, and adult controls recovered from confirmed COVID-19. Although not statistically significant, compared to seropositive adults, infants have high serum levels of IgG and IgA to SARS-CoV-2 spike protein, with a corresponding functional ability to block SARS-CoV-2 cellular entry. Infants also exhibit robust saliva anti-spike IgG and IgA responses. Spike-specific IFN-γ production by infant peripheral blood mononuclear cells appears restrained, but the frequency of spike-specific IFN-γ- and/or TNF-α-producing T cells is comparable between infants and adults. On principal-component analysis, infant immune responses appear distinct from their parents. Robust functional antibody responses alongside restrained IFN-γ production may help protect infants from severe COVID-19.
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Affiliation(s)
- Anu Goenka
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK.,Department of Paediatric Immunology and Infectious Diseases, Bristol Royal Hospital for Children, Bristol, UK
| | - Alice Halliday
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK
| | - Michaela Gregorova
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK
| | | | - Amy Thomas
- Bristol Veterinary School, University of Bristol, Bristol, UK
| | | | - Holly Baum
- School of Chemistry, University of Bristol, Bristol, UK.,Bristol Synthetic Biology Centre, University of Bristol, Bristol, UK
| | - Elizabeth Oliver
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK
| | - Anna E Long
- Diabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lea Knezevic
- Bristol Veterinary School, University of Bristol, Bristol, UK
| | | | - Vito Lampasona
- Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Piemonti
- Diabetes Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Kapil Gupta
- School of Biochemistry, University of Bristol, Bristol, UK
| | - Natalie Di Bartolo
- Bristol Synthetic Biology Centre, University of Bristol, Bristol, UK.,School of Biochemistry, University of Bristol, Bristol, UK
| | - Imre Berger
- Bristol Synthetic Biology Centre, University of Bristol, Bristol, UK.,School of Biochemistry, University of Bristol, Bristol, UK
| | - Ashley M Toye
- Bristol Synthetic Biology Centre, University of Bristol, Bristol, UK.,School of Biochemistry, University of Bristol, Bristol, UK.,NIHR Blood and Transplant Research Unit in Red Blood Cell Products, University of Bristol, Bristol, UK.,Bristol Institute of Transfusion Science, NHS Blood and Transplant, Bristol, UK
| | - Barry Vipond
- National Infection Service, Public Health England South West, Southmead Hospital, Bristol, UK
| | - Peter Muir
- National Infection Service, Public Health England South West, Southmead Hospital, Bristol, UK
| | - Jolanta Bernatoniene
- Department of Paediatric Immunology and Infectious Diseases, Bristol Royal Hospital for Children, Bristol, UK
| | - Mick Bailey
- Bristol Veterinary School, University of Bristol, Bristol, UK
| | - Kathleen M Gillespie
- Diabetes and Metabolism, Bristol Medical School, University of Bristol, Bristol, UK
| | - Andrew D Davidson
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK
| | | | - Laura Rivino
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK
| | - Adam Finn
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK.,Department of Paediatric Immunology and Infectious Diseases, Bristol Royal Hospital for Children, Bristol, UK.,School of Population Health Sciences, University of Bristol, Bristol, UK
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56
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Conti MG, Natale F, Stolfi I, Pedicino R, Boscarino G, Ajassa C, Cardilli V, Ciambra GL, Guadalupi L, Favata P, Repole P, De Luca F, Zacco G, Brunelli R, Terrin G. Consequences of Early Separation of Maternal-Newborn Dyad in Neonates Born to SARS-CoV-2 Positive Mothers: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5899. [PMID: 34072815 PMCID: PMC8199070 DOI: 10.3390/ijerph18115899] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 12/18/2022]
Abstract
As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection continues its spread all over the world, data on perinatal management of the maternal-infant dyad are urgent. We performed an observational study to describe the effects of the early separation of the maternal-infant dyad, in case of maternal SARS-CoV-2 infection. We reported the medical records for 37 neonates born to 37 SARS-CoV-2 positive mothers in a setting of separation of the dyad after birth. Data on neonatal infection, clinical condition, and breastfeeding rate were recorded until the first month of life. No maternal deaths were recorded; 37.8% of women had at least one pregnancy-related complication. We reported a high adherence to recommended safety measures after discharged with 84.8% of the mothers using at least one personal protective device and 51.5% using all the protective devices. We reported one case of vertical transmission and no cases of horizontal transmission. However, the separation of the dyad had a negative impact on breastfeeding because only 23.5% of the newborns received exclusively human milk during the first month of life. Despite early separation of the dyad protecting the newborns from possible horizontal transmission of SARS-CoV-2, it negatively affects breastfeeding during the first months of life.
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Affiliation(s)
- Maria Giulia Conti
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
- Department of Molecular Medicine, Sapienza University of Rome, 00185 Roma, Italy
| | - Fabio Natale
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Ilaria Stolfi
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Roberto Pedicino
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Giovanni Boscarino
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Camilla Ajassa
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Viviana Cardilli
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Giovanni Luca Ciambra
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Laura Guadalupi
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Paola Favata
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Paola Repole
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Francesca De Luca
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Giulia Zacco
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Roberto Brunelli
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
| | - Gianluca Terrin
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Roma, Italy; (M.G.C.); (F.N.); (I.S.); (R.P.); (G.B.); (C.A.); (V.C.); (G.L.C.); (L.G.); (P.F.); (P.R.); (F.D.L.); (G.Z.); (R.B.)
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57
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Harding BR, Vora F. Report of a Confirmed SARS-CoV-2 Positive Newborn after Delivery Despite Negative SARS-CoV-2 Testing on Both Parents. AJP Rep 2021; 11:e80-e83. [PMID: 34150353 PMCID: PMC8208836 DOI: 10.1055/s-0041-1728783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/23/2021] [Indexed: 01/15/2023] Open
Abstract
We present a case of a term infant born to an asymptomatic mother at a community hospital who required transfer to a local neonatal intensive care unit (NICU) immediately after birth for respiratory distress. The infant was tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at 24 hours of life by reverse transcription polymerase chain reaction (RT-PCR) testing due to the absence of prenatal maternal COVID-19 testing and was found to be positive for SARS-CoV-2 at that time. A second RT-PCR test was obtained on the infant on day of life (DOL) 4 and was also positive, confirming an accurate diagnosis of COVID-19 disease in the infant. Both the mother and father remained asymptomatic and concomitantly tested negative for SARS-CoV-2 on two separate occasions. The infant subsequently clinically improved and was discharged without any complications. This case raises the potential concern for two unreported newborn issues related to COVID-19. First, the potential unreliability of negative maternal COVID-19 testing surrounding the time of delivery as it relates to routine newborn testing and isolation needs, and second, if the negative material testing was accurate, this raises the concern for a potential case of nosocomial COVID-19 infection within the first 24 hours of life.
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Affiliation(s)
- Benjamin R Harding
- Division of Neonatology, Department of Pediatrics, Loma Linda University Children's Hospital, Loma Linda, California
| | - Farha Vora
- Division of Neonatology, Department of Pediatrics, Loma Linda University Children's Hospital, Loma Linda, California
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58
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Alvarado-Socarras JL, Theurel-Martin D, Cruz-Hernandez M, Rodriguez-Morales AJ. Community-Acquired Neonatal SARS-CoV-2 Infection Associated with Neurological Symptoms in Colombia. J Trop Pediatr 2021; 67:fmab022. [PMID: 33823049 PMCID: PMC8083524 DOI: 10.1093/tropej/fmab022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The SARS-CoV-2/COVID-19 may produce neurological manifestations, including its occurrence in children, and newborns, which has been little reported so far in newborns with COVID-19. CASE We present a case in Colombia, of community-acquired neonatal infection of SARS-CoV-2, with suggestive symptoms, such as fever, and showing neurological findings, such as drowsiness, poor suction and mild hypotonia for a short time. DISCUSSION The clinical manifestations of SARS-COV-2 in neonates are beginning to be described in detail. We report a case of SARS-COV-2-associated neurological compromise in a newborn, with features of drowsiness, poor suction and hypotonia.
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Affiliation(s)
- Jorge L Alvarado-Socarras
- Department of Pediatrics, Neonatal Care Unit, Fundación Cardiovascular de Colombia, 6810 Bucaramanga, Colombia
| | - Delia Theurel-Martin
- Department of Pediatrics, Neonatal Care Unit, Fundación Cardiovascular de Colombia, 6810 Bucaramanga, Colombia
| | - Monica Cruz-Hernandez
- Department of Pediatrics, Neonatal Care Unit, Fundación Cardiovascular de Colombia, 6810 Bucaramanga, Colombia
| | - Alfonso J Rodriguez-Morales
- Latin American Network for COVID-19 Research (LANCOVID), Pereira 660003, Risaralda, Colombia
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Americas, Pereira 660003, Risaralda, Colombia
- School of Medicine, Universidad Privada Franz Tamayo (UNIFRANZ), 1408 Cochabamba, Bolivia
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59
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Wildwing T, Holt N. The neurological symptoms of COVID-19: a systematic overview of systematic reviews, comparison with other neurological conditions and implications for healthcare services. Ther Adv Chronic Dis 2021; 12:2040622320976979. [PMID: 33796241 PMCID: PMC7970685 DOI: 10.1177/2040622320976979] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 11/06/2020] [Indexed: 01/02/2023] Open
Abstract
Aims: In response to the rapid spread of COVID-19, this paper provides health professionals with better accessibility to available evidence, summarising findings from a systematic overview of systematic reviews of the neurological symptoms seen in patients with COVID-19. Implications of so-called ‘Long Covid’ on neurological services and primary care and similarities with other neurological disorders are discussed. Methods: Firstly, a systematic overview of current reviews of neurological symptoms of COVID-19 was conducted. Secondly, the implications of these findings are discussed in relation to the potential effect on neurological services and the similarities in the experience of patients with COVID-19 and those with other neurological disorders. A total of 45 systematic reviews were identified within seven databases, published between 11 April 2020 and 15 October 2020, following a search in June 2020, updated on 20 October 2020. Results: The results indicated that COVID-19 exhibits two types of neurological symptoms; life-threatening symptoms such as Guillain–Barre Syndrome (GBS) and encephalitis, and less devastating symptoms such as fatigue and myalgia. Many of these so-called lesser symptoms appear to be emerging as longer-term for some sufferers and have been recently labelled Long Covid. When compared, these less devastating symptoms are very similar to other neurological conditions such as chronic fatigue syndrome (CFS) and functional neurological disorder (FND). Conclusion: Implications for neurological healthcare services in the United Kingdom (UK) may include longer waiting times and a need for more resources (including more qualified health professionals). There is also a possible change-effect on health professionals’ perceptions of other neurological conditions such as CFS and FND. Future research is recommended to explore changes in health professionals’ perceptions of neurological symptoms because of COVID-19.
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Affiliation(s)
- Tamar Wildwing
- Faculty of Health and Wellbeing, Canterbury Christ Church University Ringgold Standard Institution, North Holmes Road, Canterbury, UK
| | - Nicole Holt
- Faculty of Health and Wellbeing, Canterbury Christ Church University Ringgold Standard Institution, Canterbury, Kent, UK
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60
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Mitoulas LR, Schärer-Hernández NG, Liabat S. Breastfeeding, Human Milk and COVID-19-What Does the Evidence Say? Front Pediatr 2020; 8:613339. [PMID: 33330294 PMCID: PMC7714759 DOI: 10.3389/fped.2020.613339] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 10/28/2020] [Indexed: 01/10/2023] Open
Affiliation(s)
- Leon R. Mitoulas
- Medela AG, Baar, Switzerland
- Honorary Research Fellow, School of Molecular Sciences, The University of Western Australia, Perth, WA, Australia
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