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A Case Report to Assess Passive Immunity in a COVID Positive Pregnant Patient
Introduction Data regarding transplacental passage of maternal coronavirus disease 2019 (COVID-19) antibodies and potential immunity in the newborn is limited.
Case Report We present a 25-year-old multigravida with known red blood cell isoimmunization, who was found to be COVID-19 positive at 27 weeks of gestation while undergoing serial periumbilical blood sampling and intrauterine transfusions. Maternal COVID-19 antibody was detected 2 weeks after positive molecular testing. Antibodies were never detected on cord blood samples from two intrauterine fetal cord blood samples as well as neonatal cord blood at the time of delivery.
Conclusion This case demonstrates a lack of passive immunity of COVID-19 antibodies from a positive pregnant woman to her fetus, neither in utero nor at the time of birth. Further studies are needed to understand if passage of antibodies can occur and if that can confer passive immunity in the newborn.
Passive immunity should not be assumed in COVID-19 infection in pregnancy.
Isoimmunization may impair passive immunity of certain antibodies.
Vaccination to or maternal infection of COVID-19 may not be protective for the fetus.
Received: 01 July 2020
Accepted: 21 July 2020
13 August 2020 (online)
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- 1 Fox NS, Melka S. COVID-19 in pregnant women: case series from one large new york city obstetrical practice. Am J Perinatol 2020; 37 (10) 1002-1004
- 2 Lu X, Zhang L, Du H. , et al; Chinese Pediatric Novel Coronavirus Study Team. SARS-CoV-2 infection in children. N Engl J Med 2020; 382 (17) 1663-1665
- 3 Chen H, Guo J, Wang C. , et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020; 395 (10226): 809-815
- 4 Baud D, Greub G, Favre G. , et al. Second-trimester miscarriage in a pregnant woman with SARS-CoV-2 infection. JAMA 2020; DOI: 10.1001/jama.2020.7233.
- 5 Zeng H, Xu C, Fan J. , et al. Antibodies in infants born to mothers with COVID-19 pneumonia. JAMA 2020; DOI: 10.1001/jama.2020.4861.
- 6 Wilcox CR, Holder B, Jones CE. Factors affecting the FcRn-mediated transplacental transfer of antibodies and implications for vaccination in pregnancy. Front Immunol 2017; 8: 1294
- 7 Martinez DR, Fong Y, Li SH. , et al. Fc IgG in HIV-infected women. Cell 2019; 178 (01) 190-201.e11