The specific maternal-neonatal immunity against respiratory syncytial virus after the COVID-19 pandemic: an

Maria Giulia Conti1, Leonardo Sorrentino2, Laura Petrarca1

  • 1Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy.

Insights

The COVID-19 pandemic altered immune responses to Respiratory Syncytial Virus (RSV) in pregnant women and newborns. This immunological shift may explain changes in RSV seasonality and increased bronchiolitis hospitalizations.

Area of Science:

  • Immunology
  • Virology
  • Public Health

Background:

  • Respiratory Syncytial Virus (RSV) bronchiolitis poses the highest risk to infants in their first months.
  • Maternal anti-RSV IgG antibodies are crucial for protecting newborns against early-life RSV infection.
  • The COVID-19 pandemic significantly disrupted the typical seasonality of RSV epidemics.

Purpose of the Study:

  • To investigate the impact of COVID-19 restrictions on RSV-specific immunity in pregnant women and their newborns.
  • To compare anti-RSV IgM and IgG levels across different RSV seasons affected by the pandemic.
  • To explore the potential link between altered maternal-newborn immunity and changes in RSV seasonality.

Main Methods:

  • Collected maternal and cord blood samples from mother-newborn dyads over three RSV seasons (2020-2023).
  • Measured anti-RSV IgM and IgG antibody levels in maternal and cord blood samples.
  • Compared antibody levels between groups representing different periods of the pandemic's influence on RSV circulation.

Main Results:

  • Maternal anti-RSV IgM levels were significantly higher in the 2021-2022 and 2022-2023 seasons compared to 2020-2021.
  • Anti-RSV IgG levels were significantly lower in maternal and cord blood in the 2021-2022 season, and in cord blood in the 2022-2023 season, compared to 2020-2021.
  • These changes suggest a pandemic-induced 'immunological debit' in RSV-specific immunity.

Conclusions:

  • The COVID-19 pandemic appears to have negatively impacted RSV-specific immunity in pregnant women and their infants.
  • This immunological deficit may contribute to the observed alterations in RSV seasonality.
  • The findings could help explain the rise in bronchiolitis hospitalizations following the pandemic restrictions.

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