Vertical Transmission of COVID‑19

We reviewed the hospital records of neonates delivered to 176 COVID-positive mothers admitted in our university (mid-May to mid-December 2020). All these neonates were tested by RT-PCR of nasopharyngeal swab within
48 h of birth.

Out of 179 neonates (3 twins), 7 (3.3%) were COVID positive. All except 1 were born by lower segment cesarean section. Five were asymptomatic and 2 had severe birth asphyxia; of which 1 expired within 2 h of birth. The other neonate was incubated in delivery room for 72 h. Sepsis screen was negative but CRP was raised (15.5 mg/dL).

Blood culture was sterile. On day 9, repeat RT-PCR was negative and the neonate was discharged on day 14. Of the
positive neonates, 3 were on exclusive breast-feeding and others were on formula feed. Skin-to-skin contact was not
provided, as guidelines at that time were not clear. On repeat testing (day 5–7) by RT-PCR, all positive neonates tested negative. Of the 172 neonates who tested negative within 48 h of birth, 24 were retested after day 5 and all were negative.

Our data for vertical transmission of SARS-CoV-2 was similar to that found in other studies abroad and from India
[1]. The rates were higher from a study from India (10.7%). Most of their neonates were asymptomatic and none died due to SARS-CoV-2 [2]. However, data from Mumbai reported higher rates of vertical transmission (4.25%), more symptomatic neonates, and mortality (16.6%) [3]. The authors also reported multi system inflammatory syndrome (MIS-C) in 1 neonate. Another study from Mumbai [4] reported infection rate of 10.9%, a third had symptoms.

In our hospital the perinatal transmission rate of SARSCoV-2 was low, and was maximum at the time of peak of COVID transmission in September 2020. Most cases were asymptomatic with no mortality attributable to SARS-CoV-2.

Declarations
Conflict of Interest None.

References

1. Yang Z, Liu Y. Vertical transmission of severe acute respiratory syndrome corona virus 2: a systematic review. Am J Perinatol. 2020;37:1055–60.

2. Anand P, Yadav A, Debata P, Bachani S, Gupta N, Gera R. Clinical profile, viral load, management and outcome of neonates born to COVID 19 positive mothers: a tertiary care center experience from India. Eur J Pediatric. 2020;10:1–13.
3. Shah B, Dande V, Rao S, Prabhu S, Bodhanwala M. outcome of covid-19 positive newborns presenting to a tertiary care hospital.  Indian Pediatr. 2021;58:177–9.
4. Nanavati R, Mascarenhas D, Goyal M, Haribalakrishna A,Nataraj G. A single-center observational study on clinical features and outcomes of 21 SARS-Covid-2-infected neonates from India. Eur J Pediatric. 2021;5:1–12.

* Shalini Tripathi
1 Department of Pediatrics, King George’s Medical University
(KGMU), Lucknow, UP 226003, India

Leave a Reply

Your email address will not be published. Required fields are marked *