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      Vertical Transmission of Coronavirus Disease 19 (COVID-19) from Infected Pregnant Mothers to Neonates: A Review

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          Abstract

          Background: Since early December 2019, the Coronavirus Disease 19 (COVID-19) infection has been prevalent in China and eventually spread to other countries. There are a few published cases of COVID-19 occurring during pregnancy and due the possibility of mother-fetal vertical transmission, there is a concern that the fetuses may be at risk of congenital COVID-19. Methods: We reviewed the risk of vertical transmission of COVID-19 to the fetus of infected mothers by using data of published articles or official websites up to March 4, 2020. Results: A total of 31 infected pregnant mothers with COVID-19 were reported. No COVID-19 infection was detected in their neonates or placentas. Two mothers died from COVID-19-related respiratory complications after delivery. Conclusions: Currently, based on limited data, there is no evidence for intrauterine transmission of COVID-19 from infected pregnant women to their fetuses. Mothers may be at increased risk for more severe respiratory complications.

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          Most cited references 16

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          Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records

          Summary Background Previous studies on the pneumonia outbreak caused by the 2019 novel coronavirus disease (COVID-19) were based on information from the general population. Limited data are available for pregnant women with COVID-19 pneumonia. This study aimed to evaluate the clinical characteristics of COVID-19 in pregnancy and the intrauterine vertical transmission potential of COVID-19 infection. Methods Clinical records, laboratory results, and chest CT scans were retrospectively reviewed for nine pregnant women with laboratory-confirmed COVID-19 pneumonia (ie, with maternal throat swab samples that were positive for severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) who were admitted to Zhongnan Hospital of Wuhan University, Wuhan, China, from Jan 20 to Jan 31, 2020. Evidence of intrauterine vertical transmission was assessed by testing for the presence of SARS-CoV-2 in amniotic fluid, cord blood, and neonatal throat swab samples. Breastmilk samples were also collected and tested from patients after the first lactation. Findings All nine patients had a caesarean section in their third trimester. Seven patients presented with a fever. Other symptoms, including cough (in four of nine patients), myalgia (in three), sore throat (in two), and malaise (in two), were also observed. Fetal distress was monitored in two cases. Five of nine patients had lymphopenia (<1·0 × 10⁹ cells per L). Three patients had increased aminotransferase concentrations. None of the patients developed severe COVID-19 pneumonia or died, as of Feb 4, 2020. Nine livebirths were recorded. No neonatal asphyxia was observed in newborn babies. All nine livebirths had a 1-min Apgar score of 8–9 and a 5-min Apgar score of 9–10. Amniotic fluid, cord blood, neonatal throat swab, and breastmilk samples from six patients were tested for SARS-CoV-2, and all samples tested negative for the virus. Interpretation The clinical characteristics of COVID-19 pneumonia in pregnant women were similar to those reported for non-pregnant adult patients who developed COVID-19 pneumonia. Findings from this small group of cases suggest that there is currently no evidence for intrauterine infection caused by vertical transmission in women who develop COVID-19 pneumonia in late pregnancy. Funding Hubei Science and Technology Plan, Wuhan University Medical Development Plan.
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            Coronavirus Disease 2019 (COVID-19) and Pregnancy: What obstetricians need to know

            Coronavirus Disease 2019 (COVID-19) is an emerging disease with a rapid increase in cases and deaths since its first identification in Wuhan, China, in December 2019. Limited data are available about COVID-19 during pregnancy; however, information on illnesses associated with other highly pathogenic coronaviruses (i.e., severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS)) might provide insights into COVID-19’s effects during pregnancy.
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              Severe acute respiratory syndrome-related coronavirus – The species and its viruses, a statement of the Coronavirus Study Group

              The present outbreak of lower respiratory tract infections, including respiratory distress syndrome, is the third spillover, in only two decades, of an animal coronavirus to humans resulting in a major epidemic. Here, the Coronavirus Study Group (CSG) of the International Committee on Taxonomy of Viruses, which is responsible for developing the official classification of viruses and taxa naming (taxonomy) of the Coronaviridae family, assessed the novelty of the human pathogen tentatively named 2019-nCoV. Based on phylogeny, taxonomy and established practice, the CSG formally recognizes this virus as a sister to severe acute respiratory syndrome coronaviruses (SARS-CoVs) of the species Severe acute respiratory syndrome-related coronavirus and designates it as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To facilitate communication, the CSG further proposes to use the following naming convention for individual isolates: SARS-CoV-2/Isolate/Host/Date/Location. The spectrum of clinical manifestations associated with SARS-CoV-2 infections in humans remains to be determined. The independent zoonotic transmission of SARS-CoV and SARS-CoV-2 highlights the need for studying the entire (virus) species to complement research focused on individual pathogenic viruses of immediate significance. This research will improve our understanding of virus-host interactions in an ever-changing environment and enhance our preparedness for future outbreaks.
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                Author and article information

                Journal
                Fetal Pediatr Pathol
                Fetal Pediatr Pathol
                IPDP
                ipdp20
                Fetal and Pediatric Pathology
                Taylor & Francis
                1551-3815
                1551-3823
                2020
                02 April 2020
                : 0
                : 0
                : 1-5
                Affiliations
                [a ]Department of Obstetrics and Gynecology, Iran University of Medical Sciences , Tehran, Iran;
                [b ]Endometriosis Research Center, Iran University of Medical Sciences , Tehran, Iran;
                [c ]Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences , Yazd, Iran;
                [d ]Mother and Newborn Research Center, Shahid Sadoughi University of Medical Sciences , Yazd, Iran;
                [e ]Department of Medical Genetics, School of Medicine, Shiraz University of Medical Sciences , Shiraz, Iran;
                [f ]Department of Obstetrics and Gynecology, Shahid Beheshti University of Medical Sciences , Tehran, Iran;
                [g ]Department of Pediatrics, Shahid Sadoughi University of Medical Sciences , Yazd, Iran;
                [h ]Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences , Yazd, Iran;
                [i ]Neonatal Research Center, Shiraz University of Medical Sciences , Shiraz, Iran
                Author notes
                CONTACT Seyed Alireza Dastgheib dastgheibsa@ 123456gmail.com Department of Medical Genetics, School of Medicine, Shiraz University of Medical Sciences , Shiraz, Iran; Hajar Abbasi haabbasi65@ 123456gmail.com Department of Obstetrics and Gynecology, Shahid Beheshti University of Medical Sciences , Tehran, Iran.
                Article
                1747120
                10.1080/15513815.2020.1747120
                7157948
                32238084
                © 2020 Taylor & Francis Group, LLC

                This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

                Page count
                Figures: 0, Tables: 0, Pages: 5, Words: 2250
                Product
                Categories
                Review

                Pathology

                covid-19, corona virus, vertical transmission, placenta, pregnant mothers, neonate

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