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Case Reports
. 2020 Nov;36(4):609-613.
doi: 10.1177/0890334420960433. Epub 2020 Sep 28.

Early Identification of IgA Anti-SARSCoV-2 in Milk of Mother With COVID-19 Infection

Cibele Wolf Lebrão  1 , Manuela Navarro Cruz  2 , Mariliza Henrique da Silva  3 , Letícia Veríssimo Dutra  4 , Camila Cristiani  5 , Fernando Luiz Affonso Fonseca  6 , Fabíola Isabel Suano-Souza  7
Affiliations
Case Reports

Early Identification of IgA Anti-SARSCoV-2 in Milk of Mother With COVID-19 Infection

Cibele Wolf Lebrão et al. J Hum Lact. 2020 Nov.

Abstract
in English, German

Introduction: Human milk cannot currently be considered a major source of COVID-19 infection. On the other hand, it can contain specific antibodies that could modulate a possible newborn infection by SARS-CoV-2.

Main issue: A 32-year-old pregnant woman, gestational age 37 and 3/7 weeks, was admitted with a flu-like syndrome caused by COVID-19. The female newborn was appropriate for gestational age, with a birth weight of 2,890 g, length 48 cm, and head circumference 34 cm.

Management: The mother-infant dyad remained in the rooming-in unit during hospitalization, exclusively breastfeeding and following World Health Organization recommendations for contact and airway precautions. On the 3rd day after delivery, two mother's milk samples (3 and 5 mL) were collected by hand expression. The samples were centrifuged for 10 min twice consecutively to separate fat, which was removed, and the remaining material was transferred to another tube to determine anti-SARS-CoV-2 Immunoglobulin A and Immunoglobulin G (ELISA, Kit EUROIMMUN AG, Luebeck, Germany). Anti-SARS-CoV-2 Immunoglobulin A was detected in the two samples evaluated, whose values were 2.5 and 1.9, respectively. No anti-SARSCoV-2 immunoglobulin G was detected. The exclusively-breastfed infant remained well through 45 days of age.

Conclusion: The presence of SARS-CoV-2 Immunoglobulin A in the milk of mothers infected with COVID-19 may be related to protection against the transmission and severity of the disease in their infants.

O leite humano não é considerado como fonte de transmissão de COVID-19 até o momento. Por outro lado, ele pode conter anticorpos que podem proteger o recém-nascido da infecção pelo SARS-CoV-2.

Uma gestante de 32 anos, idade gestacional 37 3/7 semanas, foi admitida para realização do parto, com síndrome gripal causada por COVID-19. O seu recém-nascido, do sexo feminino, foi adequado para idade gestacional, pesou 2.890 gramas, comprimento 48 cm e circunferência craniana de 34 cm.

A mãe e seu recém-nascido permaneceram em alojamento conjunto durante a hospitalização, realizando aleitamento materno exclusivo, conforme as recomendações da Organização Mundial da Saúde em relação as precauções de contato e proteção de vias aéreas para nutrizes infectadas pelo COVID-19. No terceiro dia após o nascimento, coletou-se, por expressão manual, duas amostras de leite materno (2 e 5 mL) que foram centrifugadas por 10 min por duas vezes, para remoção da gordura e separação do material remanescente, que foi transferido para outro tudo para dosagem de anti-SARS-CoV-2 IgA and IgG (ELISA, Kit EUROIMMUN AG, Luebeck, Germany). Como resultado, foi detectado nas duas amostras de leite materno, a presença de IgA anti-SARS-CoV-2, cujos valores foram 2,5 e 1,9; respectivamente. Não se verificou a presença de IgG anti- SARSCoV-2. O recém-nascido permaneceu, clinicamente bem, em aleitamento materno exclusivo até a última avaliação que foi realizada aos 45 dias de vida.

A presença de IgA anti-SARS-CoV-2 no leite materno de mulher infectada pela COVID-19 pode se relacionar a proteção contra a transmissão e gravidade da doença nos recém-nascidos. Translation confirmed by Dr. Monica Pina.

Keywords: COVID-19; SARS-CoV-2; breastfeeding; case study; human milk; infant; infant care; infant nutrition; pregnancy; vertical transmission.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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