SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS-2 ANTIGENS AND ANTIBODIES IN BREAST MILK

Year 2021, Volume: 84 Issue: 3, 287 - 292, 31.07.2021

Gonca Keskindemirci , Nalan Karabayır , Ayşe İstanbullu Selda Hançerli Törün , Ceren Altay , Muhammet Fatih Sebirli , Özge Kaba , Büşra Sultan Kibar , Gülbin Gökçay

https://doi.org/10.26650/IUITFD.2021.928835

Abstract

Objective: This study aimed to determine the presence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antigens and IgM and IgG antibodies in breast milk of mothers diagnosed with Coronavirus disease-19 (COVID-19). Methods: The study was conducted in 11 mother-child pairs. Breastfeeding mothers who were either positive according to a PCR test or those who were negative but had COVID symptoms were included in the study. Expressed milk was stored at -20/-80°C until analysis. Breastmilk SARS-CoV-2 antigens and IgM and IgG antibodies were measured. The infants were followed for at least 15 days. Results: SARS-CoV-2 PCR tests using a nasopharyngeal swab was positive in 10 of 11 mothers. Nine mothers had symptoms of COVID-19. Breast milk samples were taken, on average, 15 days after symptom onset or a positive PCR result. SARS-CoV-2 PCR tests using a nasopharyngeal swab was positive in seven infants. The SARS-CoV-2 antigen was not detected in the breast milk of any of the mothers. However, SARS-CoV-2 IgG and IgM antibodies were detected in the breast milk of two mothers, who had a positive PCR test and experienced clinical symptoms. The children of these two mothers experienced no symptoms. Conclusion: Official institutions have recommended and supported breastfeeding during the SARS-CoV-2 pandemic. Our findings support this recommendation. The promotion and protection of breastfeeding under emergency conditions is of great importance for the health of children, mothers, and society.

Keywords

Breast milk, COVID-19, breastfeeding

ANNE SÜTÜNDE SARS-COV-2 ANTİJENİ VE ANTİKORU

Abstract

Amaç: Koronavirüs hastalığı-19 (COVID-19) tanısı almış annelerin anne sütünde Şiddetli Akut Solunum Sendromu koronavirüs-2 (SARS-CoV-2) antijeni ile IgM ve IgG antikorlarının belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Çalışma 11 anne-çocuk çifti ile gerçekleştirildi. Çalışmaya PCR testine göre pozitif olan veya negatif olup ancak COVID semptomları olan emziren anneler dahil edildi. Sağılmış anne sütü, analiz aşamasına kadar -20/-80°C’de saklandı. Anne sütü SARS-CoV-2 antijeni ve IgM ve IgG antikorları ölçüldü. Bebekler en az 15 gün takip edildi. Bulgular: Nazofarengeal sürüntüde SARS-CoV-2 PCR testleri 11 annenin 10’unda pozitifti. Dokuz annede COVID-19 semptomları vardı. Annelerin semptomlarından veya pozitif PCR sonuçlarından ortalama 15 gün sonra anne sütü örneği alındı. Nazofarengeal sürüntü testlerinde SARS-CoV-2 PCR testleri 11 anne bebeğinin 7’sinde pozitifti. SARS-CoV-2 antijeni hiçbir annenin anne sütünde saptanmadı. Ancak PCR testi pozitif olan ve klinik semptomlar yaşayan iki annenin sütünde SARS-CoV-2 IgG ve IgM antikorları tespit edildi. Bu iki annenin çocukları hiçbir belirti göstermedi. Sonuç: SARS-CoV-2 salgınında resmi kurumlar tarafından emzirme tavsiye edilmiş ve desteklenmiştir. Bulgularımız bu öneriyi desteklemektedir. Emzirmenin acil koşullarda teşviki ve korunması, çocuğun, annenin ve toplumun sağlığı açısından çok önemlidir.

Keywords

Anne sütü, COVID-19, emzirme

References

• 1. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA 2020;323(13):1239-42. [CrossRef]
• 2. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. Available at: https:// www.who.int/dg/speeches/detail/who-director-generalsopening- remarks-at-the-media-briefing-on-covid-19---11- march-2020
• 3. Children in Coronavirus in children. Available at https:// www.nhs.uk/conditions/coronavirus-covid-19/symptoms/ coronavirus-in-children/. Last accessed date: 25.11.2020
• 4. Wang L, Shi Y, Xiao T, Fu J, Feng X, Mu D, et al. Chinese expert consensus on the perinatal and neonatal management for the prevention and control of the 2019 novel coronavirus infection. Annals of Translational Medicine 2020;8(3):47. [CrossRef]
• 5. World Health Organization Q&A on COVID-19, pregnancy, childbirth and breastfeeding.World Health Organization. Geneva Available at: https://www.who.int/news-room/qa- detail/q-a-on-covid-19-pregnancy-childbirth-andbreastfeeding. Last accessed: date: 25.11.2020.
• 6. Coronavirus disease (COVID-19): How is it transmitted? How does COVID-19 spread between people Available at: www.who.int/coronavirus/spread. Last accessed date: 26.11.2020.
• 7. World Health Organisation. Coronavirus disease (COVID-19): Pregnancy and childbirth. Available at: https:// www.who.int/news-room/q-a-detail/coronavirus-diseasecovid- 19-pregnancy-and-childbirth
• 8. World Health Organisation. Rapid advice note on home care for patients with Middle East respiratory syndrome coronavirus (MERS-CoV) infection presenting with mild symptoms and management of contacts. Available at: https://www.who.int/csr/disease/coronavirus_infections/ MERS_home_care.pdf?ua. Last accessed dat: 09.12.2020.
• 9. Lubbe W, Botha E, Niela-Vilen H, Reimers P. Breastfeeding during the COVID-19 pandemic - a literature review for clinical practice. Int Breastfeed J 2020;15(1):82. [CrossRef]
• 10. Lawrence RA., & Lawrence, R. M. Breastfeeding. A Guide For the Medical Profession. Eighth Editionl. Elsevier Health Sciences. 2016, Philadelphia, USA p:573
• 11. Chang R, Zen Sun W, & Bun Ng T. Lactoferrin as potential preventative and treatment for COVID-19. International Journal of Antimicrobial Agents 2020;56:106118. [CrossRef]
• 12. Tam PCK, Ly KM, Kernich ML, Spurrier N, Lawrence D, Gordon DL, Tucker EC. Detectable severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in human breast milk of a mildly symptomatic patient with coronavirus disease 2019 (COVID-19). Clin Infect Dis. 2020 May 30:ciaa673. doi: 10.1093/cid/ciaa673. Epub ahead of print. [CrossRef]
• 13. Food and Drug Administration. A Closer Look at Coronavirus Disease 2019 (COVID-19) Diagnostic Testing. Available at: https://www.fda.gov/media/143737/download. Last accessed date: 14.12.2020.
• 14. Options for the use of rapid antigen tests for COVID-19 in the EU/EEA and the UK.Available at: https://www.ecdc. europa.eu/sites/default/files/documents/Options-use-ofrapid- antigen-tests-for-COVID-19.pdf. Last accessed date: 14.12.2020.
• 15. Center for Disease Conrtol and Prevention. Coronavirus Disease 2019 (COVID-19) Interim Guidance for Antigen Testing for SARS-CoV-2 Available at: https://www.cdc. gov/coronavirus/2019-ncov/lab/resources/antigen-testsguidelines. html#table1. Last accessed dat: 14.12.22020.
• 16. Demers-Mathieu V, Do DM, Mathijssen GB, Sela DA, Seppo A, Järvinen KM, Medo E. Difference in levels of SARS-CoV-2 S1 and S2 subunits- and nucleocapsid protein-reactive SIgM/IgM, IgG and SIgA/IgA antibodies in human milk. J Perinatol. 2020:1-10. [CrossRef]
• 17. Gao X, Wang S, Zeng W, Chen S, Wu J, Lin X, Liu Y, Sun Z, Feng L. Clinical and immunologic features among COVID- 19-affected mother-infant pairs: antibodies to SARSCoV- 2 detected in breast milk. New Microbes New Infect 2020;37:100752. [CrossRef]
• 18. Dong Y, Chi X, Hai H, Sun L, Zhang M, Xie WF, Chen W. Antibodies in the breast milk of a maternal woman with COVID-19. Emerg Microbes Infect 2020;9(1):1467-9. [CrossRef]
• 19. Deeks JJ, Dinnes J, Takwoingi Y, Davenport C, Spijker R, Taylor-Phillips S, Adriano A, Beese S, Dretzke J, Ferrante di Ruffano L, Harris IM, Price MJ, Dittrich S, Emperador D, Hooft L, Leeflang MM, Van den Bruel A; Cochrane COVID-19 Diagnostic Test Accuracy Group. Antibody tests for identification of current and past infection with SARSCoV- 2. Cochrane Database Syst Rev 2020;6(6):CD013652. [CrossRef]
• 20. Drugs and Lactation Database (LactMed). Available at: https://www.ncbi.nlm.nih.gov/books/NBK501541/