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Fenizia C, Biasin M, Cetin I, Vergani P, Mileto D, Spinillo A, Gismondo MR, Perotti F, Callegari C, Mancon A, Cammarata S, Beretta I, Nebuloni M, Trabattoni D, Clerici M, Savasi V. Analysis of SARS-CoV-2 vertical transmission during pregnancy. Nat Commun 2020; 11:5128. [PMID: 33046695 PMCID: PMC7552412 DOI: 10.1038/s41467-020-18933-4] [Citation(s) in RCA: 248] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 09/18/2020] [Indexed: 12/18/2022] Open
Abstract
The impact of SARS-CoV-2 infection during gestation remains unclear. Here, we analyse the viral genome on maternal and newborns nasopharyngeal swabs, vaginal swabs, maternal and umbilical cord plasma, placenta and umbilical cord biopsies, amniotic fluids and milk from 31 mothers with SARS-CoV-2 infection. In addition, we also test specific anti-SARS-CoV-2 antibodies and expression of genes involved in inflammatory responses in placentas, and in maternal and umbilical cord plasma. We detect SARS-CoV-2 genome in one umbilical cord blood and in two at-term placentas, in one vaginal mucosa and in one milk specimen. Furthermore, we report the presence of specific anti-SARS-CoV-2 IgM and IgG antibodies in one umbilical cord blood and in one milk specimen. Finally, in the three documented cases of vertical transmission, SARS-CoV-2 infection was accompanied by a strong inflammatory response. Together, these data support the hypothesis that in utero SARS-CoV-2 vertical transmission, while low, is possible. These results might help defining proper obstetric management of COVID-19 pregnant women, or putative indications for mode and timing of delivery.
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MESH Headings
- Adolescent
- Adult
- Antibodies, Viral/analysis
- Betacoronavirus/genetics
- Betacoronavirus/immunology
- Betacoronavirus/isolation & purification
- COVID-19
- Coronavirus Infections/diagnosis
- Coronavirus Infections/pathology
- Coronavirus Infections/transmission
- Coronavirus Infections/virology
- Female
- Genome, Viral
- Humans
- Infant, Newborn
- Infectious Disease Transmission, Vertical
- Inflammation
- Middle Aged
- Pandemics
- Pneumonia, Viral/diagnosis
- Pneumonia, Viral/pathology
- Pneumonia, Viral/transmission
- Pneumonia, Viral/virology
- Pregnancy
- Pregnancy Complications, Infectious/diagnosis
- Pregnancy Complications, Infectious/pathology
- Pregnancy Complications, Infectious/virology
- SARS-CoV-2
- Young Adult
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Affiliation(s)
- Claudio Fenizia
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Mara Biasin
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Irene Cetin
- Department of Woman, Mother and Neonate Buzzi Children's Hospital, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, Milan, Italy
| | - Patrizia Vergani
- Department of Maternal Fetal Medicine, Fondazione MBBM, San Gerardo Hospital, University of Milan-Bicocca, Monza, Italy
| | - Davide Mileto
- Clinical Microbiology, Virology and Bio-emergence Diagnosis, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Arsenio Spinillo
- Department of Obstetrics and Gynecology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Maria Rita Gismondo
- Clinical Microbiology, Virology and Bio-emergence Diagnosis, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Francesca Perotti
- Department of Obstetrics and Gynecology, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Clelia Callegari
- Department of Maternal Fetal Medicine, Fondazione MBBM, San Gerardo Hospital, University of Milan-Bicocca, Monza, Italy
| | - Alessandro Mancon
- Clinical Microbiology, Virology and Bio-emergence Diagnosis, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Selene Cammarata
- Unit of Obstetrics and Gynecology, ASST Fatebenefratelli-Sacco, Department of Biological and Clinical Sciences, University of Milan, Milan, Italy
| | - Ilaria Beretta
- Division of Infectious Diseases, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Manuela Nebuloni
- Pathology Unit, ASST Fatebenfretalli-Sacco, Department of Biological and Clinical Sciences, University of Milan, Milan, Italy
| | - Daria Trabattoni
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Mario Clerici
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- IRCCS Fondazione don Carlo Gnocchi, Milan, Italy
| | - Valeria Savasi
- Unit of Obstetrics and Gynecology, ASST Fatebenefratelli-Sacco, Department of Biological and Clinical Sciences, University of Milan, Milan, Italy.
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