Neonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.
Università Cattolica del Sacro Cuore, Rome, Italy.
Clin Chem Lab Med. 2022 Jun 24;60(9):1486-1491. doi: 10.1515/cclm-2022-0238. Print 2022 Aug 26.
Coronavirus disease (COVID-19) can present with various symptoms and can involve multiple organs. Women infected during pregnancy have a higher incidence of obstetrical complications and infants born to "positive" mothers may get the infection with different manifestations. Presepsin seems to be a promising sepsis biomarker in adults and neonates. The aim of this study was to assess if presepsin levels in neonatal cord blood could be influenced by maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
A total of 119 neonates born from women with a confirmed diagnosis of SARS-CoV-2 infection were enrolled and presepsin levels of cord blood samples were collected. All neonates were tested for SARS-CoV-2 infection at birth and after 48-72 h.
The median presepsin value in umbilical cord blood samples collected after birth was 455 pg/mL. Presepsin levels were not influenced by maternal symptoms of COVID-19, weight for gestational age, or delivery mode, and did not significantly differ between infants with and without adverse neonatal outcomes. Infants hospitalized for more than 5 days had a significantly higher presepsin level at birth rather than those discharged up to 4 days of life. Three infants with positive nasopharyngeal swab at birth had higher Presepsin levels than two infants tested positive at 48 h.
This is the first study reporting cord presepsin levels in term and preterm infants born to mothers with COVID-19, that appeared to be not influenced by maternal clinical presentation. However, further studies are needed to explain the mechanisms of P-SEP increase in neonates exposed to perinatal maternal SARS-CoV-2 infection or with an indeterminate/possible SARS-CoV-2 infection in the same neonates.
冠状病毒病（COVID-19）可表现出多种症状，并可累及多个器官。孕妇感染 COVID-19 后，产科并发症的发生率更高，而“阳性”母亲所生婴儿可能会出现不同表现的感染。降钙素原前体（Presepsin）似乎是成人和新生儿脓毒症有前途的生物标志物。本研究旨在评估产妇严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染是否会影响新生儿脐血中 Presepsin 的水平。
共纳入 119 例确诊 SARS-CoV-2 感染的产妇所生新生儿，并采集脐血样本检测 Presepsin 水平。所有新生儿在出生时和出生后 48-72 小时均接受 SARS-CoV-2 感染检测。
出生后采集的脐血样本中 Presepsin 的中位数为 455pg/mL。Presepsin 水平不受 COVID-19 产妇症状、胎龄体重或分娩方式的影响，在新生儿无不良结局和有不良结局的婴儿之间也无显著差异。住院时间超过 5 天的婴儿出生时 Presepsin 水平明显高于住院 4 天以内的婴儿。出生时鼻咽拭子检测阳性的 3 例婴儿 Presepsin 水平高于 48 小时检测阳性的 2 例婴儿。
这是第一项研究报告 COVID-19 产妇所生足月和早产婴儿的脐血 Presepsin 水平，似乎不受产妇临床表现的影响。然而，需要进一步的研究来解释围产期母体 SARS-CoV-2 感染或同一新生儿 SARS-CoV-2 感染不确定/可能感染的情况下新生儿 Presepsin 水平升高的机制。
