School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
J Med Virol. 2021 Mar;93(3):1361-1369. doi: 10.1002/jmv.26622. Epub 2020 Nov 10.
Current evidence suggests that coronavirus disease 2019 (COVID-19), caused by severe respiratory syndrome coronavirus 2 (SARS-CoV-2), is predominantly transmitted from human-to-human. However, evidence on vertical transmission and natural passive immunity among the newborns exposed to COVID-19 is scanty and varies. This poses a challenge on preventive interventions for the newborns. We conducted a systematic review to first, determine the likelihood of vertical transmission among COVID-19 exposed infants and second, determine whether antibodies against SARS-CoV-2 were generated among COVID-19 vertically exposed but negative infants. This review registered in PROSPERO searched evidence from PubMed/MEDLINE and Google Scholar, among others. About 517 studies were pooled, where 33 articles (5.8%) met the inclusion criteria such as infection prevention and control measures at birth. A total of 205 infants born to COVID-19 positive mothers were studied. Overall, 6.3% (13/205; 95% CI: 3.0%-9.7%) of the infants tested positive for COVID-19 virus at birth. Of 33 eligible studies, six studies (18.8%) reported about immunoglobulin G/M (IgG/IgM) against SARS-CoV-2. IgG/IgM were detected in 90% infants (10/11; 95% CI: 73.9%-107.9%) who tested negative for COVID-19 virus. The median antibody levels detected were 75.49 AU/ml (range, 7.25-140.32 AU/ml) and 3.79 AU/ml (range, 0.16-45.83 AU/ml), p = .0041 for IgG and IgM, respectively. In conclusion, the current evidence revealed a low possibility of vertical transmission of COVID-19 and antibodies against SARS-CoV-2 were detected among vertically exposed but negative infants. Further studies on transplacental transmission and the magnitude of natural passive immunity in infants born to mothers with COVID-19 are warranted.
目前的证据表明，由严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）引起的 2019 年冠状病毒病（COVID-19）主要通过人与人之间传播。然而，关于 COVID-19 暴露新生儿中的垂直传播和自然被动免疫的证据很少且存在差异。这对新生儿的预防干预措施构成了挑战。我们进行了一项系统评价，首先确定 COVID-19 暴露婴儿垂直传播的可能性，其次确定 COVID-19 垂直暴露但呈阴性的婴儿是否产生针对 SARS-CoV-2 的抗体。这项在 PROSPERO 注册的综述从 PubMed/MEDLINE 和 Google Scholar 等数据库中搜索了证据。共汇总了约 517 项研究，其中 33 项（5.8%）符合纳入标准，包括出生时的感染预防和控制措施。共有 205 名 COVID-19 阳性母亲所生的婴儿接受了研究。总体而言，205 名婴儿中有 6.3%（13/205；95%CI：3.0%-9.7%）在出生时检测到 COVID-19 病毒阳性。在 33 项符合条件的研究中，有 6 项（18.8%）报告了针对 SARS-CoV-2 的免疫球蛋白 G/M（IgG/IgM）。在 COVID-19 病毒检测阴性的 11 名婴儿中，有 90%（10/11；95%CI：73.9%-107.9%）检测到 IgG/IgM。检测到的抗体水平中位数分别为 75.49 AU/ml（范围：7.25-140.32 AU/ml）和 3.79 AU/ml（范围：0.16-45.83 AU/ml），IgG 和 IgM 的 p 值分别为<.0041。总之，目前的证据表明 COVID-19 的垂直传播可能性较低，并且在垂直暴露但呈阴性的婴儿中检测到针对 SARS-CoV-2 的抗体。有必要进一步研究 COVID-19 母亲所生婴儿的胎盘传播和自然被动免疫的程度。
