Further Evaluation of the Mother-to-Child Transmission Potential of SARS-CoV-2 Infection During Pregnancy: A Retrospective Study (preprint)

Background. This study aimed to comprehensively evaluate the clinical characteristics of COVID-19 in perinatal period, and systematically assess the mother-to-child transmission potential of SARS-CoV-2Methods. We retrospectively analyzed the data of 23 pregnant patients in late pregnancy. Clinical specimens, including maternal and neonatal throat swabs, vaginal secretions, placenta tissues, and breast milk, were collected for the nucleic acid test of the virus. Pregnancy outcomes and neonatal results were also analyzed.Results. Overall, 10 patients (43.5%) had no symptoms and were found by routine chest CT. Complications appeared after COVID-19 onset included PROM (17.4%) and fetal distress (4.3%). Typical signs of viral pneumonia were recorded in chest CT of all patients. No patients developed severe pneumonia or died of COVID-19. All of 25 neonates were born alive. No severe asphyxia or neonatal death was observed. Although three neonates were tested transiently suspected positive for SARS-CoV-2 after being transferred to neonatology department, no newborns developed COVID-19. Out of various clinical specimens tested, only a rectal swab sample from one pregnant patient was tested positive for SARS-CoV-2, while all the other specimens including first sample of newborn throat swabs were negative. Pathological examination found no obvious chorioamnionitis or clear virus inclusion body in placenta, and ACE2 (angiotension-converting enzyme 2) was expressed at a moderate level.Conclusions. As in the general population of COVID-19, asymptomatic patients were present in pregnant women. There is no confirmatory evidence for mother-to-child transmission in COVID-19 patients with late pregnancy.

Mothers infected with SARS-CoV-2 reveals a mild impact on newborns (preprint)

Could pregnant women infected with COVID-19 cause adverse consequences for their newborns?2. Mothers infected with COVID-19 did not cause serious adverse reactions during term labor, but premature infants were prone to gastrointestinal complications.3. It is necessary to strengthen the protective measures of nosocomial infection in NICU. Although the outbreak of SARS-CoV-2 has a serious impact on human health, the impact on newborns seems to be relatively moderate

Maternal SARS-CoV-2 IgG provides limited protection for their infants (preprint)

At present, there are still many ambiguous reports about the perinatal infection of infants born to mothers infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)1-3. The dynamic characteristics of infantile serum antibodies born to mother with SARS-CoV-2 has not been well described4-6. In this study, we analyzed the seroconversion of 27 newborns born to 26 pregnant women infected with SARS-CoV-2. The SARS-CoV-2 IgG positive rate of parturients was 80.8%, and half of their infants obtained maternal IgG. IgG transfer rates were 18.8% and 81.8% in those infants whose mother infected less and more than 2 weeks before delivery respectively. In the first two months of life, the IgG level of infants dropped sharply to one tenth of that at birth. The IgM was confirmed positive in 53.8% of mothers and negative in all infants. These results suggest that maternal IgG has limited protection for infants, which may help us to improve vaccination strategies in future.

Dynamic characteristics of Influenza A epidemic in children during the early stage of COVID-19 outbreak (preprint)

Background: At the beginning of the outbreak of coronavirus infected disease 2019 (COVID-19), children in Wuhan were experiencing an extremely strong influenza A epidemic. This study is aimed to explore the epidemic dynamics characteristics of children with influenza A and its correlation with the early stage spread of COVID-19 in Wuhan.Methods: This is a retrospective single-center clinical study.From November 28, 2019 to January 23, 2020, a total of 7904 outpatient children with signs of respiratory tract infection were admitted, and a total of 10102 throat swabs were collected. All the detection were performed to the throat swabs of patients, which include the epidemic statues, detection rate, duration of Flu A and B persistence in airway, and the positive rate of COVID-19 nucleic acid.Results: A total of 10102 throat swabs were obtained from children with respiratory symptoms, including 5450 (53.9%) male and 4652 (46.1%) female. 2899 (28.7%) cases were positive for Influenza A. There were 617 (6.1% ) cases of Influenza B . In group of Influenza A , the lowest positive rate was in the infants less than 1 year old (18.4%), and the highest in the group 12 year old (32.1%). During the period of high prevalence of influenza A, there was a low level of infection of influenza B. The detection rate of each age group fluctuated from 3% to 10%. 73.7% of children's influenza A and B virus turned negative within 7 days, and very few children's respiratory influenza virus can last even more than 1 month. Among 35 throat swabs detected with qRT-PCR, 11 (31.4%) were positive for Flu A, and all children were negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Conclusions: In the early stage of SARS-CoV-2 transmission, children in Wuhan were experiencing a high intensity of influenza A pandemic, and there was no the mixed infection of SARS-CoV-2 with influenza A. COVID-19 spread caught up the tail of influenza A pandemic. 

Clinical characteristics of 10 children with COVID-19 outside of Wuhan in Hubei Province (preprint)

Background：An outbreak of coronavirus disease 2019 (COVID-19) caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) began in Wuhan, Hubei Province, China in December 2019. This study aims to report the clinical characteristics of children COVID-19 in Xiangyang, a city outside of Wuhan within Hubei Province.Methods：We retrospectively investigated the clinical manifestations, Chest CT imaging, and laboratory characteristics of confirmed cases of children with COVID-19 with WHO interim guidance in Xiangyang Central Hospital from Feb 1 to Mar 10, 2020. 10 children cases were confirmed by real-time RT-PCR and were analyzed for epidemiological, demographic, clinical, radiological features and laboratory data. Outcomes were followed up until Mar 10, 2020.Results：6 cases (60%) had never been to Wuhan but closely contacted with family members with confirmed COVID-19, and 4 cases (40%) had made short term trips to Wuhan alone without familial clustering. The most common symptoms were cough (50%) followed by fever (40%), 4 cases (40%) showed asymptomatic characteristics including 2 cases (20%) with abnormal chest computed tomograms (CT) image. 9 cases (90%) were mild type, only 1 case (10%) was moderate type, none of them progressed in severe or critical disease. 4 (40%) cases showed leucopenia but none lymphopenia. Abnormalities on chest CT were detected among 8 cases (80%), 2 of 4 cases without obvious symptoms had abnormal chest CT.Conclusions: Children's infection is mainly caused by family clusters. No transmission to other individuals from children was found in our observation. The clinical manifestations in children with COVID-19 are non-specific with milder symptoms and good outcomes.

Guidance on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period (First Edition) / 中华实用儿科临床杂志

Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases. Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic. Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection. This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities. The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period.