1
|
Jansåker F, Holm MKA, Knudsen JD, Boel JB. Examining the influence of Covid-19 restrictions, a nurse strike, and SARS-CoV-2 coinfection on bacteremia mortality: A Danish population-based cohort study (2019-2022). Heliyon 2024; 10:e33696. [PMID: 39040231 PMCID: PMC11261871 DOI: 10.1016/j.heliyon.2024.e33696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 06/12/2024] [Accepted: 06/25/2024] [Indexed: 07/24/2024] Open
Abstract
Objectives Bacteremia is an acute severe infection with high mortality. Changes in healthcare services and coinfections with SARS-CoV-2 may have affected the mortality for bacteremia during the COVID-19 pandemic, which has been reported for other major diseases. In this study we examine the all-cause bacteremia mortality amidst the COVID-19 pandemic. Methods A population-based cohort study comprised of laboratory confirmed bacteremia episodes in the Capital Region, Denmark (March 2019-February 2022). Cox proportional hazards models were used to calculate hazard ratios (HR) and 95 % confidence intervals (CI) for all-cause bacteremia mortality associated with the Covid-19 restriction period, a strike period, and coinfection with SARS-CoV-2, adjusted for possible confounders. Results A total of 14,912 bacteremia episodes were identified in 12,693 patients during the study period. The 30- and 90-day all-cause mortality were 19 % and 27 %, respectively. The fully adjusted HR for 30- and 90-day all-cause mortality associated with the Covid-19 restriction period were 0.91 (95 % CI, 0.84 to 0.99) and 0.90 (95 % CI, 0.84 to 0.96), respectively, compared to the remaining time period. The corresponding HRs associated with SARS-CoV-2 coinfection were 1.29 (95 % CI, 1.11 to 1.50) and 1.36 (95 % CI, 1.20 to 1.55) compared to patients without coinfection. The association between the national nurse strike and all-cause bacteremia mortality was inconclusive. Conclusions In this large population-based cohort study, a significant reduction in all-cause mortality for bacteremia was observed during the Covid-19 restriction period in Denmark, while coinfection with SARS-CoV-2 seem to be a substantial risk factor for all-cause bacteremia mortality.
Collapse
Affiliation(s)
- Filip Jansåker
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Mona Katrine Alberthe Holm
- Department of Clinical Microbiology, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Jenny Dahl Knudsen
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark
| | - Jonas Bredtoft Boel
- Department of Clinical Microbiology, Herlev University Hospital, Herlev, Denmark
- Copenhagen University Hospital, The Hospital Pharmacy, Copenhagen, Denmark
| |
Collapse
|
2
|
Khodavandi P, Khodavandi A, Alizadeh F, Gholizadeh L. Possibility of intrauterine transmission from mother to fetus/newborn: Systematic review and meta-analysis of diagnostic methods to detect SARS-CoV-2 infection. Eur J Obstet Gynecol Reprod Biol 2024; 295:181-200. [PMID: 38367392 DOI: 10.1016/j.ejogrb.2024.02.026] [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: 11/01/2023] [Revised: 02/03/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
Several studies have reported vertical transmission of SARS-CoV-2; however, information regarding intrauterine transmission based on diagnostic methods to detect SARS-CoV-2 infection is scarce. A systematic review and meta-analysis was conducted to identify and explore the studies that attempt to ascertain the possibility of intrauterine transmission of SARS-CoV-2 infection according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) statement. The results demonstrate that SARS-CoV-2 can be transmitted intrauterine, as detected by clinical manifestations (1.00, 95 % CI: 1.00 - 1.00, 0.51, 95 % CI: 0.22 - 0.80), imaging (0.50, 95 % CI: 0.24 - 0.76, 0.03, 95 % CI: 0.00 - 0.17), molecular (1. 00, 95 % CI: 1.00 - 1.00, 0.92, 95 % CI: 0.77 - 1.00), immunological (0.32, 95 % CI: 0.10 - 0.57, 0.34, 95 % CI: 0.11 - 0.61), and histological approaches (0.79, 95 % CI: 0.52 - 0.98) in maternal and fetal/neonatal specimens, respectively. The possibility of intrauterine transmission of SARS-CoV-2 from mother to fetus/newborn was 41 % (95 % CI 0.37 - 0.45). We might confirm/verify the intrauterine transmission of SARS-CoCV-2 from mother to fetus/newborn.
Collapse
Affiliation(s)
| | - Alireza Khodavandi
- Department of Biology, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran.
| | - Fahimeh Alizadeh
- Department of Biology, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran
| | - Lida Gholizadeh
- Department of Nursing and Midwifery, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran
| |
Collapse
|
3
|
Calvet GA, Kara E, Gonsalves L, Seuc AH, de Oliveira RDVC, Thwin SS, Gomez Ponce de León R, Gámez MC, Peña GM, Pendás BVR, Alzugaray MG, Carballo GO, Cala DC, Guimarães PMQ, Bonet M, Taylor M, Thorson A, Kim C, Ali M, Broutet N. Viral shedding of SARS-CoV-2 in body fluids associated with sexual activity: a systematic review and meta-analysis. BMJ Open 2024; 14:e073084. [PMID: 38387982 PMCID: PMC10882346 DOI: 10.1136/bmjopen-2023-073084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVE To identify and summarise the evidence on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection and persistence in body fluids associated with sexual activity (saliva, semen, vaginal secretion, urine and faeces/rectal secretion). ELIGIBILITY All studies that reported detection of SARS-CoV-2 in saliva, semen, vaginal secretion, urine and faeces/rectal swabs. INFORMATION SOURCES The WHO COVID-19 database from inception to 20 April 2022. RISK OF BIAS ASSESSMENT The National Institutes of Health tools. SYNTHESIS OF RESULTS The proportion of patients with positive results for SARS-CoV-2 and the proportion of patients with a viral duration/persistence of at least 14 days in each fluid was calculated using fixed or random effects models. INCLUDED STUDIES A total of 182 studies with 10 023 participants. RESULTS The combined proportion of individuals with detection of SARS-CoV-2 was 82.6% (95% CI: 68.8% to 91.0%) in saliva, 1.6% (95% CI: 0.9% to 2.6%) in semen, 2.7% (95% CI: 1.8% to 4.0%) in vaginal secretion, 3.8% (95% CI: 1.9% to 7.6%) in urine and 31.8% (95% CI: 26.4% to 37.7%) in faeces/rectal swabs. The maximum viral persistence for faeces/rectal secretions was 210 days, followed by semen 121 days, saliva 112 days, urine 77 days and vaginal secretions 13 days. Culturable SARS-CoV-2 was positive for saliva and faeces. LIMITATIONS Scarcity of longitudinal studies with follow-up until negative results. INTERPRETATION SARS-CoV-2 RNA was detected in all fluids associated with sexual activity but was rare in semen and vaginal secretions. Ongoing droplet precautions and awareness of the potential risk of contact with faecal matter/rectal mucosa are needed. PROSPERO REGISTRATION NUMBER CRD42020204741.
Collapse
Affiliation(s)
| | - Edna Kara
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Lianne Gonsalves
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Armando Humberto Seuc
- National Institute of Hygiene Epidemiology and Microbiology, Habana, La Habana, Cuba
| | | | - Soe Soe Thwin
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | | | | | | | | | | | | | | | | | - Mercedes Bonet
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Melanie Taylor
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anna Thorson
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Caron Kim
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Moazzam Ali
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Nathalie Broutet
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| |
Collapse
|
4
|
Nielsen SY, Hvidman LE, Aabakke AJM, Olsen TE, Johnsen IBG, Bogaard PW, Petersen A, Westergaard HB, Sørensen A, Hedermann G, Rønneberg ET, Thisted D, Boris J, Andersen LLT, Eggers AGH, Lindved BF, Henriksen TB. SARS-CoV-2 placentitis and severe pregnancy outcome after maternal infection: A Danish case series. Acta Obstet Gynecol Scand 2023; 102:567-576. [PMID: 36958983 PMCID: PMC10072246 DOI: 10.1111/aogs.14541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 03/25/2023]
Abstract
INTRODUCTION SARS-CoV-2 infection during pregnancy may cause viral inflammation of the placenta, resulting in fetal demise even without fetal or newborn infection. The impact of timing of the infection and the mechanisms that cause fetal morbidity and mortality are not well understood. MATERIAL AND METHODS To describe placental pathology from women with confirmed SARS-CoV-2 infection during pregnancy, a SARS-CoV-2 immunohistochemistry-positive placenta and late miscarriage, stillbirth, neonatal death, or medically indicated birth due to fetal distress. RESULTS The triad of trophoblastic necrosis, inflammatory intervillous infiltrates, and increased perivillous fibrinoid deposition was present in all 17 placentas; the pregnancies resulted in eight stillbirths, two late miscarriages (19 and 21 weeks' gestation), and seven liveborn children, two of which died shortly after delivery. The severity of maternal COVID-19 was not reflected by the extent of the placental lesions. In only one case, SARS-CoV-2 was detected in lung tissue samples from the fetus. The majority events (miscarriage, stillbirth, fetal distress resulting in indicated birth, or livebirth, but neonatal death) happened shortly after maternal SARS-CoV-2 infection was diagnosed. Seven of eight sequenced cases were infected with the Delta (B.1.617.2) virus strain. CONCLUSION We consolidate findings from previous case series describing extensive SARS-CoV-2 placentitis and placental insufficiency leading to fetal hypoxia. We found sparse evidence to support the notion that SARS-CoV-2 virus had infected the fetus or newborn.
Collapse
Affiliation(s)
- Stine Y Nielsen
- Department of Clinical Microbiology, Lillebaelt University Hospital, Vejle, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Lone E Hvidman
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Anna J M Aabakke
- Department of Obstetrics and Gynecology, University of Copenhagen, Nordsjaelland, Hillerød, Denmark
- Department of Obstetrics and Gynecology, University of Copenhagen, Holbaek, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Tina E Olsen
- Department of Pathology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Iben B G Johnsen
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - Pauline W Bogaard
- Department of Pathology, Aalborg University Hospital, Aalborg, Denmark
| | - Astrid Petersen
- Department of Pathology, Aalborg University Hospital, Aalborg, Denmark
| | - Hanne B Westergaard
- Department of Obstetrics and Gynecology, University of Copenhagen, Nordsjaelland, Hillerød, Denmark
| | - Anne Sørensen
- Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Gitte Hedermann
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | | | - Dorthe Thisted
- Department of Obstetrics and Gynecology, University of Copenhagen, Holbaek, Denmark
| | - Jane Boris
- Department of Obstetrics and Gynecology, Gødstrup Hospital, Herning, Denmark
| | - Lise L T Andersen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Anne G H Eggers
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Obstetrics and Gynecology, Slagelse Sygehus, Slagelse, Denmark
| | - Birgitte F Lindved
- Department of Obstetrics and Gynecology, Regional Hospital Horsens, Horsens, Denmark
| | - Tine B Henriksen
- Department of Paediatric and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
- Clinical Institute, Aarhus University, Aarhus, Denmark
| |
Collapse
|
5
|
De Luca D, Vauloup-Fellous C, Benachi A, Vivanti A. Transmission of SARS-CoV-2 from mother to fetus or neonate: What to know and what to do? Semin Fetal Neonatal Med 2023; 28:101429. [PMID: 36935314 PMCID: PMC10010052 DOI: 10.1016/j.siny.2023.101429] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
SARS-CoV-2 can be vertically transmitted from the mother to the fetus and the neonate. This transmission route is rare compared to the environmental or horizontal spread and therefore, the risk can be deemed inconsequential by some medical providers. However, severe, although just as rare, feto-neonatal consequences are possible: fetal demise, severe/critical neonatal COVID-19 and multi-inflammatory syndrome (MIS-N) have been described. Therefore, it is important for the clinicians to know the mechanism of vertical transmission, how to recognize this, and how to deal with neonatal COVID-19 and MIS-N. Our knowledge about this field has significantly increased in the last three years. This is a summary of the pathophysiology, diagnostics, and therapeutics of vertical SARS-CoV-2 transmission that clinicians apply in their clinical practice.
Collapse
Affiliation(s)
- Daniele De Luca
- Division of Pediatrics and Neonatal Critical Care, "Antoine Béclère" Hospital, Paris Saclay University Hospitals, APHP, Clamart, France.
| | - Christelle Vauloup-Fellous
- Division of Virology, "Paul Brousse" Hospital, Paris Saclay University Hospitals, APHP, Villejuif, France
| | - Alexandra Benachi
- Division of Obstetrics and Gynecology, "Antoine Béclère" Hospital, Paris Saclay University Hospitals, APHP, Clamart, France
| | - Alexandre Vivanti
- Division of Obstetrics and Gynecology, "Antoine Béclère" Hospital, Paris Saclay University Hospitals, APHP, Clamart, France
| |
Collapse
|
6
|
Erdem D, Kayaaslan B, Cakir EY, Dinc B, Asilturk D, Kirca F, Segmen F, Turan IO, Guner R. Investigation of SARS-CoV-2 using RT-PCR in vaginal swab samples of female patients with a diagnosis of severe COVID-19. Taiwan J Obstet Gynecol 2023; 62:270-274. [PMID: 36965894 PMCID: PMC9729648 DOI: 10.1016/j.tjog.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE It is important to determine the presence of SARS-CoV-2 in the vaginal fluid samples of reproductive-aged women with severe disease during the acute stage of the disease and to determine the risks of transmission by sexual or vertical transmission. MATERIAL AND METHODS Adult women with confirmed severe COVID-19 who were admitted to Ankara City Hospital intensive care unit (ICU) between December 1st, 2020, and January 1st, 2021, were enrolled in the study. Vaginal swab samples were collected within 48 h in the ICU using Dacron or rayon swabs and tested for SARS-CoV-2 using reverse transcription real-time polymerase chain reaction (RT PCR). RESULTS Thirty women of reproductive age were included in the study, five (16.7%) of whom were pregnant. The mean age was 44.9 (±10.5) years. The most common symptoms were headache (100%), muscle soreness (86.7%), cough (76.7%), fever (60%), and nausea and vomiting (20%). Nineteen (63.3%) patients had underlying medical conditions. The time interval from obtaining vaginal swab samples to admission to the ICU was 48 h. The time between vaginal sampling and PCR positivity ranged from 2 to 18 days. SARS-CoV-2 was not detected in any vaginal samples. CONCLUSION Our study showed that women with severe COVID-19 did not have SARS-CoV-2 in their vaginal fluids. Investigation of the presence of SARS-CoV-2 in vaginal secretions may help in determining the risks of sexual transmission and vertical transmission from mother to baby. Information on this subject is still limited. Larger studies on comprehensive biological samples are needed.
Collapse
Affiliation(s)
- Deniz Erdem
- Department of Intensive Care Unıt, Univeristy of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Bircan Kayaaslan
- Infectious Disease and Clinical Microbiology, Ankara Yildırım Beyazit University, Ankara City Hospital, Ankara, Turkey
| | | | - Bedia Dinc
- Department of Medical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Dilek Asilturk
- Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Fisun Kirca
- Department of Medical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Fatih Segmen
- Department of Intensive Care Unıt, Ankara City Hospital, Ankara, Turkey
| | - Isil Ozkocak Turan
- Department of Intensive Care Unıt, Univeristy of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Rahmet Guner
- Infectious Disease and Clinical Microbiology, Ankara Yildırım Beyazit University, Ankara City Hospital, Ankara, Turkey
| |
Collapse
|
7
|
Aabakke AJM, Petersen TG, Wøjdemann K, Ibsen MH, Jonsdottir F, Rønneberg E, Andersen CS, Hammer A, Clausen TD, Milbak J, Burmester L, Zethner R, Lindved B, Thorsen‐Meyer A, Khalil MR, Henriksen B, Jønsson L, Andersen LLT, Karlsen KK, Pedersen ML, Hedermann G, Vestgaard M, Thisted D, Fallesen AN, Johansson JN, Møller DC, Dubietyte G, Andersson CB, Farlie R, Skaarup Knudsen A, Hansen L, Hvidman L, Sørensen AN, Rathcke SL, Rubin KH, Petersen LK, Jørgensen JS, Krebs L, Bliddal M. Risk factors for and pregnancy outcomes after SARS-CoV-2 in pregnancy according to disease severity: A nationwide cohort study with validation of the SARS-CoV-2 diagnosis. Acta Obstet Gynecol Scand 2023; 102:282-293. [PMID: 36695168 PMCID: PMC9951376 DOI: 10.1111/aogs.14512] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/21/2022] [Accepted: 01/01/2023] [Indexed: 01/26/2023]
Abstract
INTRODUCTION We identified risk factors and outcomes associated with SARS-CoV-2 infection in pregnancy in a universally tested population according to disease severity and validated information on SARS-CoV-2 during pregnancy in national health registers in Denmark. MATERIAL AND METHODS Cohort study using data from national registers and medical records including all pregnancies between March 1, 2020 and February 28, 2021. We compared women with a validated positive SARS-CoV-2 test during pregnancy with non-infected pregnant women. Risk factors and pregnancy outcomes were assessed by Poisson and Cox regression models and stratified according to disease severity defined by hospital admission status and admission reason (COVID-19 symptoms or other). Using medical record data on actual period of pregnancy, we calculated predictive values of the SARS-CoV-2 diagnosis in pregnancy in the registers. RESULTS SARS-CoV-2 infection was detected in 1819 (1.6%) of 111 185 pregnancies. Asthma was associated with infection (relative risk [RR] 1.63, 95% confidence interval [CI] 1.28-2.07). Risk factors for severe COVID-19 disease requiring hospital admission were high body mass index (median ratio 1.06, 95% CI 1.04-1.09), asthma (RR 7.47, 95% CI 3.51-15.90) and gestational age at the time of infection (gestational age 28-36 vs < 22: RR 3.53, 95% CI 1.75-7.10). SARS-CoV-2-infected women more frequently had hypertensive disorders in pregnancy (adjusted hazard ratio [aHR] 1.31, 95% CI 1.04-1.64), early pregnancy loss (aHR 1.37, 95% CI 1.00-1.88), preterm delivery before gestational age 28 (aHR 2.31, 95% CI 1.01-5.26), iatrogenically preterm delivery before gestational age 37 (aHR 1.49, 95% CI 1.01-2.19) and small-for-gestational age children (aHR 1.28, 95% CI 1.05-1.54). The associations were stronger among women admitted to hospital for any reason. The validity of the SARS-CoV-2 diagnosis in relation to pregnancy in the registers compared with medical records showed a negative predictive value of 99.9 (95% CI 99.9-100.0) and a positive predictive value of 82.1 (95% CI 80.4-83.7). CONCLUSIONS Women infected with SARS-CoV-2 during pregnancy were at increased risk of hypertensive disorders in pregnancy, early pregnancy loss, preterm delivery and having children small for gestational age. The validity of Danish national registers was acceptable for identification of SARS-CoV-2 infection during pregnancy.
Collapse
Affiliation(s)
- Anna J. M. Aabakke
- Department of Obstetrics and GynecologyCopenhagen University Hospital—HolbækHolbækDenmark,Department of Obstetrics and GynecologyCopenhagen University Hospital—North ZealandHillerødDenmark,Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | | | - Karen Wøjdemann
- Department of Obstetrics and GynecologyCopenhagen University Hospital—BornholmRønneDenmark
| | - Mette H. Ibsen
- Department Obstetrics and GynecologyHospital of South West JutlandEsbjergDenmark
| | - Fjola Jonsdottir
- Department of Obstetrics and GynecologyCopenhagen University Hospital—Herlev and GentofteHerlevDenmark
| | - Elisabeth Rønneberg
- Department of Obstetrics and GynecologyCopenhagen University Hospital—Herlev and GentofteHerlevDenmark
| | | | - Anne Hammer
- Department of Obstetrics and GynecologyGødstrup HospitalHerningDenmark
| | - Tine D. Clausen
- Department of Obstetrics and GynecologyCopenhagen University Hospital—North ZealandHillerødDenmark,Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Julie Milbak
- Department of Obstetrics and GynecologyCopenhagen University Hospital—North ZealandHillerødDenmark
| | - Lars Burmester
- Department of Obstetrics and GynecologyThe North Denmark Regional Hospital HjørringHjørringDenmark
| | - Rikke Zethner
- Department of Obstetrics and GynecologyCopenhagen University Hospital—HolbækHolbækDenmark,Department of Obstetrics and GynecologyCopenhagen University Hospital—Herlev and GentofteHerlevDenmark
| | - Birgitte Lindved
- Department of Obstetrics and GynecologyHorsens Regional HospitalHorsensDenmark
| | - Annette Thorsen‐Meyer
- Department of Obstetrics and GynecologyCopenhagen University Hospital – Amager and HvidovreHvidovreDenmark
| | - Mohammed R. Khalil
- Department Obstetrics and GynecologyUniversity Hospital of Southern Denmark – KoldingKoldingDenmark
| | - Birgitte Henriksen
- Department Obstetrics and GynecologyUniversity Hospital of Southern Denmark – KoldingKoldingDenmark
| | - Lisbeth Jønsson
- Department Obstetrics and GynecologyNykøbing F. HospitalNykøbing FDenmark
| | - Lise L. T. Andersen
- Department of Obstetrics and GynecologyOdense University HospitalOdenseDenmark
| | - Kamilla K. Karlsen
- Department of Obstetrics and GynecologyOdense University HospitalOdenseDenmark
| | - Monica L. Pedersen
- Department of Obstetrics and GynecologyRanders Regional HospitalRandersDenmark
| | - Gitte Hedermann
- Department of Obstetrics and GynecologyCopenhagen University Hospital – RigshospitaletCopenhagenDenmark
| | - Marianne Vestgaard
- Department of Obstetrics and GynecologyCopenhagen University Hospital – RigshospitaletCopenhagenDenmark
| | - Dorthe Thisted
- Department of Obstetrics and GynecologyCopenhagen University Hospital—HolbækHolbækDenmark,Department of Obstetrics and GynecologyZealand University HospitalRoskildeDenmark
| | - Agnethe N. Fallesen
- Department of Obstetrics and GynecologyCopenhagen University Hospital – NæstvedSlagelseDenmark
| | - Josephine N. Johansson
- Department of Obstetrics and GynecologyCopenhagen University Hospital – NæstvedSlagelseDenmark
| | - Ditte C. Møller
- Department of Obstetrics and GynecologyHospital of South JutlandAabenraaDenmark
| | - Greta Dubietyte
- Department of Obstetrics and GynecologyHospital of South JutlandAabenraaDenmark
| | - Charlotte B. Andersson
- Department of Obstetrics and GynecologyThe North Denmark Regional Hospital ThistedThistedDenmark,Danish Center for Clinical Health Services Research (DACS)AalborgDenmark
| | - Richard Farlie
- Department of Obstetrics and GynecologyViborg Regional HospitalViborgDenmark
| | | | - Lea Hansen
- Department of Obstetrics and GynecologyAarhus University HospitalAarhusDenmark
| | - Lone Hvidman
- Department of Obstetrics and GynecologyAarhus University HospitalAarhusDenmark
| | - Anne N. Sørensen
- Department of Obstetrics and GynecologyAalborg University HospitalAalborgDenmark
| | - Sidsel L. Rathcke
- Department of Obstetrics and GynecologyAalborg University HospitalAalborgDenmark
| | - Katrine H. Rubin
- OPEN, Odense University HospitalOdenseDenmark,Research Unit OPEN, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Lone K. Petersen
- Department of Obstetrics and GynecologyOdense University HospitalOdenseDenmark,Research Unit OPEN, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Jan S. Jørgensen
- Department of Obstetrics and GynecologyOdense University HospitalOdenseDenmark
| | - Lone Krebs
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark,Department of Obstetrics and GynecologyCopenhagen University Hospital – Amager and HvidovreHvidovreDenmark
| | - Mette Bliddal
- OPEN, Odense University HospitalOdenseDenmark,Research Unit OPEN, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
| |
Collapse
|
8
|
Corsi Decenti E, Salvatore MA, Mancon A, Portella G, Rocca A, Vocale C, Donati S. A large series of molecular and serological specimens to evaluate mother-to-child SARS-CoV-2 transmission: a prospective study from the Italian Obstetric Surveillance System. Int J Infect Dis 2023; 126:1-9. [PMID: 36368605 PMCID: PMC9640374 DOI: 10.1016/j.ijid.2022.10.045] [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: 07/15/2022] [Revised: 10/19/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To assay the presence of the SARS-CoV-2 genome in vaginal, rectal, and placental swabs among pregnant women and in newborn nasopharyngeal swabs and to investigate the immunological response and maternal antibody transfer through the umbilical cord blood and milk of unvaccinated mothers. METHODS Vaginal, rectal, and placental specimens, maternal and neonatal serum, and milk were collected from a wide cohort of pregnant Italian women with confirmed SARS-CoV-2 infection admitted to the hospital between February 25, 2020 and June 30, 2021. Samples were tested in selected reference laboratories according to a shared interlaboratory protocol. RESULTS Among 1086 enrolled women, the SARS-CoV-2 positive rate detected in all specimens ranged from 0.7% to 8.4%. Respectively, 45.2% of maternal sera collected during pregnancy and 39.7% of those collected at birth tested positive for immunoglobulin G, whereas 50.5% tested positive among neonates. Nasopharyngeal swabs were positive in 0.8% of the newborns, and immunoglobulin G was detected in 3.0% of the milk samples. The highest immunological response was recorded within 30 days during pregnancy and within 60 days of birth and in the neonatal population. CONCLUSION Vertical transmission should be considered a rare event; although, a good maternal immunological response and antibodies transfer throughout the umbilical cord blood was detected.
Collapse
Affiliation(s)
- Edoardo Corsi Decenti
- Istituto Superiore di Sanità - Italian National Institute of Health, National Centre for Disease Prevention and Health Promotion, 00161 Rome, Italy,University of Rome Tor Vergata, Department of Biomedicine and Prevention, 00133 Rome, Italy
| | - Michele Antonio Salvatore
- Istituto Superiore di Sanità - Italian National Institute of Health, National Centre for Disease Prevention and Health Promotion, 00161 Rome, Italy,Corresponding author at: Michele Antonio Salvatore, Istituto Superiore di Sanità - Italian National Institute of Health, National Centre for Disease Prevention and Health Promotion, Viale Regina Elena 299, 00161 Rome, Italy. Tel: +39-0649904310
| | | | - Giuseppe Portella
- Federico II University of Naples, Dipartimento di Scienze Mediche Traslazionali, 80138 Naples, Italy
| | - Arianna Rocca
- Careggi University Hospital, Department of Experimental and Clinical Medicine, 50134 Florence, Italy
| | - Caterina Vocale
- Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) - University Hospital of Bologna, Microbiology Unit, 40138 Bologna, Italy
| | - Serena Donati
- Istituto Superiore di Sanità - Italian National Institute of Health, National Centre for Disease Prevention and Health Promotion, 00161 Rome, Italy
| | - Italian Obstetric Surveillance System COVID-19 Working GroupAlberiIrene7AnelliGaia Maria8BaltaroFederica9BisulliMaria10BrusaStefano11CataneoIlaria12CetinIrene13CuomoMarianna14RìPietro Dal15CerboLidia Di16FerrettiAlice17GismondoMaria Rita1819GrisoliaGianpaolo20LivioStefania21LocciMariavittoria22MalentacchiFrancesca23MecacciFederico24PaccaloniBarbara25PednaMaria Federica26PerroneEnrica27PignattiLucrezia28PirasMartina29PrimaveraAlessandra30SavasiValeria31SimeoneSerena32TaddeiFabrizio33TironiRoberta34TorriArianna35Department of Obstetrics and Gynaecology, Santa Chiara Hospital, 38122 Trento, ItalyDepartment of Biomedical and Clinical Sciences - University of Milan, via G.B. Grassi 74, 20157, Milan, ItalyUnit of Obstetrics and Gynecology, Grande Ospedale Metropolitano di Niguarda, 20162, Milan, ItalyObstetric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138, Bologna, ItalyDipartimento di Scienze Mediche Traslazionali, Federico II University of Naples, 80138, Naples, ItalyDepartment of Obstetrics and Gynecology, Ospedale Maggiore, 40133, Bologna, ItalyDepartment of Biomedical and Clinical Sciences, University of Milan, 20154, Milan, ItalyDepartment of Biomedical and Clinical Sciences - University of Milan, via G.B. Grassi 74, 20157, Milan, ItalyUnit of Obstetrics and Gynaecology, Santa Maria del Carmine Hospital, 38068, Rovereto, ItalyOspedale Infermi, 47923, Rimini, ItalyUnit of Obstetrics and Gynaecology, Azienda Unità Sanitaria Locale-IRCCS, 42123, Reggio Emilia, ItalyDepartment of Biomedical and Clinical Sciences - University of Milan, 20157, Milan, ItalyASST Fatebenefratelli Sacco - University Hospital L. Sacco, 20157, Milan, ItalyDepartment of Obstetrics and Gynaecology, Carlo Poma Hospital, 46100, Mantua, ItalyUnit of Obstetrics and Gynecology, Hospital V. Buzzi, ASST Fatebenefratelli Sacco, Department of Biomedical and Clinical Sciences, University of Milan, 20154, Milan, ItalyFederico II University of Naples, 80138, Naples, ItalySOD Microbiologia e Virologia, AOU Careggi, 50139, Florence, ItalyDepartment of Biomedical, Division of Obstetrics and Gynecology, Experimental and Clinical Sciences, University of Florence, 50134, Florence, ItalyUnit of Obstetrics and Gynaecology, Santa Maria della Scaletta Hospital, 40026, Imola, ItalyUnit of Microbiology, Greater Romagna Hub Laboratory, 47522, Pievesestina, Cesena, ItalyServizio Assistenza Territoriale, Direzione Generale Cura Della Persona, Salute e Welfare, Emilia‐Romagna Region, 40127, Bologna, ItalyDepartment of Obstetrics and Gynaecology, Maurizio Bufalini Hospital, 47521, Cesena, ItalyClinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda USL-IRCCS Reggio Emilia, 42122, Reggio Emilia, ItalyMicrobiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138, Bologna, ItalyUnit of Obstetrics and Gynaecology, Department of Biomedical and Clinical Sciences, ASST Fatebenefratelli Sacco, University of Milan, 20157, Milan, ItalyDepartment of Woman and Child's Health, Careggi University Hospital, 50141, Florence, ItalyDepartment of Obstetrics and Gynaecology, Santa Chiara Hospital, 38122, Trento, ItalyOspedale Manzoni, 23900, Lecco, ItalyUnit of Microbiology, Greater Romagna Hub Laboratory, 47522, Pievesestina, Cesena, Italy.
| |
Collapse
|
9
|
Berrocal J, Tique-Salleg V, Miranda J, Arrieta G, Echeverri D, Peñate G, Spath D, Mattar AS, Mattar S. Seroprevalence of antibodies against to SARS-CoV 2 in umbilical cord blood in two hospital centers in Córdoba and Sucre, Colombia. J Infect Public Health 2022; 15:1076-1080. [PMID: 36113400 PMCID: PMC9433339 DOI: 10.1016/j.jiph.2022.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/14/2022] [Accepted: 08/24/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Pregnant women continue to be vulnerable to COVID-19, and their immunosuppressed state could put them at greater risk of developing more severe forms of the disease. In Colombia and Latin America, there are few studies on the immune response of the newborn against SARS-CoV-2. AIM To determine the prevalence of SARS-CoV-2 infection in umbilical cord blood in two hospital centers in Córdoba and Sucre. METHODS Between March and June 2021, a prospective descriptive cross-sectional study was carried out. Two hospitals from the departments of Córdoba and Sucre, located in the Northwest Caribbean area of Colombia, participated. Three hundred sixty umbilical cord blood samples were taken at the two hospitals. A commercial ELISA was performed to detect total IgG, IgM, and IgA antibodies against the N protein of SARS-CoV-2. The ethics committee approved the study of the participating institutions. RESULTS Of 3.291 women who gave birth in the hospital centers included in the study, 360 (11%) participated. Complete clinical data were obtained for 223 women. The mean age of the women was 24 years (range, 15-42). 29.4% (106/360) of the umbilical cord samples had total antibodies against SARS-CoV-2. Pregnant women did not have blood samples taken. 58% of the women were asymptomatic. There was no association between umbilical cord samples, clinical, epidemiological characteristics, and serological response to antibodies to SARS-CoV-2 (p > 0.05). CONCLUSIONS The prevalence of umbilical cord blood samples was 29.4% for total SARS-CoV-2 antibodies. The study provides essential aspects for the epidemiological approach to neonates infected with SARS-CoV-2.
Collapse
Affiliation(s)
| | - Vaneza Tique-Salleg
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Colombia.
| | - Jorge Miranda
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Colombia.
| | - German Arrieta
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Clínica Salud Social Sincelejo, Corporación Universitaria del Caribe: (CECAR). Sucre, Colombia.
| | - Daniel Echeverri
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Colombia.
| | | | - Doris Spath
- E.S.E Vida Sinú, Montería, Córdoba, Colombia
| | | | - Salim Mattar
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Colombia.
| |
Collapse
|
10
|
Marchi L, Vidiri A, Fera EA, Pallottini M, Perelli F, Gardelli M, Brunelli T, Poggetto PD, Martelli E, Straface G, Signore F, Fusco I, Vasarri PL, Scambia G, Cavaliere AF. SARS-CoV-2 IgG "heritage" in newborn: A credit of maternal natural infection. J Med Virol 2022; 95:e28133. [PMID: 36071636 PMCID: PMC9538415 DOI: 10.1002/jmv.28133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 08/27/2022] [Accepted: 08/31/2022] [Indexed: 01/11/2023]
Abstract
Description of transplacental passage of specific SARS-CoV-2 IgG from mothers who contracted natural infection to their newborns. Retrospective cohort analysis including pregnant women diagnosed with SARS-CoV-2 and their newborns both tested for SARS-CoV-2 specific IgG and IgM with antibody titration at delivery. Nasopharyngeal swab were taken from both mothers and neonates, and tested for SARS-CoV-2 using polymerase chain reaction (PCR). IgM and IgG were analyzed in maternal and neonatal serum of 143 mother-infant dyads. 86% of women with a positive SARS-CoV-2 PCR >14 days before delivery developed specific IgG and 84% of their infants showed transplacental passage of IgG. Pregnant women infected with SARS-CoV-2 achieve antibody seroconversion following the kinetics described in the general population, and transplacental transfer of IgG specific antibodies occurs. No conclusion can be drawn on passive immunity efficacy or duration.
Collapse
Affiliation(s)
- Laura Marchi
- Obstetrics and Gynecology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
| | - Annalisa Vidiri
- Department of Science of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCSUniversità Cattolica del Sacro CuoreRomaItaly
| | - Emanuele Arturo Fera
- Department of Woman and Child HealthAzienda Ospedaliero Universitaria CareggiFirenzeItaly
| | - Marta Pallottini
- Obstetrics and Gynecology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
| | - Federica Perelli
- Obstetrics and Gynecology Unit, Ospedale Santa Maria AnnunziataAUSL Toscana CentroFirenzeItaly
| | - Monica Gardelli
- Obstetrics and Gynecology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
| | - Tamara Brunelli
- Clinical Pathology and Microbiology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
| | - Paolo Dal Poggetto
- Paediatrics and Neonatology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
| | - Elena Martelli
- Paediatrics and Neonatology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
| | - Gianluca Straface
- Obstetrics and Gynecology UnitPoliclinico Abano TermeAbano TermeItaly
| | - Fabrizio Signore
- Obstetrics and Gynecology UnitSanto Eugenio HospitalRomaItaly,Division of Obstetrics and GynaecologyUnicamillus University RomeRomaItaly
| | - Ismaele Fusco
- Clinical Pathology and Microbiology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
| | - Pier Luigi Vasarri
- Paediatrics and Neonatology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
| | - Giovanni Scambia
- Department of Science of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCSUniversità Cattolica del Sacro CuoreRomaItaly
| | - Anna Franca Cavaliere
- Obstetrics and Gynecology Unit, Santo Stefano Hospital PratoAUSL Toscana CentroPratoItaly
| |
Collapse
|
11
|
The association between maternal characteristics and SARS-CoV-2 in pregnancy: a population-based registry study in Sweden and Norway. Sci Rep 2022; 12:8355. [PMID: 35589871 PMCID: PMC9120467 DOI: 10.1038/s41598-022-12395-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 05/10/2022] [Indexed: 01/08/2023] Open
Abstract
The objectives of the current study were to identify risk factors for SARS-CoV-2 positivity, and to address how different testing strategies, choice of comparison group, and population background characteristics may influence observed associations. National registries data for 107,627 pregnant women in Sweden and 81,195 in Norway, were used to identify risk factors for SARS-CoV-2, separately for women under non-universal testing (testing by indication) and universal testing (testing of all pregnant women in contact with a delivery ward). We also investigated underlying characteristics associated with testing for SARS-CoV-2. Overall, 2.1% of pregnant women in Sweden and 1.1% in Norway were test-positive during the pandemic’s first 18 months. We show that the choice of test strategy for SARS-CoV-2 provided different associations with risk factors for the disease; for instance, women who were overweight, obese or had gestational diabetes had increased odds of being test-positive under non-universal testing, but not under universal testing. Nevertheless, a consistent pattern of association between being born in the Middle East and Africa and test-positivity was found independent of test strategy and in both countries. These women were also less likely to get tested. Our results are useful to consider for surveillance and clinical recommendations for pregnant women during the current and future pandemics.
Collapse
|