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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-305499

ABSTRACT

The coronavirus disease 2019 (COVID-19) affects primarily the respiratory system but neurologic manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are possible. Serum neurofilament light chain (sNfL) has recently been considered as a specific biomarker to quantitate neuro-axonal damage. Concentrations of sNfL were determined in a prospective cohort study of 100 health care workers (84 females, 16 males) following a COVID-19 outbreak in a large hospital by using the single molecule array (Simoa) NF-light advantage kit. Twenty eight health care workers contracted mild-to-moderate COVID-19, recovered after 1-3 weeks without hospitalization and showed no or only minor neurological symptoms such as anosmia, fatigue or headache. sNfL levels were consistently higher in older persons and multivariable linear regression analysis revealed COVID-19 status as an independent predictor of sNfL (p=.005). In conclusion, increased sNfL levels in mild-to-moderate COVID-19 patients points towards a more general neuro-destructive capability of SARS-CoV-2.

2.
Frontiers in pediatrics ; 9, 2021.
Article in English | EuropePMC | ID: covidwho-1609929

ABSTRACT

Since the beginning of the COVID-19 pandemic, in-utero transmission of SARS-CoV-2 remains a rarity and only very few cases have been proven across the world. Here we depict the clinical, laboratory and radiologic findings of preterm triplets born at 28 6/7 weeks to a mother who contracted COVID-19 just 1 week before delivery. The triplets showed SARS-CoV-2 positivity right after birth, developed significant leukopenia and early-onset pulmonary interstitial emphysema. The most severely affected triplet I required 10 days of high-frequency oscillatory ventilation due to failure of conventional invasive ventilation, and circulatory support for 4 days. Despite a severe clinical course in two triplets (triplet I and II), clinical management without experimental, targeted antiviral drugs was successful. At discharge home, the triplets showed no signs of neurologic or pulmonary sequelae. Placental immunohistology with SARS-CoV-2 N-protein localized strongly to syncytiotrophoblast cells and, to a lesser extent, to fetal Hofbauer cells, proving intrauterine virus transmission. We discuss the role of maternal viremia as a potential risk factor for vertical transmission. To the best of our knowledge, our report presents the earliest unequivocally confirmed prenatal virus transmission in long-term surviving children, i.e., at the beginning of the third trimester.

3.
J Perinat Med ; 49(6): 702-708, 2021 Jul 27.
Article in English | MEDLINE | ID: covidwho-1327989

ABSTRACT

OBJECTIVES: In the current Severe Acute Respiratory Distress Coronavirus 2 (SARS-CoV-2) pandemic there is still great uncertainty about the effects of an infection in pregnancy especially regarding a possible fetal transmission of antibodies to SARS-CoV-2 and the longevity of this immunity. METHODS: Sixteen women who were infected with SARS-CoV-2 during pregnancy and their offspring were included. The antibody response to SARS-CoV-2 was measured in mother and umbilical cord blood peripartum and in a follow-up examination 6-11 weeks after birth. Medical history, symptoms regarding SARS-CoV-2, obstetric and neonatal information were queried following recommendations by the WHO. RESULTS: A total of 73% of the women and one third of the infants developed antibodies to SARS-CoV-2 spike (S) protein receptor binding domain (RBD), with a long interval between infection and birth proving favorable for a transplacentar transfer of antibodies to the neonates. All infants showed declining or vanishing antibody-titers in the follow-up examination, while the titers of their mothers were stable or even increased. CONCLUSIONS: Our results demonstrate that transplacental transfer of SARS-CoV-2-specific antibodies is possible, but also indicate that the immunity that may be gained as a result might decrease in newborns postpartum. This provides important evidence that could be useful for further studies covering vaccination during pregnancy.


Subject(s)
Antibody Formation , COVID-19/immunology , Infant, Newborn/immunology , Pregnancy Complications, Infectious/immunology , SARS-CoV-2/immunology , Female , Follow-Up Studies , Humans , Pregnancy , Prospective Studies , Spike Glycoprotein, Coronavirus/immunology
4.
J Neurol ; 268(11): 3969-3974, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1210701

ABSTRACT

BACKGROUND: Serum neurofilament light chain (sNfL) is an established biomarker of neuro-axonal damage in multiple neurological disorders. Raised sNfL levels have been reported in adults infected with pandemic coronavirus disease 2019 (COVID-19). Levels in children infected with COVID-19 have not as yet been reported. OBJECTIVE: To evaluate whether sNfL is elevated in children contracting COVID-19. METHODS: Between May 22 and July 22, 2020, a network of outpatient pediatricians in Bavaria, Germany, the Coronavirus antibody screening in children from Bavaria study network (CoKiBa), recruited healthy children into a cross-sectional study from two sources: an ongoing prevention program for 1-14 years, and referrals of 1-17 years consulting a pediatrician for possible infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We determined sNfL levels by single molecule array immunoassay and SARS-CoV-2 antibody status by two independent quantitative methods. RESULTS: Of the 2652 included children, 148 (5.6%) were SARS-CoV-2 antibody positive with asymptomatic to moderate COVID-19 infection. Neurological symptoms-headache, dizziness, muscle aches, or loss of smell and taste-were present in 47/148 cases (31.8%). Mean sNfL levels were 5.5 pg/ml (SD 2.9) in the total cohort, 5.1 (SD 2.1) pg/ml in the children with SARS-CoV-2 antibodies, and 5.5 (SD 3.0) pg/ml in those without. Multivariate regression analysis revealed age-but neither antibody status, antibody levels, nor clinical severity-as an independent predictor of sNfL. Follow-up of children with pediatric multisystem inflammatory syndrome (n = 14) showed no association with sNfL. CONCLUSIONS: In this population study, children with asymptomatic to moderate COVID-19 showed no neurochemical evidence of neuronal damage.


Subject(s)
COVID-19 , Intermediate Filaments , Adult , Child , Cross-Sectional Studies , Humans , Neurofilament Proteins , SARS-CoV-2 , Systemic Inflammatory Response Syndrome
7.
Pediatr Allergy Immunol ; 31(5): 560-564, 2020 07.
Article in English | MEDLINE | ID: covidwho-102331

ABSTRACT

With increasing number of SARS-CoV-2 infections and COVID-19 patients to be taken care of by the health system, more and more health workers become affected by the disease. It has been reported that right from the beginning of the outbreak in Lombardy up to 20% of the doctors and nurses became infected. Under these circumstances, the regular operation of health institutions already suffering from a shortage of staff becomes difficult. This has led to complete or partial shutdowns of hospitals, either due to a lack of uninfected personnel or because of uncontrollable chains of infection endangering patients. In one of the largest university perinatal center in Bavaria with more than 3000 births per year, an outbreak of COVID-19 occurred in March 2020, affecting 36 staff members, including doctors, nurses, and midwives. Here, we describe the outbreak and present the measures contributing to the successful containment of the outbreak within three weeks. At the same time, clinical services could be maintained, however, not without deployment of personnel exposed to employees infected with SARS-CoV-2. Apart from massive testing of personnel in pre-defined phases and increased hygiene measures, including a general obligation to wear surgical face masks, we identified the need to monitor cases of illness across all groups of employees, to ensure social distancing within personnel and to evaluate contacts of clinical personnel outside of the hospital environment, in order to be able to interpret chains of infections and to disrupt them. Overall, only a bundle of measures is needed to contain such an outbreak.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Health Personnel , Pandemics/prevention & control , Perinatal Care/methods , Pneumonia, Viral/prevention & control , COVID-19 , Female , Germany , Hand Hygiene , Hospitals, Maternity , Humans , Masks , Pregnancy , Quarantine , SARS-CoV-2 , Social Isolation
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