Case Report
SARS-CoV-2 vertical transmission in a twin-pregnant woman: a case report

https://doi.org/10.1016/j.ijid.2022.10.019Get rights and content
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Highlights

  • The possibility of vertical transmission of SARS-CoV-2 is still debated.

  • Evidence of SARS-CoV-2 vertical transmission in a twin-pregnant woman.

  • The viral genome was found in the umbilical cord blood of both twins.

  • Placental histologic examination confirmed indirect signs of viral infection.

Abstract

SARS-CoV-2 has affected millions of people around the world in recent years. Among susceptible patients, pregnant women seem to be prone to serious complications. The possibility of SARS-CoV-2 vertical transmission represents one of the most debated topics in the literature, providing inconclusive results. We present a case of a confirmed vertical transmission in a monochorial diamniotic twin pregnancy complicated by a selective intrauterine growth restriction and gestational diabetes mellitus. The analysis of different biological specimens identifies the presence of the SARS-CoV-2 genome in the umbilical cord blood of both twins, and the placental histologic examination confirmed indirect signs of viral infection, supporting the hypothesis that a transplacental infection can occur. Despite the devastating impact that SARS-CoV-2 has worldwide, neonatal infections have been infrequently reported, but they can occur under certain biologic conditions. Deep knowledge of the biological mechanisms underlying the risk of SARS-CoV-2 vertical transmission might be useful to understand the pathophysiological bases and the possible long-term implication of a mother-to-child vertical transmission.

Keywords

SARS-CoV-2 infection
Vertical transmission
Pregnancy
Placenta
Obstetric outcomes

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