Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter February 24, 2021

Peripartal anti-SARS-CoV-2-IgA/IgG in asymptomatic pregnant women during regional SARS-CoV-2-outbreak

Sebastian Häusler, Marco Weigl, Andreas Ambrosch, Rudolf Gruber, Birgit Seelbach-Göbel and Sara Fill Malfertheiner

Abstract

Objectives

The Severe Acute Respiratory Distress Corona Virus 2 (SARS-CoV-2) pandemic poses special challenges for the society and especially the medical staff. Even if a rather mild course is assumed among pregnant women the measures to prevent transmission of the infection are of outstanding importance.

Methods

To screen asymptomatic pregnant women during admission to our university maternal hospital we focused on anti-SARS-CoV-2-specific IgG and IgA antibody responses. Hundred and fifty one women admitted to the hospital for childbirth or caesarean delivery were included. In case of suspicious anti-SARS-CoV-2-antibody levels an RT-PCR was performed to confirm an ongoing infection with SARS-CoV-2.

Results

A total of 89% showed negative results for anti-SARS-CoV-2-IgA antibodies, whereas 3% were borderline and 7% positive (both labeled as suspicious). In only one patient with suspicious serology we detected SARS-CoV-2-RNA in the following RT-PCR. 2% presented anti-SARS-CoV-2-IgG antibodies, all being positive for anti-SARS-CoV-2-IgA. The observed positive rate of our study collective of 10.6% seemed much higher than the expected one (1.3%) based on the reports of the Robert Koch Institute and the specifications given by the test’s manufacturer. The expected positive predictive value (PPV) was 4.3–6.7 times higher than the observed one.

Conclusions

To our knowledge this is the first report of anti-SARS-CoV-2-antibody levels in the peripartum period of asymptomatic women. As the positive anti-SARS-CoV-2 serology poorly correlated with the confirmatory RT-PCR and the fact that mainly the detection of the virus by PCR correlates with the patient’s infectiousness we suggest to rather perform a SARS-CoV-2-PCR-based admission screening in perinatal centers to prevent the spread of the disease.


Corresponding author: Sebastian Häusler, MD, University Department of Obstetrics and Gynecology at the Hospital St. Hedwig of the Order of St. John, University Medical Center Regensburg, Steinmetzstr., 1-3, 93049 Regensburg, Germany; and Department of Obstetrics and Gynecology, School of Medicine, University of Würzburg, Josef-Schneider-Str. 4, 97080 Würzburg, Germany, E-mail:
Sebastian Häusler and Marco Weigl contributed equally to this work.

Acknowledgments

We are grateful to all obstetrics patient who participated in the study and to all staff members of our hospital supporting this research project. Moreover, we would like to thank Andrea Seitz for the collection and management of data for this study.

  1. Research funding: None declared.

  2. Author contributions: Sebastian Häusler: Conceptualization (lead); Project administration (supporting); Resources (lead); Supervision (lead); Validation (equal); Writing-review original draft (lead); Marco Weigl: Formal analysis (equal); Investigation (equal); Methodology (equal); Writing-original draft (lead); Birgit Seelbach-Göbel: Review original draft (supporting). Rudolf Gruber: Formal analysis (equal); Methodology (equal). Andreas Ambrosch: Investigation (equal); Methodology (equal); Validation (equal). Sara Fill Malfertheiner: Formal analysis (equal); Investigation (equal); Methodology (equal); Writing-original draft (supporting). All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The study was approved by the Ethics Committee of the University of Würzburg, Germany (file-number: 20200428-01).

  6. Availability of data and materials: The datasets used and/or analyzed for this paper are available from the corresponding author on reasonable request.

References

1. World-Health-Organization. Coronavirus disease (COVID-19) situation report – 162. 2020 01.07.2020. Berlin, Germany: Robert Koch-Institut. Available from: https://www.who.int/docs/default-source/coronaviruse/20200630-covid-19-sitrep-162.pdf?sfvrsn=e00a5466_2 [Accessed 30 Jun 2020].Search in Google Scholar

2. Zhou, P, Yang, XL, Wang, XG, Hu, B, Zhang, L, Zhang, W, et al.. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020;579:270–3. https://doi.org/10.1038/s41586-020-2012-7.Search in Google Scholar

3. McIntosh, K, Kapikian, AZ, Turner, HC, Hartley, JW, Parrott, RH, Chanock, RM. Seroepidemiologic studies of coronavirus infection in adults and children. Am J Epidemiol 1970;91:585–92. https://doi.org/10.1093/oxfordjournals.aje.a121171.Search in Google Scholar

4. Wu, Z, McGoogan, JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese center for disease Control and prevention. JAMA 2020;323:1239–42. https://doi.org/10.1001/jama.2020.2648.Search in Google Scholar

5. Stumpfe, FM, Titzmann, A, Schneider, MO, Stelzl, P, Kehl, S, Fasching, PA, et al.. SARS-CoV-2 infection in pregnancy - a review of the current literature and possible impact on maternal and neonatal outcome. Geburtshilfe Frauenheilkd 2020;80:380–90. https://doi.org/10.1055/a-1134-5951.Search in Google Scholar

6. Zhao, X, Jiang, Y, Zhao, Y, Xi, H, Liu, C, Qu, F, et al.. Analysis of the susceptibility to COVID-19 in pregnancy and recommendations on potential drug screening. Eur J Clin Microbiol Infect Dis 2020;39:1209–20. https://doi.org/10.1007/s10096-020-03897-6.Search in Google Scholar

7. Brandstetter, S, Roth, S, Harner, S, Buntrock-Döpke, H, Toncheva, AA, Borchers, N, et al.. Symptoms and immunoglobulin development in hospital staff exposed to a SARS-CoV-2 outbreak. Pediatr Allergy Immunol 2020;31:841–7. https://doi.org/10.1111/pai.13278.Search in Google Scholar

8. Fill Malfertheiner, S, Brandstetter, S, Roth, S, Harner, S, Buntrock-Döpke, H, Toncheva, AA, et al.. Immune response to SARS-CoV-2 in health care workers following a COVID-19 outbreak: a prospective longitudinal study. J Clin Virol 2020;130:104575. https://doi.org/10.1016/j.jcv.2020.104575.Search in Google Scholar

9. Kabesch, M, Roth, S, Brandstetter, S, Hausler, S, Juraschko, E, Weigl, M, et al.. Successful containment of COVID-19 outbreak in a large maternity and perinatal center while continuing clinical service. Pediatr Allergy Immunol 2020;31:560–4. https://doi.org/10.1111/pai.13265.Search in Google Scholar

10. Zhao, J, Yuan, Q, Wang, H, Liu, W, Liao, X, Su, Y, et al.. Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019. Clin Infect Dis 2020;71:2027–34. https://doi.org/10.1093/cid/ciaa344.Search in Google Scholar

11. Palatnik, A, McIntosh, JJ. Protecting labor and delivery personnel from COVID-19 during the second stage of labor. Am J Perinatol 2020;37:854–6. https://doi.org/10.1055/s-0040-1709689.Search in Google Scholar

12. Dinnes, J, Deeks, JJ, Adriano, A, Berhane, S, Davenport, C, Dittrich, S, et al.. Rapid, point-of-care antigen and molecular-based tests for diagnosis of SARS-CoV-2 infection. Cochrane Database Syst Rev 2020;8:Cd013705.10.1002/14651858.CD013705Search in Google Scholar

13. Garcia-Basteiro, AL, Moncunill, G, Tortajada, M, Vidal, M, Guinovart, C, Jiménez, A, et al.. Seroprevalence of antibodies against SARS-CoV-2 among health care workers in a large Spanish reference hospital. Nat Commun 2020;11:3500. https://doi.org/10.1038/s41467-020-17318-x.Search in Google Scholar

14. Contejean, A, Leporrier, J, Canouï, E, Alby-Laurent, F, Lafont, E, Beaudeau, L, et al.. Comparing dynamics and determinants of SARS-CoV-2 transmissions among health care workers of adult and pediatric settings in central Paris. Clin Infect Dis 2020 Jul 15. https://doi.org/10.1093/cid/ciaa977 [Epub ahead of print].Search in Google Scholar

15. Pflitsch, C, Feldmann, CN, Richert, L, Hagen, S, Diemert, A, Goletzke, J, et al.. In-depth characterization of monocyte subsets during the course of healthy pregnancy. J Reprod Immunol 2020;141:103151. https://doi.org/10.1016/j.jri.2020.103151.Search in Google Scholar

16. Forestieri, S, Marcialis, MA, Migliore, L, Panisi, C, Fanos, V. Relationship between pregnancy and coronavirus: what we know. J Matern Fetal Neonatal Med 2020;4:1–12. https://doi.org/10.1080/14767058.2020.1771692.Search in Google Scholar

17. Omer, SB, Clark, DR, Madhi, SA, Tapia, MD, Nunes, MC, Cutland, CL, et al.. Efficacy, duration of protection, birth outcomes, and infant growth associated with influenza vaccination in pregnancy: a pooled analysis of three randomised controlled trials. Lancet Respir Med 2020;8:597–608. https://doi.org/10.1016/s2213-2600(19)30479-5.Search in Google Scholar

18. Papachristodoulou, E, Kakoullis, L, Parperis, K, Panos, G. Long-term and herd immunity against SARS-CoV-2: implications from current and past knowledge. Pathog Dis 2020;78:ftaa025. https://doi.org/10.1093/femspd/ftaa025.Search in Google Scholar

19. Steppuhn, H, Buda, S, Wienecke, A, Kraywinkel, K, Tolksdorf, K, Haberland, J, et al.. Zeitliche Trends in der Inzidenz und Sterblichkeit respiratorischer Krankheiten von hoher Public-Health-Relevanz in Deutschland. Robert Koch-Institut, Epidemiologie und Gesundheitsberichterstattung; 2017.Search in Google Scholar

20. Charlton, CL, Kanji, JN, Johal, K, Bailey, A, Plitt, SS, MacDonald, C, et al.. Evaluation of six commercial mid to high volume antibody and six point of care lateral flow assays for detection of SARS-CoV-2 antibodies. J Clin Microbiol 2020;58:e01361–20. https://doi.org/10.1128/jcm.01361-20.Search in Google Scholar

21. van der Heide, V. SARS-CoV-2 cross-reactivity in healthy donors. Nat Rev Immunol 2020;20:408. https://doi.org/10.1038/s41577-020-0362-x.Search in Google Scholar

Received: 2021-01-01
Accepted: 2021-02-08
Published Online: 2021-02-24
Published in Print: 2021-07-27

© 2021 Walter de Gruyter GmbH, Berlin/Boston

Scroll Up Arrow