Welcome to the osmosis daily report on the corona virus pandemic. I'm Rishi Desai a pediatric infectious disease physician
I'm also a former CDC viral disease outbreak investigator, and I'm the chief medical officer at Osmosis
So as I like to do starting out all these episodes I want to talk about the Johns Hopkins data
So let's just look at that right away. So here we have a total of 242 thousand cases
Plus and we've got 5,850 deaths here in the US
That's more cases than the next two countries. Italy and Spain combined
This is also obviously the most in the world and it continues to rise quickly. So what I wanted to talk about today is
Pregnancy and whether COVID 19 goes from mother to baby
specifically there are some studies have looked at this is one in The Lancet and I wanted to go through these studies and
See what the data says as of right now
So this one looked at a handful of women a total of nine women that were confirmed
Koban 19 positive and I'm just gonna point out a couple of things. They said that essentially all
nine of the babies
had healthy apgar's
These are kind of the scores you give a baby right at birth and that they checked amniotic fluid cord blood
throat swabs in the baby as well as breast milk samples from mother to see if there's any evidence of
The virus in any of those locations and in the in the ones tested they did did testing full testing in six patients
None of those patients had a virus found in any of those sites. So based on this study
It looks like the virus did not seem to go from mother to baby
Now there's another study that that did something very similar. This one is looking at ten neonates born to mothers with COVID 19 and
Again, they were swabbing. They did pharyngeal swabs  in nine of the ten
neonates
One to nine days after birth and found that all of them showed negative results again. So the first was 9
Moms and they tested 6 of them
This one was 10 mothers and they they report testing 9 of the neonates in this way and none of these
neonates had the COVID19 disease or evidence of SARS COV 2 virus a
Third study did an analysis of 38 pregnant women again
COVID 19 positive looked at their infants to see if the infants had any evidence of what they call maternal fetal transmission
Does it go from mom to baby and the what they found essentially was the same thing
I'm just highlighting it for you here all of the specimens tested including some cases placentas
So kind of one step further looking at the the organ that essentially is the bridge between mom and baby and we're negative by rt-pcr
First SARS COV 2 they say at this point in the pandemic. There's no evidence for SARS COV 2
Actually going through the uterus or through the placenta
From an infected mother to the baby. So all of that sounded really reassuring and then I saw this letter this is a letter
It says they looked at neonates again born to mothers with
COVID 19 disease or evidence of SARS COV 2 to the virus and they wanted to look at these moms
They looked at 33 neonates and of them three of them actually
Did have evidence of the virus. So let's go through this. And again, this is actually different than what the other three studies were
we're finding and
What it tells us is that maybe there are some cases where you see transmission
But that that rate seems quite low at least based on the numbers
So let's do a little bit
Of a dive into this one what they found is there are three patients they talk about them as patient
One two three, you can see the table here all were little boys two were born term
so 40 weeks here and 40 weeks for the
Patient two the third baby was born at 31 weeks a slightly different scenario
They're much younger baby and the babies did have some signs and symptoms of disease
So, you know, you can see for example the pneumonia line all three were yes
You can also see that this third baby had signs of shortness of breath respiratory distress one thing to notice that this third
Baby also had sepsis from a bacteria enterobacter
And so this obviously complicates the picture because you wonder was all this distress and shortness of breath due to the sepsis
Which is very likely to be the case, or was it COVID 19 or both and it's obviously impossible to say for sure
But this is one thing that complicates this particular third case. Is that the baby did have another
infection happening at the same time
But what they found which I can actually show you in the graph here or a figure is that they tested the babies in
Their nose and pharynx a nasopharyngeal swab and anus and they found that the babies were rt-pcr
positive three of them all three babies showed rt-pcr positivity and then actually went negative you can see that the three babies all
Recovered, so that's actually great news
All three babies did well in the long run had stable vital signs
This third baby that had a pretty severe illness and was quite young did
did have some trouble and was intubated but ultimately did well and that's the key so
What I what I take away from this is that yes, there is some evidence of SARS COV 2 transmission from mother to baby
In fact, that was their finding these are actual images of the three baby's lungs
You can see to them that chest x-rays and the CT all of which shows some what they call ground glass
opacity so you can see some evidence of disease in the lungs and
Ultimately, this was their key finding they said although two recent studies and they actually flag the two studies. I just showed you earlier
I have shown that there were no clinical findings or investigations suggestion of Cova 19
What they do say is that their study shows that vertical maternal fetal transmission
Cannot be ruled out in the current cohort meaning that in this group of 33 women
It seems like there was a good chance that at least three of the babies did receive COVID 19 from mom
And so there is some evidence that it's transmitting from mom to baby
Based on this very very small sample of three kids that that show that they may have gotten disease that way
So that's where we're at
So with that I'll say thanks for tuning in today. Hit the red subscribe button and bell icon below to get more
Daily updates and and visit our COVID19 page, which is osmosis org slash COVID 19
Remember do your part to raise the line and flatten the curve remember We're all in this together. Thanks. Bye
