Association of Gestational Age at Coronavirus Disease 2019 (COVID-19) Vaccination, History of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection, and a Vaccine Booster Dose With Maternal and Umbilical Cord Antibody Levels at Delivery

Abstract Background: We carried out a literature search for summarizing currently published evidence on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron (B.1.1.529) variant neutralizing properties of serum or plasma collected from recipients of coronavirus disease 2019 (COVID-19) vaccines.Methods: An electronic search was conducted in Medline and Scopus, using the keywords “vaccine” AND “Omicron” OR “B.1.1.529” AND “SARS-CoV-2” AND “neutralization” OR “antibodies”, with no language or date limits (i.e., up to December 27, 2021). Studies with complete information on neutralization properties of COVID-19 vaccines against the Omicron variant, with or without the adjunctive effects of booster vaccine doses, were included.Results: Our final analysis included 10 published studies. In all, decreased neutralisation of SARS-CoV-2 Omicron B.1.1.529 variant was evidenced in post-vaccination samples, ranging between -4.3 folds to absence of neutralization compared to an ancestral SARS-CoV-2 strain. In all studies the COVID-19 vaccine booster dose was effective to elicit sustained enhancement of SARS-CoV-2 Omicron B.1.1.529 neutralisation, with such increase being comprised between 10-42 folds compared to the pre-booster period.Conclusion: Vaccine boosters seem strongly advisable for limiting the risk of SARS-CoV-2 Omicron (B.1.1.529) breakthrough infections.

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Locked twins—remote from term: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02725-5 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Abraham Fessehaye ◽

Ferid A. Abubeker ◽

Mekdes Daba

Keyword(s):

Gestational Age ◽

Twin Pregnancy ◽

Caesarian Section ◽

Obstetric Complication ◽

Second Stage ◽

Case Summary ◽

History Of ◽

Twin Pregnancies ◽

Abdominal Delivery ◽

First Stage Of Labor

Abstract Background Locked twins is a rare and hazardous obstetric complication, which occurs in approximately 1:100 twin pregnancies. One of the known etiologic factors for locked twins is size of the twins. We report a case of chin-to-chin locked twins that occurred at gestational age of 30 weeks pus 6 days. Case summary A 27 years-old primigravida Oromo mother presented with a history of pushing down pain and passage of liquor of 6 hours duration at gestational age of 30 weeks plus 6 days. With a diagnosis of twin pregnancy (first twin non-vertex), abdominal delivery was decided in latent first stage of labor but mother refused caesarian delivery and she was allowed to labor with the hope of achieving a vaginal delivery. In second stage, interlocking twin was encountered and a low vertical cesarean section was done to effect delivery of twins without the need to decapitate the first twin. Conclusion Locked twin is a rare obstetric complication. Whenever it is encountered, successful delivery can be achieved without the need to have decapitation of the first twin during caesarian section.

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Gestational Age Dependency of Umbilical Cord Serum IL-6 Levels for Detecting Fetal Inflammation

American Journal of Perinatology ◽

10.1055/s-0040-1721373 ◽

2020 ◽

Author(s):

Sota Iwatani ◽

Takao Kobayashi ◽

Sachiko Matsui ◽

Akihiro Hirata ◽

Miwa Yamamoto ◽

...

Keyword(s):

Umbilical Cord ◽

Gestational Age ◽

Area Under The Curve ◽

Roc Curves ◽

Significant Negative Correlation ◽

Cord Serum ◽

Very Preterm ◽

Key Points ◽

Extremely Preterm ◽

Preterm Newborns

Objective The fetal inflammatory response syndrome (FIRS) is characterized by elevated concentrations of inflammatory cytokines in fetal blood, with preterm delivery and morbidity. Umbilical cord serum interleukin-6 (UC-s-IL-6) is an ideal marker for detecting FIRS. However, the effect of gestational age (GA) on UC-s-IL-6 levels has not been reported. This study aimed to determine the relationship between GA and UC-s-IL-6 levels, and GA-dependent cutoff values of UC-s-IL-6 levels for detecting fetal inflammation. Study Design UC-s-IL-6 concentrations were measured in 194 newborns (44 extremely preterm newborns (EPNs) at 22–27 weeks' GA, 68 very preterm newborns (VPNs) at 28–31 weeks' GA, and 82 preterm newborns (PNs) at 32–34 weeks' GA). Linear regression analyses were used to correlate GA and UC-s-IL-6 levels. Receiver operating characteristic (ROC) curves analyses were performed for detecting the presence of funisitis, as the histopathological counterpart of FIRS. Results A significant negative correlation between GA and UC-s-IL-6 levels was found in newborns with severe funisitis (r s = − 0.427, p = 0.004) and those with mild funisitis (r s = − 0.396, p = 0.025). ROC curve analyses revealed the area under the curve for detecting funisitis were 0.856, 0.837, and 0.622 in EPNs, VPNs, and PNs, respectively. The UC-s-IL-6 cutoff value in EPNs (28.1 pg/mL) exceeded those in VPNs and PNs (3.7 and 3.0 pg/mL, respectively). Conclusion UC-s-IL-6 levels were inversely correlated with GA especially in newborns with funisitis. Such GA dependency of UC-s-IL-6 should be considered for detecting fetal inflammation. Key Points

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Are RNA-Based Tests Sufficient for COVID-19 Diagnosis? An Inspiration of Three Asymptomatic Cases

Cell Transplantation ◽

10.1177/0963689720985453 ◽

2021 ◽

Vol 30 ◽

pp. 096368972098545

Author(s):

Tao Hu ◽

Xiao Liu ◽

Qinan Yin ◽

Xingting Duan ◽

Li Yan

Keyword(s):

Computed Tomography ◽

Nucleic Acid ◽

Virus Infection ◽

Severe Acute Respiratory Syndrome ◽

The Other ◽

Computed Tomography Scan ◽

Health Authorities ◽

History Of ◽

Tomography Scan ◽

Nucleic Acid Tests

In this work, we discovered a new phenomenon—asymptomatic COVID-19 infection, or covert case, during the pandemic. All the 3 patients had a history of exposure, with no symptoms, and no abnormalities were found in computed tomography scan or lab tests. Except for case 2, the other patients’ severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) nucleic acid tests were negative. But their anti-SARS-COV-2 nucleocapsid antibody showed a dynamic trend, consistent with the process of virus infection and clearance. A growing number of asymptomatic or covert cases need more attention. Lack of surveillance may lead to another outbreak. We hope to demonstrate our cases to attract the attention of governments or health authorities that covert cases should be the focus as well.

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Candida Chorioamnionitis in Mothers with Gestational Diabetes Mellitus: A Report of Two Cases

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147450 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7450

Author(s):

Elia Shazniza Shaaya ◽

Siti Atiqah Abdul Halim ◽

Ka Wen Leong ◽

Kevin Boon Ping Ku ◽

Pei Shan Lim ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Umbilical Cord ◽

Neonatal Death ◽

Periodic Acid ◽

Careful Examination ◽

Periodic Acid Schiff ◽

History Of ◽

Methenamine Silver

Background:Candida chorioamnionitis is rarely encountered, even though vulvovaginal candidiasis incidence is about 15%. Interestingly, it has characteristic gross and histological findings on the umbilical cord that are not to be missed. Case Report: We report two cases of Candida chorioamnionitis with presence of multiple yellowish and red spots of the surface of the umbilical cord. Microscopically, these consist of microabscesses with evidence of fungal yeasts and pseudohyphae. The yeasts and pseudohyphae were highlighted by periodic acid– Schiff and Grocott methenamine silver histochemical stains. Both cases were associated with a history of gestational diabetes mellitus. Discussion: Peripheral funisitis is a characteristic feature of Candida chorioamnionitis. It is associated with high risk of adverse perinatal and neonatal outcomes, such as preterm delivery, stillbirth and neonatal death. We recommend careful examination of the umbilical cord of mothers with gestational diabetes mellitus.

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Eliciting History of Prior Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Diagnosing Interstitial Lung Disease during the Coronavirus Disease 2019 Pandemic

CHEST Journal ◽

10.1016/j.chest.2020.10.028 ◽

2021 ◽

Vol 159 (3) ◽

pp. 1306

Author(s):

Elena Stuewe ◽

Nicholas S. Hill ◽

Sucharita Kher

Keyword(s):

Interstitial Lung Disease ◽

Severe Acute Respiratory Syndrome ◽

Lung Disease ◽

History Of

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Neonatal Outcomes at Extreme Prematurity by Gestational Age Versus Birth Weight in a Contemporary Cohort

American Journal of Perinatology ◽

10.1055/s-0040-1722606 ◽

2021 ◽

Author(s):

Elizabeth B. Ausbeck ◽

Phillip Hunter Allman ◽

Jeff M. Szychowski ◽

Akila Subramaniam ◽

Anup Katheria

Keyword(s):

Birth Weight ◽

Umbilical Cord ◽

Gestational Age ◽

Predictive Value ◽

Neonatal Death ◽

Controlled Trial ◽

Neonatal Morbidity ◽

Mortality And Morbidity ◽

Severe Morbidity ◽

Multicenter Randomized Controlled Trial

Objective The aim of the study is to describe the rates of neonatal death and severe neonatal morbidity in a contemporary cohort, as well as to evaluate the predictive value of birth gestational age (GA) and birth weight, independently and combined, for neonatal mortality and morbidity in the same contemporary cohort. Study Design We performed a secondary analysis of an international, multicenter randomized controlled trial of delayed umbilical cord clamping versus umbilical cord milking in preterm infants born at 23 0/7 to 31 6/7 weeks of gestation. The current analysis was restricted to infants delivered <28 weeks. The primary outcomes of this analysis were neonatal death and a composite of severe neonatal morbidity. Incidence of outcomes was compared by weeks of GA, with planned subanalysis comparing small for gestational age (SGA) versus non-SGA neonates. Multivariable logistic regression was then used to model these outcomes based on birth GA, birth weight, or a combination of both as primary independent predictors to determine which had superior ability to predict outcomes. Results Of 474 neonates in the original trial, 180 (38%) were included in this analysis. Overall, death occurred in 27 (15%) and severe morbidity in 139 (77%) neonates. Rates of mortality and morbidity declined with increasing GA (mortality 54% at 23 vs. 9% at 27 weeks). SGA infants (n = 25) had significantly higher mortality compared with non-SGA infants across all GAs (p < 0.01). There was no difference in the predictive value for neonatal death or severe morbidity between the three prediction options (GA, birth weight, or GA and birth weight). Conclusion Death and severe neonatal morbidity declined with advancing GA, with higher rates of death in SGA infants. Birth GA and birth weight were both good predictors of outcomes; however, combining the two was not more predictive, even in SGA infants. Key Points

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Pneumococcal Nasopharyngeal Carriage following Reduced Doses of a 7-Valent Pneumococcal Conjugate Vaccine and a 23-Valent Pneumococcal Polysaccharide Vaccine Booster

Clinical and Vaccine Immunology ◽

10.1128/cvi.00117-10 ◽

2010 ◽

Vol 17 (12) ◽

pp. 1970-1976 ◽

Cited By ~ 48

Author(s):

F. M. Russell ◽

J. R. Carapetis ◽

C. Satzke ◽

L. Tikoduadua ◽

L. Waqatakirewa ◽

...

Keyword(s):

Conjugate Vaccine ◽

Pneumococcal Conjugate Vaccine ◽

Polysaccharide Vaccine ◽

Dose Effect ◽

Pneumococcal Polysaccharide Vaccine ◽

Pneumococcal Carriage ◽

Primary Series ◽

Vaccine Type ◽

Vaccine Booster ◽

Antibody Levels

ABSTRACT This study was conducted to evaluate the effect of a reduced-dose 7-valent pneumococcal conjugate vaccine (PCV) primary series followed by a 23-valent pneumococcal polysaccharide vaccine (23vPPS) booster on nasopharyngeal (NP) pneumococcal carriage. For this purpose, Fijian infants aged 6 weeks were randomized to receive 0, 1, 2, or 3 PCV doses. Within each group, half received 23vPPS at 12 months. NP swabs were taken at 6, 9, 12, and 17 months and were cultured for Streptococcus pneumoniae. Isolates were serotyped by multiplex PCR and a reverse line blot assay. There were no significant differences in PCV vaccine type (VT) carriage between the 3- and 2-dose groups at 12 months. NP VT carriage was significantly higher (P, <0.01) in the unvaccinated group than in the 3-dose group at the age of 9 months. There appeared to be a PCV dose effect in the cumulative proportion of infants carrying the VT, with less VT carriage occurring with more doses of PCV. Non-PCV serotype (NVT) carriage rates were similar for all PCV groups. When groups were pooled by receipt or nonreceipt of 23vPPS at 12 months, there were no differences in pneumococcal, VT, or NVT carriage rates between the 2 groups at the age of 17 months. In conclusion, there appeared to be a PCV dose effect on VT carriage, with less VT carriage occurring with more doses of PCV. By the age of 17 months, NVT carriage rates were similar for all groups. 23vPPS had no impact on carriage, despite the substantial boosts in antibody levels.

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