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Letter to the Editor
New evidences that discard the possible vertical transmission of SARS-CoV-2 during pregnancy
Nuevas evidencias descartan la posible transmisión vertical del SARS CoV-2 durante el embarazo
Jianghui Cai
Corresponding author
776773221@qq.com

Corresponding author.
, Yingzi Zhang, Mi Tang
Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu City 610041, China
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        "titulo" => "Nuevas evidencias descartan la posible transmisi&#243;n vertical del SARS CoV-2 durante el embarazo"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with great interest the scientific letter by Dr&#46; Jes&#250;s Joaqu&#237;n Hijona El&#243;segui and colleagues &#40;available online 12 September 2020&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> In their letter&#44; the authors have stated that there is no evidence of vertical transmission of SARS-CoV-2 in the second trimester of pregnancy based on the limited evidence available&#46; However&#44; we have some concerns about the possibility of vertical transmission of Coronavirus disease 2019 &#40;COVID-19&#41;&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">First&#44; vertical transmission refers to the way in which pathogens are transmitted from mother to offspring during the period before and after birth&#46; It includes transmission via placental blood during pregnancy&#44; via the birth canal during the process of delivery&#44; and via breastmilk during postpartum breastfeeding&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> We do agree with the authors that intrauterine tissue samples such as placenta&#44; cord blood&#44; amniotic fluid and vaginal secretion&#44; which are essential for assessment of vertical transmission&#46; Thus&#44; it is imperative to collect more kinds of specimens of SARS-CoV-2 infected pregnant women and their newborns to better evaluating the possibility of vertical transmission of SARS-CoV-2&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Second&#44; a recent study suggested that the ratio of SARS-CoV-2-infected mother-to-fetus transmission will be significantly lower than that of Zika virus&#46; Because the expression of angiotensin-converting enzyme 2 &#40;ACE2&#41;&#44; which is the receptor that SARS-CoV-2 enters the cell is deficient in all kinds of early maternal&#8211;fetal interface cells&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> And this may explain why SARS-CoV-2 can be found in human saliva rather than in vaginal secretions&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Third&#44; Alexandre J&#46; Vivanti and colleagues reported the first proven case of transplacental transmission of SARS-CoV-2 from a pregnant woman affected by COVID-19 during late pregnancy to her offspring&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> The transmission is confirmed by comprehensive virological and pathological investigations&#46; Both &#8220;E&#8221; and &#8220;S&#8221; gene of SARS-CoV-2 were found in each and every specimen&#44; the viral load is much higher in the placental tissue than in amniotic fluid or maternal blood suggests the presence of the virus in placental cells&#44; which is consistent with findings of inflammation seen at the histological examination&#46; Furthermore&#44; the RT-PCR curves of neonatal nasopharyngeal swabs at 3 and 18 day of life are higher than that at the first day &#40;while the baby was in full isolation in a negative pressure room&#41;&#58; this is also another confirmation of an actual neonatal infection&#44; rather than a contamination&#46; Notably&#44; the neonate were presenting with neurological compromise which indicates long-term follow-up of infants born to mothers with confirmed COVID-19 are needed&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">In conclusion&#44; the vertical transmission of SARS-CoV-2 infection is possible during the last weeks of pregnancy&#46; Additional good-quality studies with comprehensive serial tests from multiple specimens and long-term follow-up of infants are urgently needed&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">We declare no competing interests&#46;</p></span></span>"
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Article information
ISSN: 00257753
Original language: English
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos