Ferreira Maria de Fátima Carvalho, Pavon Janeth Aracely Ramirez, Napoleão Amanda Colichio Bini, Figueiredo Gláucia Maria Duarte Preza, Florêncio Patricia Cristina Borges, Arantes Rayssa Basílio Dos Santos, Rizzo Paula Sossai, Carmo Maria Aparecida Mazzutti Verlangieri, Nakazato Luciano, Dutra Valéria, Hahn Rosane Christine, Slhessarenko Renata Dezengrini
Hospital Universitário Júlio Muller, Universidade Federal de Mato Grosso, 78048-902, Cuiabá, Mato Grosso, Brazil.
Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Mato Grosso, 78060-900, Cuiabá, Mato Grosso, Brazil.
Microbes Infect. 2022 Jun;24(4):104949. doi: 10.1016/j.micinf.2022.104949. Epub 2022 Feb 2.
Brazil has the highest SARS-CoV-2 case-fatality rate in pregnant women in the Americas. In this study, clinical and virological findings of five mildly symptomatic pregnant women and their infected fetuses/newborns treated at a referral hospital for COVID19-pregnant women in Midwestern Brazil are reported. Mother and fetal samples were tested by RT-qPCR, ECLIA and Illumina MiSeq sequencing. From the five cases, one resulted in spontaneous abortion, one was stillborn, two were preterm births and one full-term birth. Maternal and fetal placenta, newborn and stillborn secretions were SARS-CoV-2+; one neonate developed ground-glass opacities in his lungs. One neonate's umbilical cord was IgG+ and all were IgM negative upon hospital discharge. Genomes recovered from two placentas belong to the B.1.1.28 and B.1.1.33 lineages and present nonsynonymous mutations associated with virus fitness and infectivity; other not frequently reported mutations (B.1.1.33: NSP3 V2090G, M A2S and ORF3ab S253P and Y264N; B.1.1.28: NSP3 E995D, NSP12 R240K, NSP14H1897Y and in ORF7b V21F) were found in proteins involved in viral replication, viral induction of apoptosis, viral interference on interferon and on NF-Κβ pathways. Phylogeny indicates the south of Brazil as the possible origin of these lineages circulating in Mato Grosso State. These findings contribute to describe SARS-CoV-2 infection and outcomes in pregnant women and their fetuses, at any stage of gestation and even in mild symptomatic cases.
巴西是美洲孕妇中新冠病毒2型（SARS-CoV-2）病死率最高的国家。在本研究中，报告了巴西中西部一家新冠孕妇转诊医院收治的5例症状轻微的孕妇及其感染胎儿/新生儿的临床和病毒学检查结果。对母亲和胎儿样本进行了逆转录定量聚合酶链反应（RT-qPCR）、电化学发光免疫分析（ECLIA）和Illumina MiSeq测序检测。5例病例中，1例自然流产，1例死产，2例早产，1例足月产。产妇和胎儿的胎盘、新生儿和死产儿的分泌物中均检测出SARS-CoV-2阳性；1例新生儿肺部出现磨玻璃样混浊。1例新生儿脐带血出院时IgG阳性，所有新生儿IgM均为阴性。从两份胎盘中提取的基因组属于B.1.1.28和B.1.1.33谱系，存在与病毒适应性和传染性相关的非同义突变；在参与病毒复制、病毒诱导凋亡、病毒干扰干扰素和NF-κB通路的蛋白质中发现了其他不常见的突变（B.1.1.33：非结构蛋白3（NSP3）V2090G、基质蛋白（M）A2S以及开放阅读框3ab（ORF3ab）S253P和Y264N；B.1.1.28：NSP3 E995D、NSP12 R240K、NSP14 H1897Y以及ORF7b V21F）。系统发育分析表明，巴西南部可能是这些谱系在马托格罗索州传播的起源地。这些发现有助于描述SARS-CoV-2在孕妇及其胎儿中的感染情况及结局，涵盖妊娠的任何阶段，甚至是症状轻微的病例。
