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Respiratory distress in SARS-CoV-2 exposed uninfected neonates followed in the COVID Outcomes in Mother-Infant Pairs (COMP) Study

Author

Listed:
  • Olivia M. Man

    (University of California, Los Angeles)

  • Tamiris Azamor

    (Global Center for Pathogen Research and Human Health, Lerner Research Institute, Cleveland Clinic)

  • Mary Catherine Cambou

    (University of California, Los Angeles)

  • Trevon L. Fuller

    (University of California, Los Angeles
    Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Manguinhos)

  • Tara Kerin

    (University of California, Los Angeles)

  • Sophia G. Paiola

    (University of California, Los Angeles)

  • Jessica S. Cranston

    (University of California, Los Angeles)

  • Thalia Mok

    (University of California, Los Angeles)

  • Rashmi Rao

    (University of California, Los Angeles)

  • Weiqiang Chen

    (Global Center for Pathogen Research and Human Health, Lerner Research Institute, Cleveland Clinic)

  • Jae U. Jung

    (Global Center for Pathogen Research and Human Health, Lerner Research Institute, Cleveland Clinic)

  • Viviana Fajardo Martinez

    (University of California, Los Angeles)

  • Suan-Sin Foo

    (Global Center for Pathogen Research and Human Health, Lerner Research Institute, Cleveland Clinic)

  • Karin Nielsen-Saines

    (University of California, Los Angeles)

Abstract

Respiratory distress (RD) has been reported in SARS-CoV-2 exposed uninfected (SEU) term neonates. Prior studies suggest that prenatal exposure to Coronavirus Disease 19 (COVID-19) may activate an inflammatory cascade in the newborn airway. In this study, we examine the relationship between maternal COVID-19 vaccination and neonatal RD using a longitudinal cohort of mother-infant pairs in Los Angeles, CA. Two-hundred and twenty-one mothers with laboratory confirmed SARS-CoV-2 during pregnancy and 227 exposed fetuses are enrolled in our study. Maternal disease severity and neonatal RD variables were defined based on current accepted clinical criteria. To explore the multifactorial associations between maternal COVID-19 parameters and infant RD, we utilize a multivariable logistic regression model and a proteomic sub-analysis to propose a pathway for the development of RD following in utero exposure to SARS-CoV-2. Unusually high rates of RD are observed in SEU infants (17%). The odds ratio of RD is 3.06 (95% CI:1.08-10.21) in term neonates born to unvaccinated individuals versus those born to individuals vaccinated prior to maternal infection. Proteomic analysis reveals a robust inflammatory response associated with ciliary dysregulation and enhanced IgE production among SEU neonates with RD. Maternal vaccination against COVID-19 reduces the frequency of neonatal RD.

Suggested Citation

  • Olivia M. Man & Tamiris Azamor & Mary Catherine Cambou & Trevon L. Fuller & Tara Kerin & Sophia G. Paiola & Jessica S. Cranston & Thalia Mok & Rashmi Rao & Weiqiang Chen & Jae U. Jung & Viviana Fajard, 2024. "Respiratory distress in SARS-CoV-2 exposed uninfected neonates followed in the COVID Outcomes in Mother-Infant Pairs (COMP) Study," Nature Communications, Nature, vol. 15(1), pages 1-11, December.
    • Handle: RePEc:nat:natcom:v:15:y:2024:i:1:d:10.1038_s41467-023-44549-5
    DOI: 10.1038/s41467-023-44549-5
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    References listed on IDEAS

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    1. David B. Corry & Farrah Kheradmand, 1999. "Induction and regulation of the IgE response," Nature, Nature, vol. 402(6760), pages 18-23, November.
    2. Smriti Prasad & Erkan Kalafat & Helena Blakeway & Rosemary Townsend & Pat O’Brien & Edward Morris & Tim Draycott & Shakila Thangaratinam & Kirsty Le Doare & Shamez Ladhani & Peter von Dadelszen & Laur, 2022. "Systematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy," Nature Communications, Nature, vol. 13(1), pages 1-8, December.
    3. Claudio Fenizia & Mara Biasin & Irene Cetin & Patrizia Vergani & Davide Mileto & Arsenio Spinillo & Maria Rita Gismondo & Francesca Perotti & Clelia Callegari & Alessandro Mancon & Selene Cammarata & , 2020. "Analysis of SARS-CoV-2 vertical transmission during pregnancy," Nature Communications, Nature, vol. 11(1), pages 1-10, December.
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