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Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Prenatal Maternal SARS-CoV-2: A Case Series
Ravindra Pawar1, Vijay Gavade2, Nivedita Patil1
1Department of Pediatrics, Dr. D Y Patil Medical College Hospital and Research Institute, Kolhapur 416003, MH, India.
Children (Basel, Switzerland)
|August 6, 2021
Summary
Maternal COVID-19 may lead to a neonatal hyperinflammatory condition similar to Multisystem Inflammatory Syndrome in Children (MIS-C). This study suggests transplacental antibodies cause this syndrome in newborns, requiring further investigation.
Area of Science:
- Neonatology
- Immunology
- Infectious Diseases
Background:
- Multisystem Inflammatory Syndrome in Children (MIS-C) is a post-infectious condition following COVID-19.
- Maternal SARS-CoV-2 infection raises concerns about potential neonatal hyperinflammatory syndromes due to antibody transfer.
Purpose of the Study:
- To investigate clinical features and outcomes of neonates with potential MIS-C related to maternal SARS-CoV-2.
- To explore the link between maternal COVID-19 and neonatal inflammatory conditions.
Main Methods:
- Retrospective review of 20 neonates with MIS-C-like features and their mothers' perinatal history.
- Testing for anti-SARS-CoV-2 IgG and IgM antibodies in neonates.
- Clinical data collection including cardiac, respiratory, and other organ involvement.
Main Results:
- 18 neonates born to mothers with pregnancy-related COVID-19 exposure presented with MIS-C-like symptoms within 5 days of birth.
- Nineteen neonates tested positive for anti-SARS-CoV-2 IgG, indicating transplacental antibody transfer.
- Significant findings included cardiac involvement (90%), respiratory failure (40%), and elevated inflammatory markers; two neonates died.
Conclusions:
- Maternal SARS-CoV-2 infection and transplacental antibodies may cause a neonatal multisystem inflammatory syndrome (MIS-N).
- Immunomodulatory treatments might be beneficial, warranting further research.
- This condition highlights the potential impact of maternal infections on neonatal health.
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