Meconium microbial toxins and microbiota: A novel and non-invasive proposed diagnostic sample to anticipate the severity of neonates COVID-19

Abstract
The novel coronavirus, termed severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) is a major public health challenge all over the world and is the causative agent of coronavirus disease 2019 (COVID-19). Since December 2019 the outbreak of COVID-19 has become a major epidemic issue all over world. In this pandemic, preterm and term neonates with infected mothers are becoming more vulnerable each day. Although we mostly witness asymptomatic neonates, getting symptomatic may not be a rarity in the future. After entrance of COVID-19 into the body it could affect the balance of microbiota combination which can result in microbiota dysbiosis and eventually leads to immune imbalance. Intrauterine microbiome dysbiosis in COVID-19 positive mothers and transmission of lipopolysaccharide (LPS) may restructure the environment of the developing fetus with possible short/long-term impact on the individual’s health and disease. Therefore, assessing the changes in microbiome of neonates from infected mothers via exploring meconium could be valuable. It is also logical to measure LPS level and balanced its levels by using prebiotics and probiotics as a supplemental therapeutic procedure to prevent medical challenges in future. The aim of this essay is to review the potential conception that detection of COVID-19 and the meconium microbiota and LPS quantity could be used as a source of prognostic information about the COVID-19 severity in the fetus of pregnant women with COVID-19.