Vertical Transmission of Covid-19-A Systematic Review

Author(s): Federico Fornari

Aim: Recently, the first case report of a possible vertical transmission of Covid19 infection was published on the Journal of American Medical Academy, while previous reports showed absence of transplacental transmission. Data on a key element of neonatal care in this pandemic, such as the possibility of vertical transmission, are rare.

Methods: A systematic literature review was carried out to identify papers on COVID-19, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), using the Medline and EMBASE databases between 1 January and 31 March 2020.

Results: A total of 70 newborns, born to mothers with proved Sars-Cov-2 infection, from nine different studies were cumulatively analyzed in our research. A total of sixty-five neonates (92.9% of cases) from seven independent studies was negative for a transplacental infection according to oropharyngeal or nasopharyngeal swab performed in the first hours or days of life; four patients (5.7% of cases) had early infection detected at second days of life, and vertical transmission could not be excluded; finally, one patient had a negative throat swab but positive IgM and IgG count, and was considered possibly infected in utero. Cumulatively, in 5 out of 70 cases (7.1% of neonates), a vertical transmission could not be excluded or was considered possible.

Conclusions: Findings suggesting a possible vertical transmission of Covid-19 are increasingly reported. Transplacental transmission of the infection cannot be excluded.