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Relationship between viral load, infection-to-delivery interval and mother-to-child transfer of anti-SARS-CoV-2 antibodies.
Ultrasound Obstet Gynecol. 2021 06; 57(6):974-978.UO

Abstract

OBJECTIVE

To investigate the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load and infection-to-delivery interval with maternal and cord serum concentrations of anti-SARS-CoV-2 immunoglobulin G (IgG) antibodies and transplacental transfer ratio in pregnant women with active or recovered SARS-CoV-2 infection.

METHODS

This was a prospective case series of consecutive pregnant women with laboratory-confirmed SARS-CoV-2 infection between 27 March 2020 and 24 January 2021. We collected information regarding deep throat saliva or nasopharyngeal swab (NPS) reverse transcription polymerase chain reaction (RT-PCR) test results, serial cycle threshold (Ct) values at and after diagnosis, demographic, clinical and outcome data, and neonatal NPS RT-PCR results. Qualitative and quantitative analysis of IgG and immunoglobulin M (IgM) antibodies against SARS-CoV-2 was performed in maternal and cord blood serum samples obtained at delivery. Correlation of maternal Ct values, infection-to-delivery interval, infection duration and viral load area under the curve (AUC) with gestational age (GA) at diagnosis, maternal and cord serum IgG concentrations and transplacental transfer ratio of IgG were evaluated using Pearson's correlation.

RESULTS

Twenty pregnant women who consented to participate and who had delivered their babies by 31 January 2021 were included in the study, comprising 14 who had recovered from coronavirus disease 2019 (COVID-19) and six with active infection at delivery. The median GA at clinical manifestation was 32.7 (range, 11.9-39.4) weeks. The median infection-to-delivery interval and infection duration were 41.5 (range, 2-187) days and 10.0 (range, 1-48) days, respectively. The median GA at delivery was 39.1 (range, 32.4-40.7) weeks and the median seroconversion interval was 14 (range, 1-19) days. Of 13 neonates born to seropositive mothers with recovered infection at delivery, 12 tested positive for anti-SARS-CoV-2 IgG. All neonatal NPS samples were negative for SARS-CoV-2 and all cord sera tested negative for IgM. The median transplacental transfer ratio of IgG was 1.3 (interquartile range, 0.9-1.6). There was a negative correlation between infection-to-delivery interval and anti-SARS-CoV-2 IgG concentrations in maternal (r = -0.6693, P = 0.0087) and cord (r = -0.6554, P = 0.0068) serum and a positive correlation between IgG concentration in maternal serum and viral load AUC (r = 0.5109, P = 0.0310). A negative correlation was observed between transfer ratio and viral load AUC (r = -0.4757, P = 0.0409).

CONCLUSIONS

In pregnant women who have recovered from COVID-19, anti-SARS-CoV-2 IgG concentrations at delivery increased with increasing viral load during infection and decreased with increasing infection-to-delivery interval. The median transplacental transfer ratio of IgG was 1.3 and it decreased with increasing viral load during infection. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, SAR, China.Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, SAR, China.Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong, SAR, China.Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong, SAR, China.Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, SAR, China.Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, SAR, China.Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Hong Kong, SAR, China.Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, SAR, China.Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, SAR, China.Department of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong, SAR, China.Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, SAR, China.Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, SAR, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33798280

Citation

Poon, L C., et al. "Relationship Between Viral Load, Infection-to-delivery Interval and Mother-to-child Transfer of anti-SARS-CoV-2 Antibodies." Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, vol. 57, no. 6, 2021, pp. 974-978.
Poon LC, Leung BW, Ma T, et al. Relationship between viral load, infection-to-delivery interval and mother-to-child transfer of anti-SARS-CoV-2 antibodies. Ultrasound Obstet Gynecol. 2021;57(6):974-978.
Poon, L. C., Leung, B. W., Ma, T., Yu, F. N. Y., Kong, C. W., Lo, T. K., So, P. L., Leung, W. C., Shu, W., Cheung, K. W., Moungmaithong, S., & Wang, C. C. (2021). Relationship between viral load, infection-to-delivery interval and mother-to-child transfer of anti-SARS-CoV-2 antibodies. Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 57(6), 974-978. https://doi.org/10.1002/uog.23639
Poon LC, et al. Relationship Between Viral Load, Infection-to-delivery Interval and Mother-to-child Transfer of anti-SARS-CoV-2 Antibodies. Ultrasound Obstet Gynecol. 2021;57(6):974-978. PubMed PMID: 33798280.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between viral load, infection-to-delivery interval and mother-to-child transfer of anti-SARS-CoV-2 antibodies. AU - Poon,L C, AU - Leung,B W, AU - Ma,T, AU - Yu,F N Y, AU - Kong,C W, AU - Lo,T K, AU - So,P L, AU - Leung,W C, AU - Shu,W, AU - Cheung,K W, AU - Moungmaithong,S, AU - Wang,C C, PY - 2021/03/20/revised PY - 2021/03/03/received PY - 2021/03/26/accepted PY - 2021/4/3/pubmed PY - 2021/6/16/medline PY - 2021/4/2/entrez KW - COVID-19 KW - SARS-CoV-2 KW - antibody transfer KW - pregnancy KW - viral load SP - 974 EP - 978 JF - Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology JO - Ultrasound Obstet Gynecol VL - 57 IS - 6 N2 - OBJECTIVE: To investigate the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load and infection-to-delivery interval with maternal and cord serum concentrations of anti-SARS-CoV-2 immunoglobulin G (IgG) antibodies and transplacental transfer ratio in pregnant women with active or recovered SARS-CoV-2 infection. METHODS: This was a prospective case series of consecutive pregnant women with laboratory-confirmed SARS-CoV-2 infection between 27 March 2020 and 24 January 2021. We collected information regarding deep throat saliva or nasopharyngeal swab (NPS) reverse transcription polymerase chain reaction (RT-PCR) test results, serial cycle threshold (Ct) values at and after diagnosis, demographic, clinical and outcome data, and neonatal NPS RT-PCR results. Qualitative and quantitative analysis of IgG and immunoglobulin M (IgM) antibodies against SARS-CoV-2 was performed in maternal and cord blood serum samples obtained at delivery. Correlation of maternal Ct values, infection-to-delivery interval, infection duration and viral load area under the curve (AUC) with gestational age (GA) at diagnosis, maternal and cord serum IgG concentrations and transplacental transfer ratio of IgG were evaluated using Pearson's correlation. RESULTS: Twenty pregnant women who consented to participate and who had delivered their babies by 31 January 2021 were included in the study, comprising 14 who had recovered from coronavirus disease 2019 (COVID-19) and six with active infection at delivery. The median GA at clinical manifestation was 32.7 (range, 11.9-39.4) weeks. The median infection-to-delivery interval and infection duration were 41.5 (range, 2-187) days and 10.0 (range, 1-48) days, respectively. The median GA at delivery was 39.1 (range, 32.4-40.7) weeks and the median seroconversion interval was 14 (range, 1-19) days. Of 13 neonates born to seropositive mothers with recovered infection at delivery, 12 tested positive for anti-SARS-CoV-2 IgG. All neonatal NPS samples were negative for SARS-CoV-2 and all cord sera tested negative for IgM. The median transplacental transfer ratio of IgG was 1.3 (interquartile range, 0.9-1.6). There was a negative correlation between infection-to-delivery interval and anti-SARS-CoV-2 IgG concentrations in maternal (r = -0.6693, P = 0.0087) and cord (r = -0.6554, P = 0.0068) serum and a positive correlation between IgG concentration in maternal serum and viral load AUC (r = 0.5109, P = 0.0310). A negative correlation was observed between transfer ratio and viral load AUC (r = -0.4757, P = 0.0409). CONCLUSIONS: In pregnant women who have recovered from COVID-19, anti-SARS-CoV-2 IgG concentrations at delivery increased with increasing viral load during infection and decreased with increasing infection-to-delivery interval. The median transplacental transfer ratio of IgG was 1.3 and it decreased with increasing viral load during infection. © 2021 International Society of Ultrasound in Obstetrics and Gynecology. SN - 1469-0705 UR - https://www.unboundmedicine.com/medline/citation/33798280/Relationship_between_viral_load_infection_to_delivery_interval_and_mother_to_child_transfer_of_anti_SARS_CoV_2_antibodies_ DB - PRIME DP - Unbound Medicine ER -