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Clinical outcomes and antibody transfer in a cohort of infants with in utero or perinatal exposure to SARS-CoV-2 (Coronascope Study)

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Abstract

We aimed to describe the outcomes, focusing on the hearing and neurological development, of infants born to mothers with COVID-19 during pregnancy and to evaluate the persistence of maternal antibodies in the first months of life. An observational, prospective study at a tertiary hospital in Madrid (Spain) on infants born to mothers with COVID-19 during pregnancy between March and September 2020 was conducted. A follow-up visit at 1–3 months of age with a physical and neurological examination, cranial ultrasound (cUS), SARS-CoV-2 RT-PCR on nasopharyngeal swab, and SARS-CoV-2 serology were performed. Hearing was evaluated at birth through the automated auditory brainstem response and at six months of age through the auditory steady-state response. A neurodevelopmental examination using the Bayley-III scale was performed at 12 months of age. Of 95 infants studied, neurological examination was normal in all of them at the follow-up visit, as was the cUS in 81/85 (95%) infants, with only mild abnormalities in four of them. Serology was positive in 47/95 (50%) infants, which was not associated with symptoms or severity of maternal infection. No hearing loss was detected, and neurodevelopment was normal in 96% of the infants (median Z score: 0).

Conclusion: In this cohort, the majority of infants born to mothers with COVID-19 during pregnancy were healthy infants with a normal cUS, no hearing loss, and normal neurodevelopment in the first year of life. Only half of the infants had a positive serological result during the follow-up.

What is Known:

• Hearing loss and neurodevelopmental delay in infants born to mothers with COVID-19 during pregnancy has been suggested, although data is inconsistent. Maternal antibody transfer seems to be high, with a rapid decrease during the first weeks of life.

What is New:

• Most infants born to mothers with COVID-19 during pregnancy had normal hearing screening, cranial ultrasound, and neurodevelopmental status at 12 months of life. Antibodies against SARS-CoV-2 were only detected in 50% of the infants at two months of life.

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Availability of data and materials

After de-identification all the individual data collected for the study is available from the correspondent author under reasonable request.

Abbreviations

COVID-19:

Coronavirus disease 2019

cUS:

Cranial ultrasound

IQR:

Interquartile range

NICU:

Neonatal intensive care unit

NPS:

Nasopharyngeal swab

RT-PCR:

Reverse-transcription polymerase chain reaction

SARS-CoV-2:

Severe acute respiratory syndrome coronavirus 2

SD:

Standard deviation

WGA:

Weeks of gestational age

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Acknowledgements

The authors would like to thank Mark Sefton (BiomedRed SL) for his valuable assistance in the author editing of this manuscript.

Funding

This study was not specifically founded by any source. DBG (INT20/00086) and IHG (PI19/01005) hold “Intensification of Research Activity in the National Health System” contracts from the Instituto de Salud Carlos III, co-funded by the European Social Fund. SV was funded by the Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III and Fondos FEDER (Contrato Río Hortega CM20/00173).

Author information

Author notes

  1. Jaime Carrasco Colom and Ángela Manzanares contributed equally as co-first authors.

Authors and Affiliations

  1. Pediatric Infectious Disease Unit, Hospital Universitario 12 de Octubre, Madrid, Spain

    Jaime Carrasco Colom, Ángela Manzanares, Cinta Moraleda, Cristina Epalza, Elisa Fernández-Cooke, Luis Prieto, Serena Villaverde & Daniel Blázquez-Gamero

  2. Pediatric Research and Clinical Trials Unit (UPIC), Instituto de Investigación Hospital, RECLIP, 12 de Octubre (imas12), Madrid, Spain

    Jaime Carrasco Colom, Ángela Manzanares, Estrella Esquivel, Cinta Moraleda, Cristina Epalza, Elisa Fernández-Cooke, Luis Prieto, Serena Villaverde & Daniel Blázquez-Gamero

  3. Universidad Complutense de Madrid, Madrid, Spain

    Alicia Álvaro Gómez, Isabel Serrano Escribano, Luis Prieto, Ignacio Herraiz, Alberto Galindo & Daniel Blázquez-Gamero

  4. Microbiology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain

    Alfredo Pérez-Rivilla, María Dolores Folgueira & Rafael Delgado

  5. Neonatology Department, Hospital Universitario 12 de Octubre, RICORS Network, ISCIII, Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain

    Maria Teresa Moral-Pumarega

  6. Radiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain

    Elisa Aguirre Pascual

  7. Pediatric Otorhinolaryngology Department, Hospital Universitario 12 de Octubre, Madrid, Spain

    Joaquín De Vergas & Sara Reda del Barrio

  8. Fetal Medicine Unit, Obstetrics and Gynecology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain

    Ignacio Herraiz & Alberto Galindo

  9. Neuropsychology Unit, Hospital Universitario 12 de Octubre, Madrid, Spain

    Berta Zamora

  10. Primary Care Interventions to Prevent Chronic Maternal and Child Diseases of Perinatal and Developmental Origin (RICORS Network), Instituto de Salud Carlos III, RD21/0012/0024, Madrid, Spain

    Ignacio Herraiz & Alberto Galindo

Authors
  1. Jaime Carrasco Colom
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Contributions

Daniel Blázquez-Gamero conceived the study, designed the work, analyzed the data, interpretated the data, and drafted the manuscript. Jaime Carrasco Colom conceived the study, designed the work, contributed to the acquisition of the data, and revised and made valuable contributions to the manuscript. Ángela Manzanares conceived the study, contributed to the acquisition of the data, analyzed and interpretated the data, and drafted the manuscript. Estrella Esquivel analyzed and interpretated the data and made valuable contributions to the manuscript. Alfredo Pérez-Rivilla, Rafael Delgado, María Dolores Folgueira, Alberto Galindo, and María Teresa Moral-Pumarega designed the work and revised and made valuable intellectual contributions to the manuscript. Alicia Álvaro Gómez, Isabel Serrano Escribano, Elisa Aguirre Pascual, Joaquín de Vergas, Sara Reda del Barrio, Cinta Moraleda, Cristina Epalza, Elisa Fernández-Cooke, Luis Prieto, Berta Zamora, Serena Villaverde, and Ignacio Herraiz contributed to the acquisition of the data and revised and made valuable contributions to the final version of the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Ángela Manzanares.

Ethics declarations

Ethics approval and consent to participate

The study was performed in line with the principles of the Declaration of Helsinki and was approved by the Ethics Committee of the Hospital Universitario 12 de Octubre (no. 20/241), and informed consent was obtained from the parents of all the infants that participated in the study.

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Not applicable.

Competing interests

The authors declare no competing interests.

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Communicated by Tobias Tenenbaum

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Carrasco Colom, J., Manzanares, Á., Álvaro Gómez, A. et al. Clinical outcomes and antibody transfer in a cohort of infants with in utero or perinatal exposure to SARS-CoV-2 (Coronascope Study). Eur J Pediatr 182, 4647–4654 (2023). https://doi.org/10.1007/s00431-023-05147-1

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