Current evidence suggests that coronavirus disease 2019 (COVID‐19), caused by severe respiratory syndrome coronavirus 2 (SARS‐CoV‐2), is predominantly transmitted from human‐to‐human. However, evidence on vertical transmission and natural passive immunity among the newborns exposed to COVID‐19 is scanty and varies. This poses a challenge on preventive interventions for the newborns. We conducted a systematic review to first, determine the likelihood of vertical transmission among COVID‐19 exposed infants and second, determine whether antibodies against SARS‐CoV‐2 were generated among COVID‐19 vertically exposed but negative infants. This review registered in PROSPERO searched evidence from PubMed/MEDLINE and Google Scholar, among others. About 517 studies were pooled, where 33 articles (5.8%) met the inclusion criteria such as infection prevention and control measures at birth. A total of 205 infants born to COVID‐19 positive mothers were studied. Overall, 6.3% (13/205; 95% CI: 3.0%–9.7%) of the infants tested positive for COVID‐19 virus at birth. Of 33 eligible studies, six studies (18.8%) reported about immunoglobulin G/M (IgG/IgM) against SARS‐CoV‐2. IgG/IgM were detected in 90% infants (10/11; 95% CI: 73.9%–107.9%) who tested negative for COVID‐19 virus. The median antibody levels detected were 75.49 AU/ml (range, 7.25–140.32 AU/ml) and 3.79 AU/ml (range, 0.16–45.83 AU/ml), p = .0041 for IgG and IgM, respectively. In conclusion, the current evidence revealed a low possibility of vertical transmission of COVID‐19 and antibodies against SARS‐CoV‐2 were detected among vertically exposed but negative infants. Further studies on transplacental transmission and the magnitude of natural passive immunity in infants born to mothers with COVID‐19 are warranted.

中文翻译：

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患有COVID-19的母亲所生婴儿中可能的垂直传播和抗SARS-CoV-2抗体：系统的活体检查

当前证据表明，由严重呼吸综合症冠状病毒2（SARS-CoV-2）引起的冠状病毒疾病2019（COVID-19）主要在人与人之间传播。但是，在暴露于COVID-19的新生儿中，垂直传播和自然被动免疫的证据很少且各不相同。这对新生儿的预防干预提出了挑战。我们进行了系统的审查，首先确定在COVID-19暴露的婴儿中垂直传播的可能性，其次确定在垂直暴露但阴性的COVID-19婴儿中是否产生了针对SARS-CoV-2的抗体。该评论已在PROSPERO中注册，并从PubMed / MEDLINE和Google Scholar中搜索了证据。汇集了约517个研究，其中33篇文章（5。8％）符合出生时的感染预防和控制措施等纳入标准。共研究了205例COVID-19阳性母亲的婴儿。总体上，有6.3％（13/205; 95％CI：3.0％–9.7％）的婴儿在出生时检测出COVID-19病毒呈阳性。在33项合格研究中，有6项研究（18.8％）报告了针对SARS-CoV-2的免疫球蛋白G / M（IgG / IgM）。在90％的婴儿中检测到IgG / IgM（10/11； 95％CI：73.9％–107.9％），这些婴儿的COVID-19病毒检测结果呈阴性。检测到的中位抗体水平为75.49 AU / ml（范围7.25–140.32 AU / ml）和3.79 AU / ml（范围0.16–45.83 AU / ml），8％）报告了抗SARS-CoV-2的免疫球蛋白G / M（IgG / IgM）。在90％的婴儿COVID-19病毒检测呈阴性的婴儿（10/11； 95％CI：73.9％–107.9％）中检测到IgG / IgM。检测到的中位抗体水平为75.49 AU / ml（范围7.25–140.32 AU / ml）和3.79 AU / ml（范围0.16–45.83 AU / ml），8％）报告了抗SARS-CoV-2的免疫球蛋白G / M（IgG / IgM）。在90％的婴儿中检测到IgG / IgM（10/11； 95％CI：73.9％–107.9％），这些婴儿的COVID-19病毒检测结果呈阴性。检测到的中位抗体水平为75.49 AU / ml（范围7.25–140.32 AU / ml）和3.79 AU / ml（范围0.16–45.83 AU / ml）， 对于IgG和IgM，p分别为0.0041。总之，当前证据表明，在垂直暴露但阴性的婴儿中，COVID-19垂直传播的可能性很小，并且检测到针对SARS-CoV-2的抗体。有必要对COVID-19母亲所生婴儿的胎盘传播和自然被动免疫强度进行进一步研究。