COVID-19 can be transmitted in the womb, reports pediatric infectious
disease journal
Case study provides evidence of intrauterine transmission of SARS-CoV-
2 from mother to infant

Date:
July 10, 2020
Source:
Wolters Kluwer Health
Summary:
A baby girl in Texas -- born prematurely to a mother with COVID-19
-- is the strongest evidence to date that intrauterine (in the womb)
transmission of severe acute respiratory syndrome coronavirus 2
(SARS- CoV-2) can occur, according to a new report.



FULL STORY ==========================================================================
A baby girl in Texas -- born prematurely to a mother with COVID-19 --
is the strongest evidence to date that intrauterine (in the womb)
transmission of severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2) can occur, reports The Pediatric Infectious Disease Journal,
the official journal of The European Society for Paediatric Infectious Diseases. The journal is published in the Lippincott portfolio by
Wolters Kluwer.


==========================================================================
The findings "suggest in utero transmission" of COVID-19 from an infected mother to her infant, according to the case report by Julide Sisman, MD,
and colleagues of The University of Texas Southwestern Medical Center,
Dallas.

"Numerous infants have now been delivered to pregnant women diagnosed
with SARS-CoV-2, with the majority of these infants without respiratory
illness or positive molecular evidence for SARS-CoV-2," comments Amanda
S. Evans, MD, one of the lead authors of the new study. "Our study
is the first to document intrauterine transmission of the infection
during pregnancy, based on immunohistochemical and ultrastructural
evidence of SARS-CoV-2 infection in the fetal cells of the placenta."
First Documented Intrauterine Transmission of COVID-19 The authors
report on an infant delivered to a mother diagnosed with COVID-19, who
also had type 2 diabetes. The infant was born at 34 weeks' gestation
after the mother had premature rupture of the membranes. The baby was
born "large for gestational age" (LGA) -- an important complication in
infants of diabetic mothers. She was treated in the neonatal ICU due to prematurity and possible SARS-CoV-2 exposure.

The infant appeared initially healthy, with normal breathing and other
vital signs. On the second day of life, she developed fever and relatively
mild breathing problems. "It is unlikely that the respiratory distress
observed in this infant was due to prematurity since it did not start
until the second day of life," the researchers write.

The baby tested positive for SARS-CoV-2 infection at 24 and 48 hours
after birth. She was treated with supplemental oxygen for several days
but did not need mechanical ventilation. COVID-19 tests remained positive
for up to 14 days. At 21 days, the mother and infant were sent home in
good condition.

The researchers examined the placenta, which showed signs of tissue inflammation. In addition, specialized tests documented the presence of coronavirus particles as well as a protein (SARS-CoV-2 nucleocapsid
protein) specific for the COVID-19 virus in fetal cells of the
placenta. Together, these findings confirmed that the infection was
transmitted in the womb, rather than during or after birth.

Although data on COVID-19 remain very limited, "Intrauterine transmission
of SARS-CoV-2 appears to be a rare event," Dr. Sisman and colleagues
conclude.

They highlight several urgent priorities for further research, including
the mechanisms and risk factors of in utero SARS-CoV-2 transmission and
the outcomes of congenital COVID-19 in infants.

"We wanted to be very careful of our interpretation of this
data, but now is an even more important time for pregnant women
to protect themselves from COVID- 19," comments Dr. Evans. She
adds, "The CDC has thoughtful guidance on ways to reduce risk of
infection." (See https://www.cdc.gov/coronavirus/2019-ncov/need- extra-precautions/pregnancy-breastfeeding.html) Two additional case
reports in PIDJ also describe "vertical" transmission of SARS-Co-V2 from
mother to infant occurring under different circumstances.

Together, the three cases highlight the important but difficult
distinction between virus transmission occurring before or during/after delivery (intrauterine versus intrapartum), according to a commentary
led by George K.

Siberry, MD, of the US Agency for International Development and Associate
Chief Editor of PIDJ. Dr. Siberry and coauthors write: "As these cases illustrate, evaluation for vertical -- and especially intrauterine -- SARS-CoV-2 infection can be challenging, and assessment is often limited
by lack of optimal testing of appropriate specimens obtained at specific timepoints."

========================================================================== Story Source: Materials provided by Wolters_Kluwer_Health. Note: Content
may be edited for style and length.


========================================================================== Journal Reference:
1. Julide Sisman, Mambarambath A. Jaleel, Wilmer Moreno, Veena Rajaram,
Rebecca R.J. Collins, Rashmin C. Savani, Dinesh Rakheja, Amanda
S. Evans.

Intrauterine Transmission of Sars-Cov-2 Infection in a Preterm
Infant.

Pediatric Infectious Disease Journal, 2020; Publish Ahead of Print
DOI: 10.1097/INF.0000000000002815 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/07/200710131512.htm

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