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Immunological assessment of SARS-CoV-2 Infection in Pregnancy From Diagnosis to Delivery: A multicentre prospective observational study
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  • Kate Glennon,
  • Jennifer Donnelly,
  • Susan Knowles,
  • Fionnuala McAuliffe,
  • Alma O Reilly,
  • Siobhan Corcoran,
  • Jennifer Walsh,
  • Roger McMorrow,
  • Tess Higgins,
  • Lucy Bolger,
  • Susan Clinton,
  • Sarah O Riordan,
  • Alex Start,
  • Doireann Roche,
  • Helena Bartels,
  • Ciara Malone,
  • Karl McAuley,
  • Anthony Mc Dermott,
  • Rosanna Inzitari,
  • Colm P.F. O Donnell,
  • Fergal Malone,
  • Shane Higgins,
  • Cillian De Gascun,
  • Peter Doran,
  • Donal Brennan
Kate Glennon
University College Dublin

Corresponding Author:[email protected]

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Jennifer Donnelly
RCSI School of Medicine
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Susan Knowles
National Maternity Hospital
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Fionnuala McAuliffe
UCD Perinatal Research Centre
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Alma O Reilly
RCSI School of Medicine
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Siobhan Corcoran
National Maternity Hospital
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Jennifer Walsh
National Maternity Hospital
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Roger McMorrow
National Maternity Hospital
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Tess Higgins
National Maternity Hospital
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Lucy Bolger
National Maternity Hospital
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Susan Clinton
National Maternity Hospital
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Sarah O Riordan
National Maternity Hospital
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Alex Start
UCD Perinatal Research Centre
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Doireann Roche
National Maternity Hospital
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Helena Bartels
Rotunda Hospital
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Ciara Malone
Rotunda Hospital
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Karl McAuley
Clinical Research Centre, UCD School of Medicine
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Anthony Mc Dermott
Clinical Research Centre, UCD School of Medicine
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Rosanna Inzitari
Clinical Research Centre, UCD School of Medicine
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Colm P.F. O Donnell
Neonatal Unit, UCD School of Medicine
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Fergal Malone
RCSI School of Medicine
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Shane Higgins
National Maternity Hospital
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Cillian De Gascun
National Virus Reference Laboratory
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Peter Doran
Clinical Research Centre, UCD School of Medicine
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Donal Brennan
University College Dublin
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Abstract

Objective We profile the maternal and fetal response to SARS-CoV-2 infection in symptomatic and asymptomatic pregnant women and make an assessment of passive immunity to the neonate, Design Multicentre prospective study. Setting Dublin, Ireland Methods RT-PCR for viral RNA via a nasopharyngeal swab was performed using the Cobas SARS-CoV-2 6800 platform. Maternal, and fetal serological antibody response, via umbilical cord bloods, was measured using both the Elecsys® immunoassay, Abbott SARS-CoV-2 IgG Assay and the IgM Architect assay. Main outcome Measure Prevalence of RT PCR positive SARS-CoV-2. Assessment of IgM and IgG anti-SARS-CoV-2 serology antibodies. Results Ten of twenty three symptomatic women had SARS-CoV-2 RNA in a nasopharyngeal swab. Five (5/23, 21.7%) demonstrated serological evidence of anti-SARS-CoV-2 IgG antibodies and seven (30.4%, 7/23) were positive for IgM antibodies. In the asymptomatic cohort, the prevalence of SARS-CoV-2 infection in RNA was 0.16% (1/608). IgG SARS-CoV-2 antibodies were detected in 1·67% (10/598, 95% CI 0·8%-3·1%) and IgM in 3·51% (21/598, 95% CI 2·3–5·5%). Nine women had repeat testing between post baseline. Four (4/9, 44%) remained IgM positive, one IgG positive. IgG anti SARS-CoV-2 antibodies were detectable in cord bloods from babies born to five seropositive women who delivered during the study. Conclusion Using two independent serological assays, we present a comprehensive illustration of the antibody response to SARS-CoV-2 in pregnancy, and show a low prevalence of asymptomatic SARS-CoV-2. Transplacental migration of anti-SARS-CoV-2 antibodies was identified in cord blood of women who demonstrated antenatal anti-SARS-CoV-2 antibodies, raising the possibility of passive immunity.