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(searched for: Vertical Transmission of Covid-19-A Systematic Review)
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Roberto Raschetti, Alexandre J. Vivanti, Christelle Vauloup-Fellous, Barbara Loi, Alexandra Benachi, Daniele De Luca
Nature Communications, Volume 11, pp 1-10; doi:10.1038/s41467-020-18982-9

Abstract:
A number of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections have been reported in neonates. Here, we aim to clarify the transmission route, clinical features and outcomes of these infections. We present a meta-analysis of 176 published cases of neonatal SARS-CoV-2 infections that were defined by at least one positive nasopharyngeal swab and/or the presence of specific IgM. We report that 70% and 30% of infections are due to environmental and vertical transmission, respectively. Our analysis shows that 55% of infected neonates developed COVID-19; the most common symptoms were fever (44%), gastrointestinal (36%), respiratory (52%) and neurological manifestations (18%), and lung imaging was abnormal in 64% of cases. A lack of mother–neonate separation from birth is associated with late SARS-CoV-2 infection (OR 4.94 (95% CI: 1.98–13.08), p = 0.0002; adjusted OR 6.6 (95% CI: 2.6–16), p < 0.0001), while breastfeeding is not (OR 0.35 (95% CI: 0.09–1.18), p = 0.10; adjusted OR 2.2 (95% CI: 0.7–6.5), p = 0.148). Our findings add to the literature on neonatal SARS-CoV-2 infections.
Ana Emperatriz Yupa Pallchisaca, Katterine Kariuxy Vásquez Bone, David Leonardo Serdán Ruiz
Published: 11 October 2020
Universidad Ciencia y Tecnología, Volume 24, pp 79-84; doi:10.47460/uct.v24i105.384

Abstract:
La investigación acerca del covid-19 centra en la actualidad la actividad de la comunidad científica internacional. En el contexto de la pandemia, adquiere relevancia producir conocimiento sobre la incidencia del SARS-CoV-2 en el proceso gestacional, el embarazo, los efectos en la paciente obstétrica durante el parto, puerperio y el recién nacido. Es sabido que la mujer embarazada, debido a los cambios por los que atraviesa, es propensa a enfermedades respiratorias, y eso la hace particularmente sensible a la COVID-19. Se hace útil conformar un estado de la cuestión a partir de la revisión sistemática de la literatura acerca del tema, tomando como fuente principal los informes emanados por la Organización Mundial de la Salud, así como otras comunicaciones científicas, con el objetivo de describir algunas propuestas para la atención de pacientes embarazadas contagiadas o no. En la mayoría de las fuentes consultadas, se manifestó un acuerdo en la necesidad de estudiar y establecer un protocolo de atención a la mujer en estado de gestación y al feto, incluso al neonato. Palabras Clave: proceso gestacional, parto, puerperio, COVID-19, embarazo. Referencias [1]Ministerio de Sanidad, «Enfermedad por Nuevo Coronavirus, COVID-19,» 8 Mayo 2020. [En línea]. Disponible: https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/Informacion_inicial_alerta.pdf. [Último acceso: enero 2020] [2]T. Li, «Diagnosis and clinical management of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection: an operational recommendation of Peking Union Medical College Hospital (V2.0),» Emerg Microbes Infec, vol. 9, nº 1, 2020. [3]S. Rosales y S. Cubas, «El rol del médico en la transmisión nosocomial del SARSCoV-2,» Revista Médica de Costa Rica , vol. 85, nº 629, 2020. [4]D.Di Mascio, A. Khalil, G. Saccone, G. Rizzo, D. Buca, M. Liberati y et al, «Outcome of Coronavirus spectrum infections (SARS, MERS, COVID 1 -19) during pregnancy: a systematic review and meta-analysis,» Am J Obstet Gynecol, 2020. [5]H. Zhu, L. Wang, C. Fang y et al, «Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia.,» Transl Pediatr, nº 9, pp. 51-60, 2020. [6]P. Dashraath, W. Jing Lin Jeslyn, L. Mei Xian Karen, L.Li Min, L. Sarah, A. Biswas y e. al, «Coronavirus Disease 2019 (COVID-19) Pandemic and Pregnancy,» Am. J. Obstet. Gynecol, vol. 9378, nº 20, pp. 30343-4, 2020. [7]C.Huang, Y. Wang, X. Li, L. Ren, J. Zhao, Y. Hu y et al, «Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China,» The Lancet, vol. 395, nº 10223, pp. 497-506, 2020. [8]L. Poon, H. Yang, J. Lee, J. Copel, T. Leung, Y. Zhang, D. Chen y F. Prefumo, « ISUOG Interim Guidance on 2019 novel coronavirus infection during pregnancy and puerperium: information for healthcare professionals,» 11 Marzo 2020. [En línea]. Disponible: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/uog.22013. [Último acceso: enero 2020] [9]H.Chen, J. Guo, C. Wang, F. Luo, X. Yu, W. Zhang y et al, «Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records,» The Lancet, vol. 395, nº 10226, pp. 809-815, 2020. [10]P.Mehta, D. McAuley, M. Brown y et al, «COVID-19: consider cytokine storm syndromes and immunosuppression,» The Lancet, nº 395, pp. 1033-1034, 2020. [11]M.Mardani y B. Pourkaveh, «A Controversial Debate: Vertical Transmission of COVID-19 in Pregnancy,» Arch Clin Infect Dis, vol. 15, nº 1, p. e102286, 2020. [12]Centers for Disease Control and Prevention, «Frequently asked questions and answers: Coronavirus disease 2019 (COVID-19) and pregnancy. CDCP,» 2020.[En línea]. Disponible: https://www.cdc.gov/ coronavirus/2019-ncov/faq.html. [Último acceso: enero 2020] [13]Y.Li, R. Zhao, S. Zheng, X. Chen, J. Wang, X. Sheng y et al, «Lack of vertical transmission of severe acute respiratory syndrome coronavirus 2, China,» Emerg Infect Dis, vol. 26, nº 6, 2020. [14]Word Health Organization (WHO), «Coronavirus disease 2019 (Covid-19) situation report 46,» 06 Marzo 2020. [En línea]. Disponible: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200306-sitrep-46covid-19.pdf?sfvrsn=96b04adf_2. [Último acceso: enero 2020] [15]Servicio de medicina materno fetal Clinic Barcelona, «Protocolo: Coronavirus (COVID-19) y gestación,» 24 Marzo 2020. [En línea]. Disponible: https://medicinafetalbarcelona.org/protocolos/es/patologiamaterna-obstetrica/covid19-embarazo.html.[Último acceso: enero 2020] [16]European Centre for Disease Control, «Coronavirus disease 2019 (COVID-19) pandemic: increased transmission in the EU/EEA and the UK–seventh update,» 8 Mayo 2020. [En línea]. Disponible: https://www.ecdc.europa.eu/sites/default/files/documents/RRA-seventh-update-Outbreak-of-coronavirus-disease-COVID-19.pdf. [Último acceso: enero 2020] [17]Gobierno de España, Manejo de la mujer embarazada y el recién nacido con COVID-19, Ministerio de Sanidad, 2020. [18]Organización Mundial de la Salud (OMS), «SALUD MATERNO-PERINATAL y COVID-19,» Abril 2020. [En línea]. Disponible: www.paho.org/clap/images/PDF/presentacionparteras/Presentacin_CLAP_COVID19_abril_2020.pdf?ua=1.[Último acceso: enero 2020] [19]S. Lapinsky, «Acute respiratory failure in pregnancy,» Obstet Med, vol. 8, pp. 126-32, 2015. [20]C. Burlinson, D. Sirounis, K. Walley y A. Chau, «Sepsis in pregnancy and the...
Daniele Di Mascio, Francesco D’Antonio
European Journal of Obstetrics & Gynecology and Reproductive Biology; doi:10.1016/j.ejogrb.2020.10.009

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Cynthia Carrasco, Ana Beatriz Pizarro, Gabriela Urrea, Nicolás Meza, Catalina Verdejo, Gabriel Rada, Luis E. Ortiz-Muñoz
Published: 30 September 2020
Abstract:
ObjectiveThis living systematic review aims to evaluate the vertical transmission of SARS-CoV-2 through breast milk and breastfeeding in patients with COVID-19 providing a timely, rigorous and continuously updated summary of the evidence available on .Data sources We will conduct searches in the L·OVE (Living OVerview of Evidence) platform for COVID-19, a system that maps PICO questions to a repository maintained through regular searches in electronic databases, preprint servers, trial registries and other resources relevant to COVID-19. No date or language restrictions will be applied. In response to the COVID-19 emergency, L·OVE was adapted to expand the range of evidence it covers and customised to group all COVID-19 evidence in one place. The search will cover the period until the day before submission to a journal.Eligibility criteria for selecting studies and methodsWe adapted an already published common protocol for multiple parallel systematic reviews to the specificities of this question. We will include primary studies evaluating the role of breast milk and breastfeeding transmission. Randomised trials evaluating breast milk and breastfeeding in infections caused by other coronaviruses, such as MERS-CoV and SARS-CoV, and non-randomised studies in COVID-19 will be searched in case we find no direct evidence from randomised trials, or if the direct evidence provides low- or very low-certainty for critical outcomes.Two reviewers will independently screen each study for eligibility, extract data, and assess the risk of bias. We will pool the results using meta-analysis and will apply the GRADE system to assess the certainty of the evidence for each outcome. A living, web-based version of this review will be openly available during the COVID-19 pandemic. We will resubmit it every time the conclusions change or whenever there are substantial updates.
Rahul Verma, Reshma Amin
Pediatric Research pp 1-4; doi:10.1038/s41390-020-01123-9

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Alexander Kotlyar, Reshef Tal
American Journal of Obstetrics and Gynecology; doi:10.1016/j.ajog.2020.09.004

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Léo Pomar, Karin Nielsen-Saines, David Baud
American Journal of Obstetrics and Gynecology; doi:10.1016/j.ajog.2020.09.003

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Antoine Abdelmassih, Raghda Fouda, Rana Essam, Alhussein Negm, Dalia Khalil, Dalia Habib, George Afdal, Habiba-Allah Ismail, Hadeer Aly, Ibrahim Genedy, et al.
Published: 8 September 2020
Abstract:
Background:COVID-19 is the largest outbreak to strike humanity. The wide scale of fatalities and morbidities lead to a concurrent pandemic of uncertainty in scientific evidence. Conflicting evidences are released on daily basis about the neonatal outcomes of COVID-19 positive mothers. The aim of this study was to use the relevant case reports and series to determine the percentage of newborns who test positive in COVID-19 positive mothers. Secondary outcomes included examining laboratory and placental abnormalities among fetus-mother pairs.Methods:Systematic review was performed on all studies reporting primary data on fetus-mother pairs with COVID-19. Data bases were searched for studies that met our inclusion and exclusion criteria.Results: Final screening revealed 66 studies, from which the primary data of 1787 mother-infant pairs was obtained. Only 2.8% of mother infant pairs were tested positive, and this finding is identical to percentages reported in former coronaviridae outbreaks. Whereas, 20% manifested with intrauterine hypoxia alongside placental abnormalities suggestive of heavy placental vaso-occlusive involvement. Conclusions: These findings suggest that while vertical transmission is unlikely, there appears to be an underlying risk of placental insufficiency due to the prothrombotic tendency observed in COVID-19 infection. Guidelines for proper prophylactic anticoagulation in COVID positive mothers need to be established.
European Journal of Medical Research, Volume 25, pp 1-14; doi:10.1186/s40001-020-00439-w

Abstract:
Coronavirus is challenging the global health care system from time to time. The pregnant state, with alterations in hormone levels and decreased lung volumes due to a gravid uterus and slightly immunocompromised state may predispose patients to a more rapidly deteriorating clinical course and can get a greater risk of harm for both the mother and fetus. Therefore, this systematic review was aimed to assess the effect of coronavirus infection (SARS-CoV-2, MERS-CoV, and SARS-CoV) during pregnancy and its possibility of vertical maternal–fetal transmission. A systematic search was conducted on PubMed, Web of Science, Embase, Google Scholar and the Cochrane Library until the end of April. All authors independently extracted all necessary data using excel spreadsheet form. Only published articles with fully accessible data on pregnant women infected with SARS-CoV, MARS-CoV, and SARS-CoV-2 were included. Data on clinical manifestations, maternal and perinatal outcomes were extracted and analyzed. Out of 879 articles reviewed, 39 studies involving 1316 pregnant women were included. The most common clinical features were fever, cough, and myalgia with prevalence ranging from 30 to 97%, while lymphocytopenia and C-reactive protein were the most common abnormal laboratory findings (55–100%). Pneumonia was the most diagnosed clinical symptom of COVID-19 and non-COVID-19 infection with prevalence ranged from 71 to 89%. Bilateral pneumonia (57.9%) and ground-glass opacity (65.8%) were the most common CT imaging reported. The most common treatment options used were hydroxychloroquine (79.7%), ribavirin (65.2%), and oxygen therapy (78.8%). Regarding maternal outcome, the rate of preterm birth < 37 weeks of gestation was 14.3%, preeclampsia (5.9%), miscarriage (14.5%, preterm premature rupture of membranes (9.2%) and fetal growth restriction (2.8%). From the total coronavirus infected pregnant women, 56.9% delivered by cesarean, 31.3% admitted to ICU, while 2.7% were died. Among the perinatal outcomes, fetal distress rated (26.5%), neonatal asphyxia rated (1.4%). Only, 1.2% of neonates had apgar score < 7 at 5 min. Neonate admitted to ICU was rated 11.3%, while the rate of perinatal death was 2.2%. In the current review, none of the studies reported transmission of CoV from the mother to the fetus in utero during the study period. Coronavirus infection is more likely to affect pregnant women. Respiratory infectious diseases have demonstrated an increased risk of adverse maternal obstetrical complications than the general population due to physiological changes occurred during pregnancy. None of the studies reported transmission of CoV from the mother to the fetus in utero, which may be due to a very low expression of angiotensin-converting enzyme-2 in early maternal–fetal interface cells.
Giampiero Capobianco, Laura Saderi, Stefano Aliberti, Michele Mondoni, Andrea Piana, Francesco Dessole, Margherita Dessole, Pier Luigi Cherchi, Salvatore Dessole, Giovanni Sotgiu
European Journal of Obstetrics & Gynecology and Reproductive Biology, Volume 252, pp 543-558; doi:10.1016/j.ejogrb.2020.07.006

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