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Around a third of infants with COVID-19 may have caught it from mum

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Peer-reviewed: This work was reviewed and scrutinised by relevant independent experts.

Systematic review: This type of study is a structured approach to reviewing all the evidence to answer a specific question. It can include a meta-analysis which is a statistical method of combining the data from multiple studies to get an overall result.

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A French analysis of 176 infants with COVID-19 has found more than two in three (70 per cent) acquired the disease through the environment, but around one in three (30 per cent) may have got it directly from their mothers during the period immediately before and after birth, while one in ten (10 per cent) was confirmed as having caught the disease from their mums. This transmission may have occurred via the placenta or through direct contact during or after birth, the scientists say. Breastfeeding did not increase the likelihood of COVID-19 infection, so they suggest that viral transmission through milk is rare, or may not happen at all. Infants who stayed in a crib next to their mum in hospital (roomed-in) were more likely to have COVID-19, suggesting strict hygiene and use of protective equipment should be ensured in this situation. Just over half of the infants went on to develop COVID-19 symptoms, similar to those seen in older patients, the scientists say.

Journal/conference: Nature Communications

Link to research (DOI): 10.1038/s41467-020-18982-9

Organisation/s: Paris Saclay University Hospitals, France

Funder: No information provided.

Media release

From: Springer Nature

Routes of SARS-CoV-2 transmission to infants reviewed 

Environmental exposure to SARS-CoV-2 was responsible for the majority of infections detected in newborn infants in an analysis of 176 reported cases. However, the findings, published in Nature Communications, suggest that 30% of the reported cases may have been acquired from the mother.

Daniele De Luca and colleagues performed a meta-analysis of published cases of SARS-CoV-2 infection in neonates (within the first 30 days of life), as defined by at least one positive nasopharyngeal swab test and/or the detection of specific antibodies in the blood. In total, 176 cases were analysed, which had been reported up to 30 August 2020. The authors found that 70% of the cases resulted from environmental exposure. Thirty percent were likely the result of vertical transmission (transmission of the virus from mother to baby) and around 9% of the 176 cases were confirmed to be as a result of vertical transmission with infection acquired before or during childbirth.

55% of the infants (97) in the analysis went on to develop COVID-19 and the authors note that the clinical symptoms seem to be similar to those reported in older patients, including respiratory (52% of cases), fever (44%), and gastrointestinal (36%), and neurological (18%) symptoms.

When looking at infections that occurred at least 72 hours after birth, the authors found that infants in the sample who stayed in a crib next to their mother in hospital (roomed-in) appeared to have a higher incidence of SARS-CoV-2 infections. They argue that if rooming-in takes place, then appropriate hygiene measures and protective equipment should be made available to reduce the risk of transmission as a result of environmental exposure.

The authors also note that breastfeeding was not associated with SARS-CoV-2 infection and they suggest that viral transmission through milk is rare, if at all. However, further studies are needed to confirm this.

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