1
|
Cai G, Liu S, Lu Y, Takaki Y, Matsumoto F, Yoshikawa A, Taguri T, Xie J, Arima K, Mizukami S, Wu J, Yamamoto T, Hasegawa M, Tien Huy N, Saito M, Takeuchi S, Morita K, Aoyagi K, He F. Impact of COVID-19 vaccination status on hospitalization and disease severity: A descriptive study in Nagasaki Prefecture, Japan. Hum Vaccin Immunother 2024; 20:2322795. [PMID: 38517220 PMCID: PMC10962621 DOI: 10.1080/21645515.2024.2322795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/21/2024] [Indexed: 03/23/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19) was extraordinarily harmful, with high rates of infection and hospitalization. This study aimed to evaluate the impact of COVID-19 vaccination status and other factors on hospitalization and disease severity, using data from Nagasaki Prefecture, Japan. Confirmed cases of COVID-19 infection with vaccination status were included and the differences in characteristics between different vaccination statuses, hospitalization or not, and patients with varying levels of disease severity were analyzed. Furthermore, logistic regression was used to calculate odds ratio (ORs) and 95% confidence intervals (CI) to evaluate the association of various factors with hospitalization and disease severity. From March 14, 2020 to August 31, 2022, 23,139 patients were unvaccinated 13,668 vaccinated the primary program with one or two doses, and 4,575 completed the booster. Vaccination reduced the risk of hospitalization with an odd ratio of 0.759 (95% CI: 0.654-0.881) and the protective effect of completed booster vaccination was more pronounced (OR: 0.261, 95% CI: 0.207-0.328). Similarly, vaccination significantly reduced the risk of disease severity (vaccinated primary program: OR: 0.191, 95% CI: 0.160-0.228; completed booster vaccination: OR: 0.129, 95% CI: 0.099-0.169). Overall, unvaccinated, male, elderly, immunocompromised, obese, and patients with other severe illness factors were all risk factors for COVID-19-related hospitalization and disease severity. Vaccination was associated with a decreased risk of hospitalization and disease severity, and highlighted the benefits of completing booster.
Collapse
Affiliation(s)
- Guoxi Cai
- Public Health and Hygiene Research Department, Nagasaki Prefectural Institute of Environment and Public Health, Nagasaki, Japan
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Shiwen Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, 1 Xuefu North Road, Fuzhou, Fujian Province, China
| | - Yixiao Lu
- Department of Systems Biology and Health Statistics, School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Yumika Takaki
- Public Health and Hygiene Research Department, Nagasaki Prefectural Institute of Environment and Public Health, Nagasaki, Japan
| | - Fumiaki Matsumoto
- Public Health and Hygiene Research Department, Nagasaki Prefectural Institute of Environment and Public Health, Nagasaki, Japan
| | - Akira Yoshikawa
- Public Health and Hygiene Research Department, Nagasaki Prefectural Institute of Environment and Public Health, Nagasaki, Japan
| | - Toshitsugu Taguri
- Public Health and Hygiene Research Department, Nagasaki Prefectural Institute of Environment and Public Health, Nagasaki, Japan
| | - Jianfen Xie
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian Province, China
| | - Kazuhiko Arima
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Satoshi Mizukami
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Jiwen Wu
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Taro Yamamoto
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Maiko Hasegawa
- Infectious Disease Control Office, Health & Welfare Department, Nagasaki Prefectural Government, Nagasaki, Japan
| | - Nguyen Tien Huy
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
- School of Medicine and Pharmacy, Duy Tan University, Da Nang, Vietnam
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Masaya Saito
- Department of Nutrition Science, Faculty of Nursing and Nutrition, University of Nagasaki, Nagasaki, Japan
| | - Shouhei Takeuchi
- Department of Nutrition Science, Faculty of Nursing and Nutrition, University of Nagasaki, Nagasaki, Japan
| | - Kouichi Morita
- Department of Virology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
- Dejima Infectious Disease Research Alliance, Nagasaki University, Nagasaki, Japan
| | - Kiyoshi Aoyagi
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Fei He
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, 1 Xuefu North Road, Fuzhou, Fujian Province, China
- Fujian Provincial Key Laboratory of Tumor Microbiology, Fujian Medical University, Fujian Province, China
- Fujian Digital Tumor Data Research Center, Fujian Province, China
| |
Collapse
|
2
|
Proto A, Agliardi S, Pani A, Renica S, Gazzaniga G, Giossi R, Senatore M, Di Ruscio F, Campisi D, Vismara C, Panetta V, Scaglione F, Martinelli S. COVID-Vaccines in Pregnancy: Maternal and Neonatal Response over the First 9 Months after Delivery. Biomolecules 2024; 14:435. [PMID: 38672452 PMCID: PMC11048428 DOI: 10.3390/biom14040435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/30/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
Vaccination against SARS-CoV-2 has been demonstrated to be safe during gestation. Nevertheless, there are no robust data investigating the entity of maternal antibodies' transmission through the placenta to the newborn and the persistence of the antibodies in babies' serum. The objective of this study is to assess the maternal antibody transmission and kinetics among newborns in the first months of life. Women having received one or two doses of anti-SARS-CoV-2 mRNA-vaccines during pregnancy at any gestational age, and their newborns, were recruited and followed-up over 9 months. Ninety-eight women and 103 babies were included. At birth, we observed a significant positive correlation between maternal and neonatal serum anti-SARS-CoV-2 antibody levels and a significant negative correlation between the time since last dose and antibody levels in mothers with two doses. Over the follow-up, the birth antibody level significantly decreased in time according to the received doses number at 3, 6, and 9 months. During the follow-up, we registered 34 dyad SARS-CoV-2 infection cases. The decreasing trend was slower in the SARS-CoV-2 infection group and among breastfed non-infected babies. Antibodies from maternal anti-SARS-CoV-2 vaccination are efficiently transferred via the placenta and potentially even through breast milk. Among newborns, antibodies show relevant durability in the first months of life.
Collapse
Affiliation(s)
- Alice Proto
- Neonatal Intensive Care Unit, ASST Grande Ospedale Metropolitano Niguarda, 20161 Milan, Italy; (A.P.); (S.M.)
| | - Stefano Agliardi
- Department of Medical Biotechnology and Translational Medicine, Postgraduate School of Clinical Pharmacology and Toxicology, University of Milan, 20122 Milan, Italy;
| | - Arianna Pani
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy; (A.P.); (F.S.)
| | - Silvia Renica
- Department of Biomedical, Surgical and Dental Sciences, Postgraduate School of Microbiology and Virology, University of Milan, 20122 Milan, Italy; (S.R.); (F,D,R.)
| | - Gianluca Gazzaniga
- Department of Medical Biotechnology and Translational Medicine, Postgraduate School of Clinical Pharmacology and Toxicology, University of Milan, 20122 Milan, Italy;
| | - Riccardo Giossi
- Chemical-Clinical and Microbiological Analyses Unit, ASST Grande Ospedale Metropolitano Niguarda, 20161 Milan, Italy; (R.G.); (M.S.); (D.C.); (C.V.)
| | - Michele Senatore
- Chemical-Clinical and Microbiological Analyses Unit, ASST Grande Ospedale Metropolitano Niguarda, 20161 Milan, Italy; (R.G.); (M.S.); (D.C.); (C.V.)
| | - Federica Di Ruscio
- Department of Biomedical, Surgical and Dental Sciences, Postgraduate School of Microbiology and Virology, University of Milan, 20122 Milan, Italy; (S.R.); (F,D,R.)
| | - Daniela Campisi
- Chemical-Clinical and Microbiological Analyses Unit, ASST Grande Ospedale Metropolitano Niguarda, 20161 Milan, Italy; (R.G.); (M.S.); (D.C.); (C.V.)
| | - Chiara Vismara
- Chemical-Clinical and Microbiological Analyses Unit, ASST Grande Ospedale Metropolitano Niguarda, 20161 Milan, Italy; (R.G.); (M.S.); (D.C.); (C.V.)
| | - Valentina Panetta
- L’altrastatisticasrl, Consultancy & Training, Biostatistics Office, 00174 Rome, Italy;
| | - Francesco Scaglione
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy; (A.P.); (F.S.)
- Chemical-Clinical and Microbiological Analyses Unit, ASST Grande Ospedale Metropolitano Niguarda, 20161 Milan, Italy; (R.G.); (M.S.); (D.C.); (C.V.)
| | - Stefano Martinelli
- Neonatal Intensive Care Unit, ASST Grande Ospedale Metropolitano Niguarda, 20161 Milan, Italy; (A.P.); (S.M.)
| |
Collapse
|
3
|
Vetter-Laracy S, Jimenez V, Roldán M, Bernardino M, Balliu-Badia P, Lara P, Arcay RM, Fraile-Ribot P, Vila M, Fanjul F. Neonatal SARS-CoV-2 immunoglobulin G antibodies at delivery and their impact on COVID-19. Eur J Clin Microbiol Infect Dis 2024; 43:693-702. [PMID: 38326544 DOI: 10.1007/s10096-024-04773-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/31/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE To assess neonatal SARS-CoV-2 anti-spike IgG antibody levels after maternal mRNA COVID-19 vaccination and/or infection during pregnancy and evaluate their protective effect. METHODS Prospective observational study, conducted from January 2021 to December 2022. Infants were tested for anti-spike IgG antibodies at birth and then every 3 months until disappearance of titer. A follow-up was done for SARS-CoV-2 infection up to 12 months. RESULTS In total, 147 newborns were enrolled with a median (IQR) gestational age of 39.60 weeks (38.3-40.4). Median (IQR) titers in UA/ml at 2 days were higher (P < .001) in newborns of vaccinated 7063.7 (2841.4-14,448.1), than of infected mothers 372.7 (158.00-884.90). Titers dropped significantly during the follow-up but 50% still had a detectable titer at 6 months. A high antibody titer at 2 days led to a longer persistence (HR 0.89, IC 95% 0.83-0.96, P = .004). In total, 36 infants were infected during the first months of life coinciding with the Omicron variant. Fifty percent had detectable antibodies during the infection period. Relationship between high IgG titers and month of infection was inverse (RHO - 0.52, P = .009). CONCLUSION Though a high antibody titer at birth led to longer persistence, no protective effect against infection was found. As newborns are a high risk group for COVID-19, avoiding transmission during the first year of life is important.
Collapse
Affiliation(s)
- Susanne Vetter-Laracy
- Department of Paediatrics, Division of Neonatology, University Hospital Son Espases, Palma, Spain.
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain.
| | - Victoria Jimenez
- Department of Paediatrics, Division of Neonatology, University Hospital Son Espases, Palma, Spain
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain
| | - Marina Roldán
- Department of Paediatrics, Division of Neonatology, University Hospital Son Espases, Palma, Spain
| | - Marta Bernardino
- Department of Paediatrics, Division of Neonatology, University Hospital Son Espases, Palma, Spain
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain
| | - Pere Balliu-Badia
- Department of Paediatrics, Division of Neonatology, University Hospital Son Espases, Palma, Spain
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain
| | - Paula Lara
- Department of Microbiology, University Hospital Son Espases, Palma, Spain
| | | | - Pablo Fraile-Ribot
- Department of Microbiology, University Hospital Son Espases, Palma, Spain
| | - Maria Vila
- Department of Gynecology and Obstetrics, University Hospital Son Espases, Palma, Spain
| | - Francisco Fanjul
- Balearic Islands Health Research Institute (IdISBa), Palma, Spain
- Department of Internal Medicine, University Hospital Son Espases, Palma, Spain
| |
Collapse
|
4
|
Fung CYJ, Scott M, Lerner-Ellis J, Taher J. Applications of SARS-CoV-2 serological testing: impact of test performance, sample matrices, and patient characteristics. Crit Rev Clin Lab Sci 2024; 61:70-88. [PMID: 37800891 DOI: 10.1080/10408363.2023.2254390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/29/2023] [Indexed: 10/07/2023]
Abstract
Laboratory testing has been a key tool in managing the SARS-CoV-2 global pandemic. While rapid antigen and PCR testing has proven useful for diagnosing acute SARS-CoV-2 infections, additional testing methods are required to understand the long-term impact of SARS-CoV-2 infections on immune response. Serological testing, a well-documented laboratory practice, measures the presence of antibodies in a sample to uncover information about host immunity. Although proposed applications of serological testing for clinical use have previously been limited, current research into SARS-CoV-2 has shown growing utility for serological methods in these settings. To name a few, serological testing has been used to identify patients with past infections and long-term active disease and to monitor vaccine efficacy. Test utility and result interpretation, however, are often complicated by factors that include poor test sensitivity early in infection, lack of immune response in some individuals, overlying infection and vaccination responses, lack of standardization of antibody titers/levels between instruments, unknown titers that confer immune protection, and large between-individual biological variation following infection or vaccination. Thus, the three major components of this review will examine (1) factors that affect serological test utility: test performance, testing matrices, seroprevalence concerns and viral variants, (2) patient factors that affect serological response: timing of sampling, age, sex, body mass index, immunosuppression and vaccination, and (3) informative applications of serological testing: identifying past infection, immune surveillance to guide health practices, and examination of protective immunity. SARS-CoV-2 serological testing should be beneficial for clinical care if it is implemented appropriately. However, as with other laboratory developed tests, use of SARS-CoV-2 serology as a testing modality warrants careful consideration of testing limitations and evaluation of its clinical utility.
Collapse
Affiliation(s)
- Chun Yiu Jordan Fung
- Lunenfeld Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - Mackenzie Scott
- Lunenfeld Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Jordan Lerner-Ellis
- Lunenfeld Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Taher
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
5
|
Thompson KA, White JP, Bardone-Cone AM. Associations between pressure to breastfeed and depressive, anxiety, obsessive-compulsive, and eating disorder symptoms among postpartum women. Psychiatry Res 2023; 328:115432. [PMID: 37669578 DOI: 10.1016/j.psychres.2023.115432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 08/04/2023] [Accepted: 08/24/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Data from qualitative interviews indicate postpartum individuals feel pressure from their healthcare providers, the media, and their partners to breastfeed their infant(s). However, the link between pressure to breastfeed and maternal mental health symptoms has not been evaluated quantitatively. The goal of the current study was to evaluate the associations between perceived pressure to breastfeed from various sources and depressive, anxiety, obsessive-compulsive, and eating disorder symptoms among postpartum individuals. METHODS Participants were 306 women, ages 18-39, who gave birth in the past 12 months in the United States (primarily in North Carolina). They completed an online survey about their health history (including mental health symptoms) and breastfeeding experiences. RESULTS Results found postpartum women perceived more pressure to breastfeed from healthcare providers and from the media compared to pressure to breastfeed from their partners. Pressure from healthcare providers was associated with depressive, obsessive-compulsive, and eating disorder symptoms, but not with anxiety symptoms. Pressure from the media was associated with only depressive and eating disorder symptoms. Pressure from partners was not significantly associated with mental health symptoms. Above and beyond the other sources of pressure, pressure from healthcare providers explained a unique proportion of variance of obsessive-compulsive and eating disorder symptoms. LIMITATIONS Limitations include the cross-sectional design (which limits causal interpretations), and the homogenous sample (87% identified as White). CONCLUSIONS Messaging and information about breastfeeding (particularly from healthcare providers) should be reviewed to determine if there is language which could be perceived as "pressure." It is important to screen for a variety of mental health symptoms, including eating disorders, in perinatal populations when discussing breastfeeding.
Collapse
Affiliation(s)
- Katherine A Thompson
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States; Department of Psychology and Neurosciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Jennifer P White
- Department of Psychiatry, UNC School of Medicine, Chapel Hill, NC, United States
| | - Anna M Bardone-Cone
- Department of Psychology and Neurosciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| |
Collapse
|
6
|
Karimi H, Mansouri V, Rezaei N. Vertical transmission and maternal passive immunity post-SARS-CoV-2. Future Virol 2023:10.2217/fvl-2023-0089. [PMID: 37822684 PMCID: PMC10564388 DOI: 10.2217/fvl-2023-0089] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/22/2023] [Indexed: 10/13/2023]
Abstract
Since 2020, the highly contagious nature and various transmission routes of SARS-CoV-2 have rendered the pandemic interminable. Vertical transmission (VT) through the placenta and breast milk, which is frequent for certain virus types, is thought to exist for SARS-CoV-2 and is hypothesized by many researchers. Conversely, antibodies are produced to counteract the effect of viruses. Since newborns' immunologic system cannot produce proper antibodies, maternal antibodies are usually transferred from mother to infant/fetus to meet the need. This theory leads to the hypothesis of transmission of antibodies through the placenta and breast milk following SARS-CoV-2 infection or vaccination. This paper further discusses these hypotheses, considering consequences of fetus/infant harm versus benefit.
Collapse
Affiliation(s)
- Hanie Karimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy & Autoimmunity (NIIMA), Universal Scientific Education & Research Network (USERN), Tehran, Iran
| | - Vahid Mansouri
- Gene Therapy Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy & Autoimmunity (NIIMA), Universal Scientific Education & Research Network (USERN), Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, 14194, Iran
- Network of Immunity in Infection, Malignancy & Autoimmunity (NIIMA), Universal Scientific Education & Research Network (USERN), Tehran, Iran
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
7
|
da Silva Filho AO, Gonçalves DN, de Lima LKR, da Silva Alves DAN, de Andrade Falcão FJ, Falcão REA. Levels of Neutralizing Antibodies against SARS-CoV-2 in Mothers and Neonates after Vaccination during Pregnancy. Vaccines (Basel) 2023; 11:vaccines11030620. [PMID: 36992203 DOI: 10.3390/vaccines11030620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/20/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023] Open
Abstract
Background: Maternal vaccination is safe and provides protection against COVID-19 in mothers and neonates, and it is necessary to evaluate its effect on the induction of immune responses through the levels of neutralizing antibodies present in maternal and neonatal blood. Methods: An observational study with transversal analysis was carried out. Included in the research were neonates (<1 month) whose mothers had been immunized whilst pregnant with at least one dose of the vaccine BNT16b and had not shown any symptoms of COVID-19. The blood of the mothers and newborns was collected during the Guthrie test and sent to the laboratory for the detection of neutralizing antibodies against SARS-CoV-2. Results: A total of 162 pairs of mothers and neonates were analyzed with an average age of 26.3 ± 5.97 years and 13.4 ± 6.90 days, respectively. All samples collected present neutralizing antibodies with an average percentage of 91% in the mothers and 92% in the neonates. The most satisfactory immune response was observed in neonates and mothers vaccinated during the second trimester of gestation. Conclusions: The vaccination of expectant mothers with the immunizer BNT162b2 has promoted a robust immunological response in both the mothers and the neonates.
Collapse
Affiliation(s)
- Antônio Oliveira da Silva Filho
- Post-Graduate Program in Health and Socio-Environmental Development Multicampi Garanhuns, University of Pernambuco, Garanhuns 55294-310, Brazil
- Department of Health Sciences, Multicampi Garanhuns, University of Pernambuco, Garanhuns 55294-310, Brazil
| | - Daniel Nazário Gonçalves
- Department of Health Sciences, Multicampi Garanhuns, University of Pernambuco, Garanhuns 55294-310, Brazil
| | | | | | | | - Rosângela Estevão Alves Falcão
- Post-Graduate Program in Health and Socio-Environmental Development Multicampi Garanhuns, University of Pernambuco, Garanhuns 55294-310, Brazil
| |
Collapse
|
8
|
Jorgensen SCJ, Hernandez A, Fell DB, Austin PC, D'Souza R, Guttmann A, Brown KA, Buchan SA, Gubbay JB, Nasreen S, Schwartz KL, Tadrous M, Wilson K, Kwong JC. Maternal mRNA covid-19 vaccination during pregnancy and delta or omicron infection or hospital admission in infants: test negative design study. BMJ 2023; 380:e074035. [PMID: 36754426 PMCID: PMC9903336 DOI: 10.1136/bmj-2022-074035] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
OBJECTIVE To estimate the effectiveness of maternal mRNA covid-19 vaccination during pregnancy against delta and omicron severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and hospital admission in infants. DESIGN Test negative design study. SETTING Community and hospital testing in Ontario, Canada. PARTICIPANTS Infants younger than six months of age, born between 7 May 2021 and 31 March 2022, who were tested for SARS-CoV-2 between 7 May 2021 and 5 September 2022. INTERVENTION Maternal mRNA covid-19 vaccination during pregnancy. MAIN OUTCOME MEASURES Laboratory confirmed delta or omicron infection or hospital admission of the infant. Multivariable logistic regression estimated vaccine effectiveness, with adjustments for clinical and sociodemographic characteristics associated with vaccination and infection. RESULTS 8809 infants met eligibility criteria, including 99 delta cases (4365 controls) and 1501 omicron cases (4847 controls). Infant vaccine effectiveness from two maternal doses was 95% (95% confidence interval 88% to 98%) against delta infection and 97% (73% to 100%) against infant hospital admission due to delta and 45% (37% to 53%) against omicron infection and 53% (39% to 64%) against hospital admission due to omicron. Vaccine effectiveness for three doses was 73% (61% to 80%) against omicron infection and 80% (64% to 89%) against hospital admission due to omicron. Vaccine effectiveness for two doses against infant omicron infection was highest with the second dose in the third trimester (53% (42% to 62%)) compared with the first (47% (31% to 59%)) or second (37% (24% to 47%)) trimesters. Vaccine effectiveness for two doses against infant omicron infection decreased from 57% (44% to 66%) between birth and eight weeks to 40% (21% to 54%) after 16 weeks of age. CONCLUSIONS Maternal covid-19 vaccination with a second dose during pregnancy was highly effective against delta and moderately effective against omicron infection and hospital admission in infants during the first six months of life. A third vaccine dose bolstered protection against omicron. Effectiveness for two doses was highest with maternal vaccination in the third trimester, and effectiveness decreased in infants beyond eight weeks of age.
Collapse
Affiliation(s)
- Sarah C J Jorgensen
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Deshayne B Fell
- ICES, Toronto, ON, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Peter C Austin
- ICES, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Rohan D'Souza
- Departments of Obstetrics and Gynecology and Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- School of Graduate Studies, University of Toronto, Toronto, ON, Canada
| | - Astrid Guttmann
- ICES, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada
- The Edwin SH Leong Centre for Healthy Children, University of Toronto, Toronto, ON, Canada
| | - Kevin A Brown
- ICES, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON, Canada
| | - Sarah A Buchan
- ICES, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, ON, Canada
| | - Jonathan B Gubbay
- Public Health Ontario, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Sharifa Nasreen
- ICES, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Kevin L Schwartz
- ICES, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON, Canada
| | - Mina Tadrous
- ICES, Toronto, ON, Canada
- Women's College Hospital, Toronto, ON, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Kumanan Wilson
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Jeffrey C Kwong
- ICES, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
| |
Collapse
|
9
|
Yang Y, Xing H, Zhao Y. Transplacental transmission of SARS-CoV-2 immunoglobulin G antibody to infants from maternal COVID-19 vaccine immunization before pregnancy. J Med Virol 2023; 95:e28296. [PMID: 36367230 PMCID: PMC9877834 DOI: 10.1002/jmv.28296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/26/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022]
Abstract
The coronavirus disease 2019 (COVID-19) vaccine generates functional antibodies in maternal circulation that are detectable in infants, while the information is restricted to the usage of COVID-19 vaccine during pregnancy. In this study, we aimed to evaluate the effect of maternal COVID-19 vaccines before pregnancy. Infants were included from mothers with no inactivated COVID-19 vaccine, 1-, 2-, and 3-dose before pregnancy, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) antibodies were tested. Comparative analysis was done between the groups. A total of 130 infants were enrolled in the study. Significantly higher levels of SARS-CoV-2 IgG antibodies in infants born to mothers with 3-dose COVID-19 vaccine before pregnancy compared with 1- and 2-dose groups (p < 0.0001). The levels of antibodies decreased significantly with age in infants born to mothers with the 3-dose COVID-19 vaccine before pregnancy (r = -0.338, p = 0.035), and it was still higher than that 2-dose COVID-19 vaccine group. The maternal SARS-CoV-2 antibodies produced from the inactivated COVID-19 vaccine before pregnancy can be transferred to newborns via the placenta. Maternal immunization with 3-dose of the COVID-19 vaccine before pregnancy could be more beneficial for both mothers and infants.
Collapse
Affiliation(s)
- Yuting Yang
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child Development and Critical Disorders, Pediatric Research InstituteChildren's Hospital of Chongqing Medical UniversityChongqingChina
| | - Huiwu Xing
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child Development and Critical Disorders, Pediatric Research InstituteChildren's Hospital of Chongqing Medical UniversityChongqingChina
| | - Yao Zhao
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child Development and Critical Disorders, Pediatric Research InstituteChildren's Hospital of Chongqing Medical UniversityChongqingChina
| |
Collapse
|
10
|
Hakala SM, Fujioka H, Gapp K, De Gasperin O, Genzoni E, Kilner RM, Koene JM, König B, Linksvayer TA, Meurville MP, Negroni MA, Palejowski H, Wigby S, LeBoeuf AC. Socially transferred materials: why and how to study them. Trends Ecol Evol 2022; 38:446-458. [PMID: 36543692 DOI: 10.1016/j.tree.2022.11.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022]
Abstract
When biological material is transferred from one individual's body to another, as in ejaculate, eggs, and milk, secondary donor-produced molecules are often transferred along with the main cargo, and influence the physiology and fitness of the receiver. Both social and solitary animals exhibit such social transfers at certain life stages. The secondary, bioactive, and transfer-supporting components in socially transferred materials have evolved convergently to the point where they are used in applications across taxa and type of transfer. The composition of these materials is typically highly dynamic and context dependent, and their components drive the physiological and behavioral evolution of many taxa. Our establishment of the concept of socially transferred materials unifies this multidisciplinary topic and will benefit both theory and applications.
Collapse
|
11
|
Kouba I, Yaghoubian Y, Rochelson B, Shan W, Combs A, Nimaroff M, Blitz MJ. Acceptance of coronavirus disease 2019 vaccination among postpartum women during delivery hospitalization. J Matern Fetal Neonatal Med 2022; 35:10502-10505. [PMID: 36210157 DOI: 10.1080/14767058.2022.2131386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE The immediate postpartum period, during delivery hospitalization, represents a unique opportunity to offer coronavirus disease 2019 (COVID-19) vaccination to those who did not previously receive it. In this study, we evaluated patient characteristics associated with acceptance of vaccination in this group. METHODS This retrospective cohort study evaluated all unvaccinated patients who were offered postpartum COVID-19 vaccination during delivery hospitalization between May 2021 and September 2021 at seven hospitals within a large integrated health system in New York. During the study period, each hospitalized, unvaccinated obstetrical patient was offered the vaccine prior to discharge. Patients with positive SARS-CoV-2 PCR testing during hospitalization were excluded. Medical records were reviewed to obtain sociodemographic characteristics and to confirm administration of COVID-19 vaccination. Multiple logistic regression was performed to model the probability of receiving postpartum vaccination. RESULTS A total of 8,281 unvaccinated postpartum patients were included for analysis and 412 (5%) received a COVID-19 vaccine before hospital discharge. Patients who received the vaccine were more likely to be older, have private insurance, decline to answer questions about religious affiliation, and deliver in the final two months of the study period. Likelihood of receiving postpartum vaccination was not affected by race-ethnicity, preferred language, marital status, parity, body mass index, or neighborhood socioeconomic conditions. Patients who declined vaccination were more likely to have positive SARS-CoV-2 antibody testing at delivery compared to those who received vaccination (49 vs. 29%; p < .001). CONCLUSION Only 5% of unvaccinated postpartum patients received a COVID-19 vaccine before hospital discharge. It is concerning that patients with public health insurance were less likely to receive vaccination. This may be due to variation in vaccine counseling or other unmeasured factors. Despite the low acceptance rate in our study population, COVID-19 vaccination should be offered in a variety of clinical settings to maximize opportunities for administration.
Collapse
Affiliation(s)
- Insaf Kouba
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Yasaman Yaghoubian
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Burton Rochelson
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Weiwei Shan
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Adriann Combs
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Michael Nimaroff
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Matthew J Blitz
- Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| |
Collapse
|
12
|
Whittaker R, Greve-Isdahl M, Bøås H, Suren P, Buanes EA, Veneti L. COVID-19 Hospitalization Among Children <18 Years by Variant Wave in Norway. Pediatrics 2022; 150:188698. [PMID: 35916036 DOI: 10.1542/peds.2022-057564] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES There is limited evidence on whether the relative severity of coronavirus disease 2019 (COVID-19) in children and adolescents differs for different severe acute respiratory syndrome coronavirus 2 variants. We compare the risk of hospitalization to acute COVID-19 or multisystem inflammatory syndrome in children (MIS-C) among unvaccinated persons <18 years with COVID-19 (cases) between waves of the Alpha, Delta, and Omicron (sublineage BA.1) variants in Norway. METHODS We used linked individual-level data from national registries to calculate adjusted risk ratios (aRR) with 95% confidence interval (CI) using multivariable log-binomial regression. We adjusted for variant wave, demographic characteristics, and underlying comorbidities. RESULTS We included 10 538 Alpha (21 hospitalized with acute COVID-19, 7 MIS-C), 42 362 Delta (28 acute COVID-19, 14 MIS-C), and 82 907 Omicron wave cases (48 acute COVID-19, 7 MIS-C). The risk of hospitalization with acute COVID-19 was lower in the Delta (aRR: 0.53, 95% CI: 0.30-0.93) and Omicron wave (aRR: 0.40, 95% CI: 0.24-0.68), compared to the Alpha wave. We found no difference in this risk for Omicron compared to Delta. The risk of MIS-C was lower for Omicron, compared to Alpha (aRR: 0.09, 95% CI: 0.03-0.27) and Delta (aRR: 0.26, 95% CI: 0.10-0.63). CONCLUSIONS We do not find clear evidence that different variants have influenced the risk of hospitalization with acute COVID-19 among unvaccinated children and adolescents in Norway. The lower risk of this outcome with Omicron and Delta may reflect changes in other factors over time, such as the testing strategy, maternal vaccination and/or hospitalization criteria. The emergence of Omicron has reduced the risk of MIS-C.
Collapse
Affiliation(s)
| | | | | | - Pål Suren
- Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Eirik Alnes Buanes
- Department of Anaesthesia and Intensive Care.,Norwegian Intensive Care and Pandemic Registry, Haukeland University Hospital, Bergen, Norway
| | | |
Collapse
|
13
|
Lin K, Liu M, Bao L, Lv Q, Zhu H, Li D, Xu Y, Xiang Z, Liu J, Liang X, Han Y, Cong Z, Liu R, Deng R, Wang S, Guo Z, Sun L, Wei Q, Qiao H, Wang S, Pan S, Gao H, Qin C. Safety and protective capability of an inactivated SARS-CoV-2 vaccine on pregnancy, lactation and the growth of offspring in hACE2 mice. Vaccine 2022; 40:4609-4616. [PMID: 35738970 PMCID: PMC9174435 DOI: 10.1016/j.vaccine.2022.06.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 04/17/2022] [Accepted: 06/05/2022] [Indexed: 12/19/2022]
Abstract
The mass inoculation of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine to induce herd immunity is one of the most effective measures to fight COVID-19. The vaccination of pregnant women cannot only avoid or reduce the probability of infectious diseases, but also offers the most effective and direct protection for neonates by means of passive immunization. However, there is no randomized clinical data to ascertain whether the inactivated vaccination of pregnant women or women of childbearing age can affect conception and the fetus. We found that human angiotensin-converting enzyme 2 (hACE2) mice that were vaccinated with two doses of CoronaVac (an inactivated SARS-CoV-2 vaccine) before and during pregnancy exhibited normal weight changes and reproductive performance indices; the physical development of their offspring was also normal. Following intranasal inoculation with SARS-CoV-2, pregnant mice in the immunization group all survived; reproductive performance indices and the physical development of offspring were all normal. In contrast, mice in the non-immunization group all died before delivery. Analyses showed that inoculation of CoronaVac was safe and did not exert any significant effects on pregnancy, lactation, or the growth of offspring in hACE2 mice. Vaccination effectively protected the pregnant mice against SARS-CoV-2 infection and had no adverse effects on the growth and development of the offspring, thus suggesting that inoculation with an inactivated SARS-CoV-2 vaccine may be an effective strategy to prevent infection in pregnant women.
Collapse
Affiliation(s)
- Kaili Lin
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Meixuan Liu
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Linlin Bao
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Qi Lv
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Hua Zhu
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Dan Li
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Yanfeng Xu
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Zhiguang Xiang
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Jiangning Liu
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Xujian Liang
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Yunlin Han
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Zhe Cong
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Ruixue Liu
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Ran Deng
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Siyuan Wang
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Zhi Guo
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Lu Sun
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Qiang Wei
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Hongwei Qiao
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Shunyi Wang
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Sidan Pan
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China
| | - Hong Gao
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China.
| | - Chuan Qin
- Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences and Comparative Medicine Center, Peking Union Medical College, Beijing 100021, China.
| |
Collapse
|
14
|
Humoral response to anti-SARS-CoV-2 vaccine in breastfeeding mothers and mother-to-infant antibody transfer through breast milk. NPJ Vaccines 2022; 7:63. [PMID: 35739127 PMCID: PMC9226003 DOI: 10.1038/s41541-022-00499-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/16/2022] [Indexed: 11/08/2022] Open
Abstract
The magnitude of mother-to-infant transfer of anti-SARS-CoV-2 antibodies through breast milk (BM) after maternal vaccination during breastfeeding, in the absence of transplacental transfer of IgG, remains unclear. Here, we quantified anti-S and anti-RBD IgG, IgA, IgA1, and IgA2 in maternal serum, maternal saliva, BM, infant buccal swabs, and infant feces up to 90 days after the second maternal vaccine dose. BNT162b2 vaccine induced long-lasting IgG in maternal serum, but weaker mucosal antibody production, with anti-SARS-CoV-2 IgG and IgA amounts in BM between 10- and 150-fold lower compared to serum. BM IgA were exclusively of the IgA1 isotype, with no production of the mucosal-specific and protease-resistant IgA2. Accordingly, only traces of antibodies were retrieved from the feces of breastfed infants, and no IgG nor IgA were retrieved from infants' buccal swabs. Newly engineered anti-SARS-CoV-2 vaccines may be needed to stimulate the antibody production at mucosal sites such as breast milk.
Collapse
|
15
|
Pang Z, Hu R, Tian L, Lou F, Chen Y, Wang S, He S, Zhu S, An X, Song L, Liu F, Tong Y, Fan H. Overview of Breastfeeding Under COVID-19 Pandemic. Front Immunol 2022; 13:896068. [PMID: 35711421 PMCID: PMC9192965 DOI: 10.3389/fimmu.2022.896068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/22/2022] [Indexed: 12/19/2022] Open
Abstract
During the global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), pregnant and lactating women are at higher risk of infection. The potential of viral intrauterine transmission and vertical transmission by breastfeeding has raised wide concerns. Breastmilk is rich in nutrients that contribute to infant growth and development, and reduce the incidence rate of infant illness and death, as well as inhibit pathogens significantly, and protect infants from infection. Although it is controversial whether mothers infected with COVID-19 should continue to breastfeed, many countries and international organizations have provided recommendations and guidance for breastfeeding. This review presents the risks and benefits of breastfeeding for mothers infected with COVID-19, and the reasons for the absence of SARS-CoV-2 active virus in human milk. In addition, the antiviral mechanisms of nutrients in breastmilk, the levels of SARS-CoV-2 specific antibodies in breastmilk from COVID-19 infected mothers and vaccinated mothers are also summarized and discussed, aiming to provide some support and recommendations for both lactating mothers and infants to better deal with the COVID-19 pandemic.
Collapse
Affiliation(s)
- Zehan Pang
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Ruolan Hu
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Lili Tian
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Fuxing Lou
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Yangzhen Chen
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Shuqi Wang
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Shiting He
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Shaozhou Zhu
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Xiaoping An
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Lihua Song
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Feitong Liu
- Health & Happiness Group, Health & Happiness Research, China Aesearch and Innovation, Guangzhou, China
| | - Yigang Tong
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Huahao Fan
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| |
Collapse
|
16
|
Sessa R, Anastasi E, Brandolino G, Brunelli R, Di Pietro M, Filardo S, Masciullo L, Terrin G, Viscardi MF, Porpora MG. What is the Hidden Biological Mechanism Underlying the Possible SARS-CoV-2 Vertical Transmission? A Mini Review. Front Physiol 2022; 13:875806. [PMID: 35600312 PMCID: PMC9117645 DOI: 10.3389/fphys.2022.875806] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS- CoV-2) represents an emerging infection that is spreading around the world. Among susceptible patients, pregnant women are more likely to develop serious complications and negative obstetric outcomes. Vertical transmission constitutes a debating issue which has not been completely understood. This review aims at describing the currently available evidence on SARS-CoV2 vertical transmission. We carried out a computerized literature search in the Cochrane Library, PubMed, Scopus and Web of Science, selecting the most relevant studies on vertical transmission from the outbreak onset until February 2022. The analysis of the available literature identifies the presence of SARS-CoV2 genome in different biological specimens, confirming the hypothesis that a transplacental infection can occur. In spite of the high number of infected people around the world, mother-to-child infections have been infrequently reported but it can be observed under certain biologic conditions. A deep knowledge of the underlying mechanisms of SARS-CoV2 vertical transmission is of paramount importance for planning an adequate management for the affected mothers and newborns.
Collapse
Affiliation(s)
- Rosa Sessa
- Department of Public Health and Infectious Diseases, Microbiology Section, Sapienza University of Rome, Rome, Italy
| | - Emanuela Anastasi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Gabriella Brandolino
- Department of Maternal and Child Health and Urology, Sapienza University of Rome, Rome, Italy
| | - Roberto Brunelli
- Department of Maternal and Child Health and Urology, Sapienza University of Rome, Rome, Italy
| | - Marisa Di Pietro
- Department of Public Health and Infectious Diseases, Microbiology Section, Sapienza University of Rome, Rome, Italy
| | - Simone Filardo
- Department of Public Health and Infectious Diseases, Microbiology Section, Sapienza University of Rome, Rome, Italy
| | - Luisa Masciullo
- Department of Maternal and Child Health and Urology, Sapienza University of Rome, Rome, Italy
| | - Gianluca Terrin
- Department of Maternal and Child Health and Urology, Sapienza University of Rome, Rome, Italy
| | - Maria Federica Viscardi
- Department of Maternal and Child Health and Urology, Sapienza University of Rome, Rome, Italy
| | - Maria Grazia Porpora
- Department of Maternal and Child Health and Urology, Sapienza University of Rome, Rome, Italy
- *Correspondence: Maria Grazia Porpora,
| |
Collapse
|
17
|
Leow OMY, Aoyama R, Chan SM. The evolution of severity of paediatric COVID-19 in Singapore: Vertical transmission and multisystem inflammatory syndrome in children. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2022; 51:115-118. [PMID: 35224609 DOI: 10.47102/annals-acadmedsg.2021426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Olivia Min Yi Leow
- Division of Paediatric Infectious Diseases, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore
| | | | | |
Collapse
|
18
|
Overview of Memory NK Cells in Viral Infections: Possible Role in SARS-CoV-2 Infection. IMMUNO 2022. [DOI: 10.3390/immuno2010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
NK cells have usually been defined as cells of the innate immune system, although they are also involved in adaptative responses. These cells belong to the innate lymphocyte cells (ILC) family. They remove unwanted cells, tumoral cells and pathogens. NK cells are essential for viral infection clearance and are involved in tolerogenic responses depending on the dynamic balance of the repertoire of activating and inhibitory receptors. NK plasticity is crucial for tissue function and vigilant immune responses. They directly eliminate virus-infected cells by recognising viral protein antigens using a non-MHC dependent mechanism, recognising viral glycan structures and antigens by NCR family receptors, inducing apoptosis by Fas-Fas ligand interaction, and killing cells by antibody-dependent cell cytotoxicity via the FcγIII receptor. Activating receptors are responsible for the clearance of virally infected cells, while inhibitory KIR receptor activation impairs NK responses and facilitates virus escape. Effective NK memory cells have been described and characterised by a low NKG2A and high NKG2C or NKG2D expression. NK cells have also been used in cell therapy. In SARS-CoV-2 infection, several contradicting reports about the role of NK cells have been published. A careful analysis of the current data and possible implications will be discussed.
Collapse
|
19
|
Nachega JB, Sam-Agudu NA, Siedner MJ, Rosenthal PJ, Mellors JW, Zumla A, Hermans MP, Ntakwinja MB, Mukwege DM, Langenegger E, Mofenson LM. OUP accepted manuscript. Clin Infect Dis 2022; 75:1462-1466. [PMID: 36130226 PMCID: PMC9214132 DOI: 10.1093/cid/ciac362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 05/02/2022] [Indexed: 11/19/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) in pregnancy is associated with excess maternal and infant morbidity and mortality in both African and higher-resource settings. Furthermore, mounting evidence demonstrates the safety and efficacy of COVID-19 vaccination for pregnant women and infants. However, national guidelines in many African countries are equivocal or lack recommendations on COVID-19 vaccine in pregnancy. We summarize key data on COVID-19 epidemiology and vaccination among pregnant African women to highlight major barriers to vaccination and recommend 4 interventions. First, policymakers should prioritize pregnant women for COVID-19 vaccination, with a target of 100% coverage. Second, empirically supported public health campaigns should be sustainably implemented to inform and support pregnant women and their healthcare providers in overcoming vaccine hesitancy. Third, COVID-19 vaccination for pregnant women should be expanded to include antenatal care, obstetrics/gynecology, and targeted mass vaccination campaigns. Fourth, national monitoring and evaluation of COVID-19 vaccine uptake, safety, surveillance, and prospective outcomes assessment should be conducted.
Collapse
Affiliation(s)
- Jean B. Nachega
- Correspondence: J. B. Nachega, University of Pittsburgh School of Public Health, Departments of Epidemiology, Infectious Diseases and Microbiology and Center for Global Health, 130 DeSoto St, A532 Crabtree Hall, Pittsburgh, PA 15261 ()
| | - Nadia A. Sam-Agudu
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Paediatrics and Child Health, University of Cape Coast School of Medical Sciences, Cape Coast, Ghana
| | - Mark J. Siedner
- Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts, USA
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Philip J. Rosenthal
- Division of Infectious Diseases, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - John W. Mellors
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Alimuddin Zumla
- Center for Clinical Microbiology, Division of Infection and Immunity, University College London, London, United Kingdom
- National Institutes of Health and Research Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Michel P. Hermans
- Department of Endocrinology and Nutrition, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - Mukanire B. Ntakwinja
- Department of Obstetrics and Gynecology, Panzi Hospital and Université Evangelique en Afrique, Bukavu, Democratic Republic of the Congo
| | - Denis M. Mukwege
- Department of Obstetrics and Gynecology, Panzi Hospital and Université Evangelique en Afrique, Bukavu, Democratic Republic of the Congo
| | - Eduard Langenegger
- Department of Obstetrics and Gynecology, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa
| | - Lynne M. Mofenson
- Elizabeth Glaser Pediatric AIDS Foundation, Washington, District of Columbia, USA
| | | |
Collapse
|