Decreased Fetal Movements: A Sign of Placental SARS-CoV-2 Infection with Perinatal Brain Injury

Neonatal COVID-19 is rare and mainly results from postnatal transmission. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), however, can infect the placenta and compromise its function. We present two cases of decreased fetal movements and abnormal fetal heart rhythm 5 days after mild maternal COVID-19, requiring emergency caesarean section at 29 + 3 and 32 + 1 weeks of gestation, and leading to brain injury. Placental examination revealed extensive and multifocal chronic intervillositis, with intense cytoplasmic positivity for SARS-CoV-2 spike antibody and SARS-CoV-2 detection by RT-qPCR. Vertical transmission was confirmed in one case, and both neonates developed extensive cystic peri-ventricular leukomalacia.

Cytomegalovirus pneumonia of infants in Africa: a narrative literature review

Cytomegalovirus pneumonia has repeatedly been described in the context of HIV-exposed uninfected and HIV-infected infants. Despite its significant role in the etiology of childhood pneumonia, there is still a paucity of literature generally, and specifically in Africa, suggesting that it might be a neglected disease. Emerging evidence highlights the importance of postnatal transmission through breastmilk. The pathogenetic significance of the multiplicity of strains acquired through repeated re-infections in early infancy is unknown. The development of cheap, accurate diagnostic tools and safe, effective antivirals and the maintenance of effective prevention and treatment of pediatric HIV are needed to manage cytomegalovirus pneumonia in low-resource settings.

Avoidance of Natural Suckling from Dams with Bovine Leukemia Virus Is a Low Priority Countermeasure against Postnatal Transmission

Although natural suckling from dams with bovine leukemia virus (BLV) has not been recommended in Japan, the frequency of BLV transmission through natural suckling under natural conditions is still unclear. The purpose of this study was to elucidate the risk of BLV transmission through natural suckling. Dams with BLV were classified into three groups (high, middle, low) based on the proviral loads (PVLs). PCR positivity of their colostrum and the correlations between the ratios of calves with BLV and types of feeding milk were analyzed. In dams with low PVLs, no colostrum or calves were confirmed to have BLV. In dams with middle and high PVLs, 17 out of 25 (68.0%) colostrum were PCR positive, and 10 out of 23 (43.4%) and 13 out of 29 (44.8%) calves with natural suckling and artificial rearing were infected with BLV, respectively. No difference was confirmed between the infection rates of natural-suckled and artificially reared calves. Thus, we concluded that the avoidance of natural suckling from dams with BLV and the introduction of artificial rearing were low priority countermeasures against BLV transmission.

Perinatal Transmission and Outcome of Neonates Born to SARS-CoV-2-Positive Mothers: The Experience of 2 Highly Endemic Italian Regions

<b><i>Introduction:</i></b> COVID-19 is the disease caused by the novel coronavirus SARS-CoV-2, responsible of the pandemic declared in March 2020 and still ongoing. COVID-19 affects all ages but presents less complications and fatalities in children. Neonatal infections have rarely been reported worldwide, and vertical transmission is uncertain. <b><i>Methods:</i></b> We conducted a prospective cohort study of all infants born to SARS-CoV-2-positive mothers admitted to 2 hospitals in South (Bari) and North (Varese) of Italy from April to December 2020. A molecular nasopharyngeal swab for SARS-CoV-2 using a reverse transcriptase polymerase chain reaction was made at birth for all enrolled newborns to evaluate vertical transmission of infection. We also evaluated postnatal transmission with a second nasopharyngeal swab made at 1 month of life and described maternal and neonatal clinical findings and short-term outcomes. <b><i>Results:</i></b> 176/179 (97%) newborns were SARS-CoV-2 negative at birth and 151/156 (97%) infants were still negative at 1 month of life. All newborns were asymptomatic. Seventy percent of newborns were breastfed during hospitalization. At 1 month of life, 76% of infants were breastfed. <b><i>Conclusion:</i></b> According to our results, vertical and perinatal infection is very rare. Breastfeeding does not increase the risk of COVID-19 and should be encouraged.

Neonates with coronavirus disease 2019 acquired from infected mothers: the incompatibility of maternal intensity and infant lung involvement: two case reports

Background The outbreak of coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared a public health emergency by the World Health Organization on January 30, 2020. The results of recent studies have suggested that neonates may present symptoms of COVID-19. Although the presentation of the disease in neonates is known to vary, only a limited number of studies have investigated newborns infected with COVID-19. Case presentation This study presents two Asian cases of newborns with COVID-19. Maternal–fetal or postnatal transmission was suggested based on the simultaneity of maternal infection. Chest radiography in one of the neonates showed severe lung involvement. Despite support and resuscitation attempts, the poor clinical condition of the neonate led to his death. However, the two mothers and one of the neonates were discharged from the hospital in good general condition. Conclusion The neonates had worse clinical conditions than the mothers, and the intensity of pneumonia and level of lung involvement in the newborns were not associated with the stage and severity of the disease in the mothers with COVID-19.

Maintaining Safe Breastfeeding Practices During the COVID-19 Pandemic: An Overview of the Evidence to Inform Clinical Guidelines

The impact of the COVID-19 pandemic upon the health care landscape has prompted many organizations to revise policies in response to ever-changing guidelines and recommendations regarding safe breastfeeding practices. The application of these professional guidelines into clinical practice is fraught with barriers, inconsistencies, and often-minimal evidential support. Key concerns for health care providers and patients include antenatal versus postnatal transmission, milk transmission, and separation care versus rooming-in, including the subsequent impacts upon breastfeeding and bonding. While SARS-CoV-2 is a novel virus, the volume of literature to support best practice for couplet care continues to be developed at a rapid pace. The benefits of breastfeeding are steeped in evidence and outweigh the potential risk of transmission of COVID-19 from mother to newborn. Health care organizations must continue to seek guidance for policy revision within the ever-growing body of evidence for best practice and evaluate current practices for feasibility during and after hospitalization.

Two infants with COVID-19 acquired from infected mothers: The incompatibility of maternal intensity and infant lung involvement: A case report

IntroductionThe outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared a public health emergency by world health organization (WHO) on 30 January 2020. Recent studies have suggested that infants present the symptoms of COVID-19. Although the presentation of the disease in babies is variable, there are limited studies about the infected babies with 2019-nCoV.Case presentationIn this study, we have presented a case report of two infants with COVID-19. According to the simultaneity of maternal infection, maternal-fetal transmission or postnatal transmission was suggested. The chest radiography of one of the neonates suggested severe lung involvement. Despite the supportive and resuscitation attempts, poor clinical condition of him led to his death. Fortunately, the two mothers and one of the babies were discharged from the hospital with a good general condition.ConclusionIn this paper, we have reported two infants who had positive results of COVID-19 testing at day one of life. The babies had worse clinical conditions than their mothers and the intensity of pneumonia and the level of lung involvement of the infants were not associated with the stage and disease severity of the mothers who infected with 2019-nCoV.

Errata ao artigo “Parto por Cesariana em Grávida com COVID-19: O Primeiro Caso Descrito em Portugal”, publicado em Acta Med Port 2020 Jun;33(6):429-431

Article published with errors:https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13883On page 430, section “Discussion”, line 5, where it reads: (...) given the conflicting data about pre and postnatal transmission,6,7 a multi-disciplinary team consensus comprising obstetricians, neonatologists and infectious diseases specialists at our institution decided on mother-neonate separation immediately after birth until both were tested negative for SARS-CoV-2.4It should read: (...) given the conflicting data about pre and postnatal transmission,6,7 after thoughtful discussion between a multidisciplinary team and the mother, and respecting her expressed will, a shared decision was made of mother infant separation immediately after birth until both were tested negative for SARS-CoV-2.4 Artigo publicado com erros:https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13883Na página 430, secção “Discussão”, linha 6, onde se lê: (...) given the conflicting data about pre and postnatal transmission,6,7 a multi-disciplinary team consensus comprising obstetricians, neonatologists and infectious diseases specialists at our institution decided on mother-neonate separation immediately after birth until both were tested negative for SARS-CoV-2.4Deverá ler-se: (...) given the conflicting data about pre and postnatal transmission,6,7 after thoughtful discussion between a multidisciplinary team and the mother, and respecting her expressed will, a shared decision was made of mother infant separation immediately after birth until both were tested negative for SARS-CoV-2.4